Fill and Sign the Mha Request for Short Sale Form

[Name of Servicer] [Name of Borrower] [Address of Servicer] [Name of Co-Borrower] [Address of Borrower] [Loan #] [Borrower Phone] [Servicer FAX] [Borrower Email] [Servicer Email] [Date] RE: Request for Approval of Short Sale Pursuant to Agreement Dated [Date of SSA] This is a Request for Approval of the Short Sale Pursuant to Agreement Dated [Date of SSA] between the above referenced Servicer (“Servicer”) and the borrower and co-borrower (“Borrower” or “you”). Under penalty of perjury you certify that: 1) the sale of the property is an “arm’s length” transaction, between parties who are unrelated and unafliated by family, marriage, or commercial enterprise; 2) there are no agreements or understandings between you and the Buyer that you will remain in the property as a tenant or later obtain title or ownership of the property; 3) neither you nor the Buyer will receive any funds or commissions from the sale of the property; and 4) there are no agreements or ofers relating to the sale or subsequent sale of the property that have not been disclosed to the Servicer. Please complete, sign and return the Terms of Sale on the following page. Supplemental Directive 09-09 Revised Page A1- 1 Terms of Sale [All blanks to be completed by Borrower]: 1. Contract Sales Price $       6. Closing Date:       2. Less Total Allowable Closing Costs $       7. Approved Buyer(s):       a. Commissions $       b. Settlement Escrow/Attorney Fees $       c. Seller’s Title and Escrow Fees $       8. Settlement Agent:       d. Subordinate Lien Payof $       e. Transfer taxes/stamps/recording fees $       f. Real Property Taxes $       9. Settlement Agent’s Address:       g. Termite Inspection/Repair $       h. Borrower Relocation Assistance $ 3,000 i. Other (attach explanation) $       3. Net Proceeds to Servicer       4. Earnest Money Deposit       10. Settlement Agent’s Ofce Phone:       5. Down Payment       11. Settlement Agent’s Ofce Fax:       As required by the Short Sale Agreement, copies of the following documents are attached: Sales contract and all addenda Buyer’s documentation of funds or Buyer’s pre-approval or commitment letter on letterhead from lender The Borrower represents that the information provided in this Request is true and accurate and authorizes the Servicer to disclose to the U.S. Department of the Treasury or other government agency, Fannie Mae and/or Freddie Mac any information provided in connection with the Making Home Afordable program.             Borrower Signature       Date Co- Borrower Signature       Date Printed Name Printed Name If you would like to speak with a counselor about this program, call the Homeowners HOPE™ Hotline 1-888-995-HOPE (4673) . The Homeowner’s HOPE™ Hotline ofers free HUD-certifed counseling services and is available 24/7 in English and Spanish. Other languages are available by appointment. If you have questions, please contact us directly between the hours of [insert hours] at [insert toll free number.] NOTICE TO BORROWER Be advised that by signing this document you understand that any documents and information you submit to your servicer in connection with the Making Home Afordable Program are under penalty of perjury. Any misstatement of material fact made in the completion of these documents including but not limited to misstatement regarding your occupancy in your home, hardship circumstances, and/or income, expenses, or assets will subject you to potential criminal investigation and prosecution for the following crimes: perjury, false statements, mail fraud, and wire fraud. The information contained in these documents is subject to examination and verifcation. Any potential misrepresentation will be referred to the appropriate law enforcement authority for investigation and prosecution. By Supplemental Directive 09-09 Revised Page A1- 2 signing this document you certify, represent and agree that:” Under penalty of perjury, all documents and information I have provided to Lender in connection with the Making Home Afordable Program, including the documents and information regarding my eligibility for the program, are true and correct.” If you are aware of fraud, waste, abuse, mismanagement or misrepresentations afliated with the Troubled Asset Relief Program, please contact the SIGTARP Hotline by calling 1-877-SIG-2009 (toll-free), 202-622-4559 (fax), or www.sigtarp.gov. Mail can be sent Hotline Ofce of the Special Inspector General for Troubled Asset Relief Program, 1801 L St. NW, Washington, DC 20220. To be Completed by Your Servicer Approval of Short Sale - The Servicer consents to this Request for Approval of Short Sale and agrees to accept all net proceeds from the settlement as full and fnal satisfaction of the frst mortgage indebtedness on the referenced property. This agreement is subject to the following: A. Terms – The sale and closing comply with all terms and conditions of the Short Sale Agreement between the Servicer and the Borrower as well as all terms and representations provided herein by the Borrower. B. Changes – Any change to the terms and representations contained in this Request for Approval of Short Sale or the attached sales contract between you and the buyer must be approved by the Servicer in writing. The Servicer is under no obligation to approve such changes. C. Subordinate Liens – Prior to releasing any funds to holders of subordinate liens/mortgages, the closing agent must obtain a written commitment from the subordinate lien holder that it will release Borrower from all claims and liability relating to the subordinate lien in exchange for receiving the agreed upon payof amount. D. HUD-1 – A HUD-1 Settlement Statement, which will be signed by you and the buyer at closing, must be provided to the Servicer not later than one business day before the date indicated in Line 4, Closing Date . E. Bankruptcy – If you are currently in bankruptcy or you fle bankruptcy prior to closing, you must obtain any required consent or approval of the Bankruptcy Court. F. Tax Consequences – A short payof of the mortgage may have tax consequences. You are advised to contact a tax professional to determine the extent of tax liability, if any. G. Credit Bureau Reporting – We will follow standard industry practice and report to the major credit reporting agencies that your mortgage was settled for less than the full payment. We have no control over or responsibility for the impact of this report on your credit score. To learn more about the potential impact of a short sale on your credit you may want to go to http://www.ftc.gov/bcp/edu/pubs/consumer/credit/cre24.shtm . H. Payment Instructions – Payof funds and a fnal HUD-1 Settlement Statement must be received by the Servicer within 48 hours of closing in accordance with the attached wiring instructions. [ include instructions ] I. Closing Instructions – [ include proprietary closing instructions, if any ] If you have questions, please contact us directly between the hours of [insert hours] at [insert toll free number.] Supplemental Directive 09-09 Revised Page A1- 3 Signature of Servicer Representative Title Printed Name of Servicer Representative Date Supplemental Directive 09-09 Revised Page A1- 4 To be Completed by Your Servicer Disapproval of Short Sale - The Servicer disapproves this Request for Approval of Short Sale, for the following reasons (check all applicable reasons):  You did not comply with all terms and conditions of the Short Sale Agreement between Servicer and Borrower dated _____/______/_______ as it relates to section/s: __________________________________ ________________________________________________________________________________________  The Request for Approval of Short Sale was not complete and/or fully executed. □ Failure to provide executed sales contract or addenda □ Failure to provide buyer’s documentation of funds to close or buyer’s pre- approval or commitment letter on letterhead from lender  The net proceeds available to pay of the frst mortgage loan are insufcient, due to: □ Contract sales price is below list price stated in Short Sale Agreement □ Net proceeds amount is less than acceptable net proceeds stated in Short Sale Agreement □ Excessive fnancial concessions □ Excessive commissions □ Excessive closing costs □ Excessive payments to subordinate liens/mortgages OR release of subordinate liens did not occur  The mortgage insurer did not approve the short sale.  Other: If you have questions, please contact us directly between the hours of [insert hours] at [insert toll free number.] Signature of Servicer Representative Title Printed Name of Servicer Representative Date Supplemental Directive 09-09 Revised Page A1- 5