Notice of Request for Loss Mitigation – By Creditor (NJB NRLMC)

UNITED STATES BANKRUPTCY COURT DISTRICT OF NEW JERSEY Caption in Compliance with D.N.J. LBR 9004-2(c) ____________________________________________ In Re: Case No.: Chapter: Judge: ____________________ ____________________ ____________________ NOTICE OF REQUEST FOR LOSS MITIGATION ­ BY A CREDITOR I am a creditor (including a holder, assignee, servicer or trustee of a mortgage or lien secured by property used by the debtor as a principal residence) of the debtor. I hereby request loss mitigation with respect to: Property address: __________________________________________________________________________ Creditor is the holder of a: first mortgage or second mortgage. I have reviewed the Loss Mitigation Program and Procedures and understand that if the court orders loss mitigation in this case I will be bound by the Loss Mitigation Procedures and will participate in good faith. I will not require the debtor to request or cause dismissal of this case as part of any resolution or settlement that is offered or agreed to during the Loss Mitigation Period. Date: ______________________ __________________________________ Signature Creditor Information: Name: ____________________________________________________________________________ Title: _____________________________________________________________________________ Firm or Company: ___________________________________________________________________ Telephone number: _________________________ Fax number: ______________________________ Email address (if any): _______________________________________________________________ Pursuant to Section V. A. of the Loss Mitigation Program and Procedures, the debtor(s) has 14 days to file with the court, and serve on the creditor and trustee, an objection to this Request. new. 8/1/11 American LegalNet, Inc. www.FormsWorkFlow.com