Certification Of Creditor Regarding Post Petition Payment History (Note And Mortgage) {NJB PHNM}

UNITED STATES BANKRUPTCY COURT DISTRICT OF NEW JERSEY Caption in Compliance with D.N.J. LBR 9004-1(b) In Re: Case No.: Chapter: Hearing Date: Judge: __________________ __________________ __________________ __________________ CERTIFICATION OF CREDITOR REGARDING POST PETITION PAYMENT HISTORY ( NOTE AND MORTGAGE DATED ______________________ ) _______________________________, employed as ___________________________________ by _________________________________________, hereby certifies the following: Recorded on ___________________, in ________________ County, in Book __________ at Page __________ Property Address: ___________________________________________________________________________ Mortgage Holder: ___________________________________________________________________________ Mortgagor(s)/ Debtor(s): ____________________________________________________________________ POST-PETITION PAYMENTS (Petition filed on ____________________________) Amount Due Date Payment Was Due How Payment Was Applied (Mo./Yr.) Amount Received Date Payment Received Check or Money Order Number 1. 2. 3. American LegalNet, Inc. www.FormsWorkFlow.com Amount Due 4. 5. 6. 7. 8. 9. 10. TOTAL: $ Date Payment Was Due How Payment Was Applied (Mo./Yr.) Amount Received Date Payment Received Check or Money Order Number $ [Continue on attached sheets if necessary.] Monthly payments past due: _____________ mos. x $ _____________________ (Monthly payment + late charge) = $ _______________________ as of __________________. Each current monthly payment is comprised of: Principal Interest R.E. Taxes: Insurance: Late Charge: Other: TOTAL $ ____________________ $ ____________________ $ ____________________ $ ____________________ $ ____________________ $ ____________________ $ ____________________ (Specify:_______________________________________ ) If the monthly payment has changed during the pendency of the case, please explain (attach separate sheet(s) if necessary): ________________________________________________________________________________________ __________________________________________________________________________________________________ Pre-petition arrears: _________________ to _________________ ( _____mos. x $ ___________/mo. = $ ___________ ) I certify under penalty of perjury that the above is true. Date: ______________________ _____________________________ Signature rev.8/1/15 2 American LegalNet, Inc. www.FormsWorkFlow.com