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Loan Modification

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April 26, 2011

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BUDGET CALCULATOR

Your contact information

Your Name

*

Name of
Spouse or Co-Borrower

Street Address

*

City

*

State

* Zip *

Mobile Number

*

Mobile Number of
Spouse or Co-Borrower

Email

*

Tell us about your loan

	1st Mortgage		2nd Mortgage
Name of Lender (who you pay)
Loan #
Interest Rate
Unpaid Principal Balance
Payment $
Type of loan Example: 5 year, interest only taken out in October 2004
Adjusting? Y N
Date of adjustment
Number of months behind

Credit Card Payments

Credit Card	Balance		Minimum Monthly Payment










	Total Balance:		Total Monthly Minimum:

Your monthly expenses

Monthly Expenses

Monthly
Amt.

Income

Monthly
Amt.

Mortgage Payment

Net Salary
(after deductions)

Property Taxes
(if not included in Mtg.)

Monthly
Every 2 Weeks
Weekly

Homeowner’s Insurance
(if not included in Mtg.)

Gross Salary
(before deductions)

Association Fees
Other Mortgages

Monthly
Every 2 Weeks
Weekly

Automobile Payment

Other Automobile
Loan Payment

Spouse's Net Salary
Monthly
Every 2 Weeks
Weekly

Automobile Insurance
Vehicle Gasoline
Electricity

Spouse's Gross Salary
Monthly
Every 2 Weeks
Weekly

Gas

Alimony/Child Support

Water/Sewage

Disability

Garbage

Social Security

Other Utility

Pension

Clothing

Rental Property

Vehicle Maintenance

Other Income

Property Maintenance

Total Net Income

Home Telephone

Total Gross Income

Cell Phone

Total Expenses

Cable TV/Internet

Net Difference +/-

Other Loans (Specify)

Gross Difference +/-

Health Ins. (not deducted)

How Many People
in Household

Dues/Memberships

Medical Bills (not insured)

Prescription Medications

Child Care

Alimony

Child Support

Tuitions

Food/Household

Other Expenses
(Please Specify)

Other insurance

Miscellaneous

Miscellaneous

Miscellaneous

Vehicle Maintenance

Life Insurance

Maintenance on the Home (Pest, landscape, etc...)

Clothing Expense (laundry/dry cleaning/uniforms)

Second Property
- 1st Mortgage

Second Property
- 2nd Mortgage

Third Property
- 1st Mortgage

Third Property
- 2nd Mortgage

*required item

Total Expenses & Balances

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