REGISTER WITH THE SECOND CHANCE PROGRAM

REGISTRATION FORM

Kindly fill out this questionnaire. We will call you within 2 - 4 hours to let you know if you've been approved for the Second Chance Program.

1. Is there a steady income in your home?

Yes

No

2. Is there a sales date (auction of home)?

Yes

No

3. What is your mortgage payment?

5. What is your yearly property insurance?

If yes, what is your gross annual income?

If yes, what is the sales date?

4. What it is your principle and interest?

6. What is your yearly property taxes?

7. Select what you own:

9. What is the current balance on your loan?

8. What is the value of your home?

10. Do you want to keep or sell your home?

Keep

Sell

11. How did you find out about us?

Thanks for submitting!

Copies of documents to upload, if approved for the Second Chance Program:

Your ID • Pay Stub • Credit Report • Pay Off • Last Year's 1040 Tax Return