UNIFORMBORROWERASSISTANCEFORM

Ifyouareexperiencingatemporaryorlongtermhardshipandneedhelp,youmustcompleteandsubmitthisformalongwith otherrequireddocumentationtobeconsideredforavailablesolutions.Onthispage,youmustdiscloseinformationabout(1) youandyourintentionstoeitherkeeportransitionoutofyourhome;(2)thepropertysstatus;(3)bankruptcy;and(4)your creditcounselingagency. OnPage2,youmustdiscloseinformationaboutallofyourincome,expensesandassets.Page2alsoliststherequiredincome documentationthatyoumustsubmitinsupportofyourrequestforassistance.ThenonPage3,youmustcompletethe HardshipAffidavitinwhichyoudisclosethenatureofyourhardship.TheHardshipAffidavitinformsyouoftherequired documentationthatyoumustsubmitinsupportofyourhardshipclaim.

NOTICE:Inaddition,whenyousignanddatethisform,youwillmakeimportantcertifications,representationsand agreements,includingcertifyingthatalloftheinformationinthisBorrowerAssistanceFormisaccurateandtruthful andanyidentifiedhardshiphascontributedtoyoursubmissionofthisrequestformortgagerelief.

REMINDER:TheBorrowerResponsePackageyouneedtoreturnconsistsof:(1)thiscompleted,signedanddatedBorrower AssistanceForm;(2)completedandsignedIRSForm4506TEZ(4506Tforselfemployedborrowersorborrowerswithrental income);(3)requiredincomedocumentation;and(4)requiredhardshipdocumentation. LoanNumber (usually yourmonthly mortgagestatement) ServicersName
Iwantto: Thepropertyiscurrently: Thepropertyiscurrently:
BORROWERSNAME
SOCIALSECURITYNUMBER HOMEPHONENUMBERWITHAREACODE CELLORWORKNUMBERWITHAREACODE MAILINGADDRESS PROPERTYADDRESS(IFSAMEASMAILINGADDRESS,JUSTWRITESAME) DATEOFBIRTH

KeeptheProperty MyPrimaryResidence OwnerOccupied

VacatetheProperty ASecondHome RenterOccupied

SelltheProperty AnInvestmentProperty Vacant

Undecided

BORROWER

COBORROWER
COBORROWERSNAME
SOCIALSECURITYNUMBER DATEOFBIRTH

HOMEPHONENUMBERWITHAREACODE CELLORWORKNUMBERWITHAREACODE

EMAILADDRESS

Isthepropertylistedforsale? Yes No Haveyoucontactedacreditcounselingagencyforhelp? No Ifyes,whatwasthelistingdate? Yes Ifpropertyhasbeenlistedforsale,haveyoureceivedanofferonthe Ifyes,pleasecompletethecounselorcontactinformationbelow: property? CounselorsName: Yes No AmountofOffer:$ Dateofoffer: AgencysName: AgentsName: CounselorsPhoneNumber: AgentsPhoneNumber: CounselorsEmailAddress: ForSalebyOwner? Yes No Doyouhavecondominiumorhomeownerassociation(HOA)fees? Yes No Totalmonthlyamount:$ Nameandaddressthatfeesarepaidto: Haveyoufiledforbankruptcy? Yes No Chapter7 Chapter11 Chapter12 Chapter13 Ifyes: FilingDate: Hasyourbankruptcybeendischarged? Yes No Bankruptcycasenumber: FannieMae/FreddieMacForm710 Page1of4 August2012

UNIFORMBORROWERASSISTANCEFORM
MonthlyHouseholdIncome
Grosswages Overtime

MonthlyHouseholdExpensesandDebt HouseholdAssets(associatedwiththe Payments propertyand/orborrower(s))

FirstMortgagePayment

CheckingAccount(s) CheckingAccount(s)

ChildSupport/Alimony*

Nontaxablesocialsecurity/SSDI

TaxableSSbenefitsorothermonthly incomefromannuitiesorretirement plans

$ $
$

SecondMortgagePayment HomeownersInsurance PropertyTaxes

CreditCards/InstallmentLoan(s)(total $ minimumpaymentpermonth)

$ $

Savings/MoneyMarket CDs

Stocks/Bonds

$ $ $
$ $

Tips,commissions,bonusandself employedincome RentsReceived

Alimony,childsupportpayments

OtherCashonHand

UnemploymentIncome FoodStamps/Welfare Other

Total(Grossincome)

$ $ $
$ $

HOA/CondoFees/PropertyMaintenance $ MortgagePaymentsonotherproperties $ Other $ TotalHouseholdExpensesandDebt $

CarLeasePayments $ Payments

OtherRealEstate(estimatedvalue) Other

TotalAssets

$ $ $
$ $

Anyotherliens(mortgageliens,mechanicsliens,taxliens,etc.) LienHoldersName

BalanceandInterestRate

LoanNumber

LienHoldersPhoneNumber

RequiredIncomeDocumentation
Doyouearnasalaryorhourlywage? Foreachborrowerwhoisasalariedemployeeor paidbythehour,includepaystub(s)reflectingthe mostrecent30daysearningsanddocumentation reflectingyeartodateearnings,ifnotreported onthepaystubs(e.g.signedletterorprintout fromemployer). Areyouselfemployed? Foreachborrowerwhoreceivesselfemployedincome,includeacomplete,signed individualfederalincometaxreturnand,asapplicable,thebusinesstaxreturn;AND eitherthemostrecentsignedanddatedquarterlyoryeartodateprofit/lossstatement thatreflectsactivityforthemostrecentthreemonths;ORcopiesofbankstatementsfor thebusinessaccountforthelasttwomonthsevidencingcontinuationofbusiness activity.

Doyouhaveanyadditionalsourcesofincome?Provideforeachborrowerasapplicable: OtherEarnedIncomesuchasbonuses,commissions,housingallowance,tips,orovertime: Reliablethirdpartydocumentationdescribingtheamountandnatureoftheincome(e.g.,paystub,employmentcontractorprintouts documentingtipincome). SocialSecurity,disabilityordeathbenefits,pension,publicassistance,oradoptionassistance: Documentationshowingtheamountandfrequencyofthebenefits,suchasletters,exhibits,disabilitypolicyorbenefitsstatementfromthe provider,and Documentationshowingthereceiptofpayment,suchascopiesofthetwomostrecentbankstatementsshowingdepositamounts. Rentalincome: Copyofthemostrecentfiledfederaltaxreturnwithallschedules,includingScheduleESupplementIncomeandLoss.Rentalincomefor qualifyingpurposeswillbe75%ofthegrossrentyoureportedreducedbythemonthlydebtserviceontheproperty,ifapplicable;or IfrentalincomeisnotreportedonScheduleESupplementalIncomeandLoss,provideacopyofthecurrentleaseagreementwitheither bankstatementsorcancelledrentchecksdemonstratingreceiptofrent. Investmentincome: Copiesofthetwomostrecentinvestmentstatementsorbankstatementssupportingreceiptofthisincome. Alimony,childsupport,orseparationmaintenancepaymentsasqualifyingincome:* Copyofdivorcedecree,separationagreement,orotherwrittenlegalagreementfiledwithacourt,orcourtdecreethatstatestheamount ofthealimony,childsupport,orseparationmaintenancepaymentsandtheperiodoftimeoverwhichthepaymentswillbereceived,and Copiesofyourtwomostrecentbankstatementsorotherthirdpartydocumentsshowingreceiptofpayment. *Notice:Alimony,childsupport,orseparatemaintenanceincomeneednotberevealedifyoudonotchoosetohaveitconsideredforrepaying thisloan.

FannieMae/FreddieMacForm710

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UNIFORMBORROWERASSISTANCEFORM
HARDSHIPAFFIDAVIT
IamrequestingreviewofmycurrentfinancialsituationtodeterminewhetherIqualifyfortemporaryorpermanentmortgageloanrelief options. DateHardshipBeganis: Ibelievethatmysituationis: Shortterm(under6months) Mediumterm(612months) LongtermorPermanentHardship(greaterthan12months)

Iamhavingdifficultymakingmymonthlypaymentbecauseofreasonsetforthbelow:
(Pleasechecktheprimaryreasonandsubmitrequireddocumentationdemonstratingyourprimaryhardship)

IfYourHardshipis:
Unemployment ReductioninIncome:ahardshipthat hascausedadecreaseinyourincome duetocircumstancesoutsideyour control(e.g.,eliminationofovertime, reductioninregularworkinghours,a reductioninbasepay) IncreaseinHousingExpenses:a hardshipthathascausedanincreasein yourhousingexpensesdueto circumstancesoutsideyourcontrol Divorceorlegalseparation;Separation ofBorrowersunrelatedbymarriage, civilunionorsimilardomestic partnershipunderapplicablelaw

ThentheRequiredHardshipDocumentationis:
Nohardshipdocumentationrequired Nohardshipdocumentationrequired

Nohardshipdocumentationrequired

Doctorscertificateofillnessordisability;OR Medicalbills;OR Proofofmonthlyinsurancebenefitsorgovernmentassistance(ifapplicable) Insuranceclaim;OR FederalEmergencyManagementAgencygrantorSmallBusinessAdministration loan;OR BorrowerorEmployerpropertylocatedinafederallydeclareddisasterarea Distantemploymenttransfer/Relocation Foractivedutyservicemembers:NoticeofPermanentChangeofStation(PCS)or actualPCSorders. Foremploymenttransfers/newemployment: Copyofsignedofferletterornoticefromemployershowingtransfertoanew employmentlocation;OR Paystubfromnewemployer;OR Ifnoneoftheseapply,providewrittenexplanation Inadditiontotheabove,documentationthatreflectstheamountofanyrelocation assistanceprovided,ifapplicable(notrequiredforthosewithPCSorders). BusinessFailure Taxreturnfromthepreviousyear(includingallschedules)AND Proofofbusinessfailuresupportedbyoneofthefollowing: Bankruptcyfilingforthebusiness;OR Twomonthsrecentbankstatementsforthebusinessaccountevidencing cessationofbusinessactivity;OR Mostrecentsignedanddatedquarterlyoryeartodateprofitandloss statement Other:ahardshipthatisnotcovered Writtenexplanationdescribingthedetailsofthehardshipandrelevant above documentation

Deathofaborrowerordeathofeither theprimaryorsecondarywageearner inthehousehold Longtermorpermanentdisability; Seriousillnessofaborrower/co borrowerordependentfamilymember Disaster(naturalormanmade) adverselyimpactingthepropertyor Borrowersplaceofemployment

Divorcedecreesignedbythecourt;OR Separationagreementsignedbythecourt;OR Currentcreditreportevidencingdivorce,separation,ornonoccupying borrowerhasadifferentaddress;OR RecordedquitclaimdeedevidencingthatthenonoccupyingBorrowerorco Borrowerhasrelinquishedallrightstotheproperty Deathcertificate;OR Obituaryornewspaperarticlereportingthedeath

FannieMae/FreddieMacForm710

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UNIFORMBORROWERASSISTANCEFORM

Borrower/CoBorrowerAcknowledgementandAgreement Icertify,acknowledge,andagreetothefollowing: 1. AlloftheinformationinthisBorrowerAssistanceFormistruthfulandthehardshipthatIhaveidentified contributedtomyneedformortgagerelief. 2. TheaccuracyofmystatementsmaybereviewedbytheServicer,ownerorguarantorofmymortgage,their agent(s),oranauthorizedthirdparty*,andImayberequiredtoprovideadditionalsupportingdocumentation. IwillprovideallrequesteddocumentsandwillrespondtimelytoallServicer,orauthorizedthirdparty*, communications. 3. KnowinglysubmittingfalseinformationmayviolateFederalandotherapplicablelaw. 4. IfIhaveintentionallydefaultedonmyexistingmortgage,engagedinfraudormisrepresentedanyfact(s)in connectionwiththisrequestformortgagerelieforifIdonotprovideallrequireddocumentation,theServicer maycancelanymortgagereliefgrantedandmaypursueforeclosureonmyhomeand/orpursueanyavailable legalremedies. 5. TheServicerisnotobligatedtooffermeassistancebasedsolelyontherepresentationsinthisdocumentor otherdocumentationsubmittedinconnectionwithmyrequest. 6. Imaybeeligibleforatrialperiodplan,repaymentplan,orforbearanceplan.IfIameligibleforoneofthese plans,Iagreethat: a. AllthetermsofthisAcknowledgmentandAgreementareincorporatedintosuchplanbyreferenceas ifsetforthinsuchplaninfull. b. Myfirsttimelypaymentundertheplanwillserveasacceptanceofthetermssetforthinthenoticeof theplansentbytheServicer. c. TheServicersacceptanceofanypaymentsundertheplanwillnotbeawaiverofanyaccelerationof myloanorforeclosureactionthathasoccurredandwillnotcuremydefaultunlesssuchpaymentsare sufficienttocompletelycuremyentiredefaultundermyloan. d. Paymentsdueunderatrialperiodplanforamodificationwillcontainescrowamounts.IfIwasnot previouslyrequiredtopayescrowamounts,andmytrialperiodplancontainsescrowamounts,Iagree totheestablishmentofanescrowaccountandagreethatanypriorwaiverisrevoked.Paymentsdue underarepaymentplanorforbearanceplanmayormaynotcontainescrowamounts.IfIwasnot previouslyrequiredtopayescrowamountsandmyrepaymentplanorforbearanceplancontains escrowamounts,Iagreetotheestablishmentofanescrowaccountandagreethatanypriorescrow waiverisrevoked. 7. Acondemnationnoticehasnotbeenissuedfortheproperty. 8. TheServicerorauthorizedthirdparty*willobtainacurrentcreditreportonallborrowersobligatedonthe Note. 9. TheServicerorauthorizedthirdparty*willcollectandrecordpersonalinformationthatIsubmitinthis BorrowerResponsePackageandduringtheevaluationprocess.Thispersonalinformationmayinclude,butis notlimitedto:(a)myname,address,telephonenumber,(b)mysocialsecuritynumber,(c)mycreditscore,(d) myincome,and(e)mypaymenthistoryandinformationaboutmyaccountbalancesandactivity.Iunderstand andconsenttotheServicerorauthorizedthirdparty*,aswellasanyinvestororguarantor(suchasFannie MaeorFreddieMac),disclosingmypersonalinformationandthetermsofanyrelieforforeclosurealternative thatIreceivetothefollowing: a. Anyinvestor,insurer,guarantor,orservicerthatowns,insures,guarantees,orservicesmyfirstlienor subordinatelien(ifapplicable)mortgageloan(s)oranycompaniesthatperformsupportservicesto them;and b. TheU.S.DepartmentofTreasury,FannieMaeandFreddieMac,inconjunctionwiththeir responsibilitiesundertheMakingHomeAffordableprogram,oranycompaniesthatperformsupport servicestothem. 10. Iconsenttobeingcontactedconcerningthisrequestformortgageassistanceatanytelephonenumber, includingmobiletelephonenumber,oremailaddressIhaveprovidedtotheLender/Servicer/orauthorized thirdparty*.Bycheckingthisbox,Ialsoconsenttobeingcontactedby textmessaging. ________________________________________________________________________________ BorrowerSignature Date CoBorrowerSignature Date *Anauthorizedthirdpartymayinclude,butisnotlimitedto,acounselingagency,HousingFinanceAgency(HFA)or othersimilarentitythatisassistingmeinobtainingaforeclosurepreventionalternative.
FannieMae/FreddieMacForm710 Page4of4 August2012