selene finance insurance department phonie number

(circle one) Updated of 5Ģ DRAFT PROPERTY INFORMATION Is the property listed for sale? Yes No If yes, what was the listing date? For Sale by Owner? Yes Have you received an offer on the property? Yes No Date of Offer: Amount of Offer: *Agent/Authorized Third Party Name: Agent/Authorized Third Party Phone#: Agent/Authorized Company Name/Law Firm: Agent/Authorized Company/Law Firm Street Address, City, State, Zip: Agent/Authorized Third Party *By providing the above information you are authorizing Selene Finance to release information on the mortgage loan to the Third Party identified. Contact Name: Phone #: Day: Time: a.m./p.m. Please provide contact information for the individual we should call to schedule an inspection time and provide the most convenient time during the week that we may conduct an inspection. Loan Number (usually found on your monthly mortgage statement): Are you currently living in the property as your primary residence? Yes No If no, what is the status of the property: Occupied by Non-Borrower/Tenant Second/Vacation Home Vacant How many people live in your property? I want to: Keep the Property Vacate the Property Sell the Property Undecided CONTACT INFORMATION Borrower Name: Co-Borrower Name: Phone #: Phone #: Selene is authorized to call & text this phone number for loss mitigation efforts? Address: Yes No Selene is authorized to call & text this phone number for loss mitigation efforts? Address: Yes No Can we contact you via (optional)? Yes No Can we contact you via (optional)? Yes No Property Address: Mailing Address (if different from property address): PROPERTY INSPECTION We may require an interior inspection of the property to be conducted.

The documents required to evaluation you for available loss mitigation options consists of: (1) this completed, signed, and dated Form (2) completed and signed IRS Form 4506C (3) required income documentation and (4) required hardship documentation. Box 8619 Philadelphia, PA Questions: (877) We strongly recommend you or an authorized representative contact your Single Point of Contact to review your information and discuss all options available to you at (877) If you are experiencing a financial hardship and need help, you must complete and submit this entire Borrower Assistance Form ( Form ) to be evaluated for all loss mitigation options that may be available to you.

1 DRAFT This completed Borrower Assistance Form and all required documentation must be sent to one of the following locations: Mail: Selene Finance Fax: (866) Attn: Loss Mitigation P.O.

Selene finance insurance department phonie number