APPENDIX A (Page 1 of 3)

NOTICE OF INTENT TO FORECLOSE

[Owner-Occupied Property - Mortgage Loan Default - No Prefile Mediation Offer]
This Notice is Required by Maryland Law (Real Property Article, §7-105.1(c), Annotated Code of Maryland).

You are at risk of losing your home to foreclosure. You have missed one or more
payments on your mortgage loan or you are otherwise in default. If you do not bring the loan
current, otherwise cure the default, or reach an agreement with your mortgage company to avoid
foreclosure (such as a loan modification, repayment plan, or other alternative to foreclosure), a
foreclosure action may be filed in court as early as 45 days from the post mark date of this Notice.

There may be options available to avoid foreclosure, but you must act immediately.
You should seek housing counseling services now.

TO ACCESS FREE HOUSING COUNSELING SERVICES,

CALL THE MARYLAND HOPE HOTLINE AT
1-877-462-7555 OR GO TO WWW.MDHOPE.ORG

Please follow the instructions that are outlined below.

■ Read this entire Notice carefully and act immediately.

■ Contact [insert name of an agent or employee of the secured party authorized to

modify the terms of the mortgage loan. The agent or employee may be an individual or group
of individuals or a department such as “loss mitigation department”] at [insert the telephone
number of the agent or employee] to discuss options available to avoid foreclosure.

■ Complete the enclosed Loss Mitigation Application according to its instructions and
include copies of all requested documents.

■ Mail your completed Loss Mitigation Application and the accompanying documents
using the addressed envelope provided.

■ Keep a copy of your Loss Mitigation Application, accompanying documents, your

mail receipt confirmation, and the date of mailing for your own record.

If you have already sent a Loss Mitigation Application to your mortgage company, please
call your mortgage company at the number above to confirm the status of your request.

Beware of anyone offering to “save” your home or requesting an upfront fee before providing
assistance. If you believe you have been a victim of a scam, please contact Maryland's office of
the Commissioner of Financial Regulation by calling 410-230-6077 or visiting
www.dllr.state.md.us/finance. Free resources are available at the Maryland HOPE Hotline at 1-
877-462-7555 or go to www.MDHOPE.org. Attached is a list of government and nonprofit
foreclosure-related resources available to help you.

If you have funds available to bring your loan current, contact [insert contact person to provide
reinstatement figure and instructions to reinstate the loan] before sending any money to your
mortgage company. When you call, ask for the amount needed to reinstate your loan.
 APPENDIX A (Page 2 of 3)

THE MARYLAND
FORECLOSURE PROCESS AND TIME LINE
[Owner-Occupied - Mortgage Loan Default - No Offer of Prefile Mediation]

A Notice of Intent to Foreclose is enclosed with this document. In this Notice you will find
specific information about your mortgage, an application for loss mitigation, and instructions to
complete the application. THIS IS NOT YET A FORECLOSURE FILING. A foreclosure
action, called an order to docket or complaint to foreclose (the "OTD"), may not be filed against
you in court until at least 45 days after this Notice was mailed. The OTD must be filed in Circuit
Court in order to move forward with foreclosure proceedings.

The OTD cannot be filed until your loan is 90 days past due, and you have been sent this Notice.

You will receive a copy of the OTD and it will include one of the following affidavits:

1. Preliminary Loss Mitigation Affidavit, which will be filed with the OTD if the
mortgage company has not started or completed the review of your loan for
foreclosure alternatives known as loss mitigation. An application for loss mitigation
will be included in the OTD. Complete and return the application immediately;
OR
2. Final Loss Mitigation Affidavit, which will be filed with the OTD if the mortgage
company believes it has no available alternatives to foreclosure. This affidavit will
come with a “Request for Postfile Foreclosure Mediation,” an application, and
instructions. You have only 25 days to request foreclosure mediation after you
receive these documents. To request foreclosure mediation you must send the
completed application with a non-refundable fee of $50 to the Circuit Court.

* If your order to docket includes a Preliminary Loss Mitigation Affidavit, open all future
mail because you may receive a Final Loss Mitigation Affidavit in as soon as 28 days.

Foreclosure Mediation:
You will have the opportunity to request foreclosure mediation after you receive the Final Loss
Mitigation Affidavit. Foreclosure mediation is a process that allows you, a representative from
your mortgage company, and a neutral third party mediator from the Maryland Office of
Administrative Hearings to meet and discuss alternatives to foreclosure. The goal of foreclosure
mediation is to help you avoid foreclosure. At mediation, you and your mortgage company may
agree to an option to avoid foreclosure. However, making a request for foreclosure mediation
does not guarantee a loan modification or other relief.

TO ACCESS FREE HOUSING COUNSELING SERVICES,

CALL THE MARYLAND HOPE HOTLINE AT
1-877-462-7555 OR GO TO WWW.MDHOPE.ORG
 APPENDIX A (Page 3 of 3)

The following is important information about your mortgage loan:

Date of Notice: ____________________________

Address of Property Subject to This Notice: __________________________________________
Name of Borrower(s): ___________________________________________________________
Mailing Address of Borrower(s): ___________________________________________________
Name of Record Owner (if different from Borrower(s)): ________________________________
Mailing Address of Record Owner (if different from Borrower(s)): ________________________
Name of Secured Party: _________________________________________________________
Telephone Number of Secured Party: _______________________________________________
[If the secured party is a trust, real estate mortgage investment conduit (REMIC), or the like, the
secured party may insert the telephone number of its authorized loan servicer.]

Name of Loan Servicer (if different from Secured Party): _______________________________

Telephone Number of Loan Servicer (if applicable): ___________________________________
Mortgage Loan Number: ______________________________________
Lien Position (Indicate whether first or subordinate lien): _______________________________
Date Most Recent Loan Payment Received: __________________________________________
Period to Which Most Recent Mortgage Loan Payment Was Applied: _____________________
Date of Default: _______________________________
Total Amount Required to Cure Default as of the Date of this Notice: _____________________
(If you wish to reinstate your loan by paying all past due payments and fees, please call the
mortgage company and ask for the total amount required to cure the default and reinstate the
loan.)

[Note type of default by inserting one or both of the following two default statements: (1) Your
mortgage loan payment is currently [insert number of days payment past due] past due and is in
default. (2) Your mortgage loan is in default because [insert type of default other than a past-due
payment]: _____________________________________________________________________
_____________________________________________________________________________]

Name of Mortgage Lender (if applicable): __________________________________________

Maryland Mortgage Lender License Number (if applicable): ____________________________
Name of Mortgage Loan Originator (if applicable): ___________________________________
Maryland Mortgage Loan Originator License Number (if applicable): _____________________
NOTE: The data contained in this Notice of Intent to Foreclose is electronically filed with the
Commissioner of Financial Regulation in accordance with COMAR 09.03.12.02.
 APPENDIX A-1 (Page 1 of 2)

NOTICE OF INTENT TO FORECLOSE

[Owner-Occupied Property - Mortgage Loan Default - Pre-file Mediation Offer]
This Notice is Required by Maryland Law (Real Property Article, §7-105.1, Annotated Code of Maryland).

You are at risk of losing your home to foreclosure. You have missed one or more
payments on your mortgage loan or you are otherwise in default. If you do not bring the loan
current, or reach an agreement with your mortgage company to avoid foreclosure (such as a loan
modification, repayment plan, or other alternative to foreclosure), a foreclosure action may be filed
in court as early as 45 days from the post mark date of this Notice.

READ THIS ENTIRE NOTICE CAREFULLY AS IT CONTAINS

INFORMATION ABOUT FORECLOSURE MEDIATION AND OTHER
OPTIONS AVAILABLE TO YOU.
Foreclosure mediation is a process that allows you, a representative from your mortgage
company, and a neutral third party mediator from the Maryland Office of Administrative
Hearings to meet and discuss alternatives to foreclosure. The goal of foreclosure mediation is
to help you avoid foreclosure. However, participating in foreclosure mediation does not
guarantee a loan modification or other relief.

PREFILE MEDIATION: If you choose to participate in foreclosure

mediation at this time (before a foreclosure action is filed against you), please
refer to the enclosed Prefile Mediation Packet.

LOSS MITIGATION: If you do not choose to participate in foreclosure

mediation at this time, please refer to the enclosed Loss Mitigation Packet.
Beware of anyone offering to “save” your home or requesting an upfront fee before providing
assistance. If you believe you have been a victim of a scam, please contact Maryland's office of
the Commissioner of Financial Regulation by calling 410-230-6077 or visiting
www.dllr.state.md.us/finance. Free resources are available at the Maryland HOPE Hotline at
1-877-462-7555 or go to www.MDHOPE.org. Attached is a list of government and nonprofit
foreclosure-related resources available to help you.

If you have funds available to bring your loan current, contact [insert contact person to provide
reinstatement figure and instructions to reinstate the loan] before sending any money to your
mortgage company. When you call, ask for the amount needed to reinstate your loan.

REGARDLESS OF WHETHER YOU PARTICIPATE IN PREFILE

MEDIATION, YOU SHOULD SEEK HOUSING COUNSELING SERVICES
AS SOON AS POSSIBLE.

TO ACCESS FREE HOUSING COUNSELING SERVICES,

CALL THE MARYLAND HOPE HOTLINE AT
1-877-462-7555 OR GO TO WWW.MDHOPE.ORG
 APPENDIX A-1 (Page 2 of 2)

The following is important information about your mortgage loan:

Date of Notice: ____________________________
Address of Property Subject to This Notice: __________________________________________
Name of Borrower(s): ___________________________________________________________
Mailing Address of Borrower(s): ___________________________________________________
Name of Record Owner (if different from Borrower(s)): ________________________________
Mailing Address of Record Owner (if different from Borrower(s)): ________________________
Name of Secured Party: _________________________________________________________
Telephone Number of Secured Party: _______________________________________________
[If the secured party is a trust, real estate mortgage investment conduit (REMIC), or the like, the
secured party may insert the telephone number of its authorized loan servicer.]

Name of Loan Servicer (if different from Secured Party): _______________________________

Telephone Number of Loan Servicer (if applicable): ___________________________________
Mortgage Loan Number: ______________________________________
Lien Position (Indicate whether first or subordinate lien): _______________________________
Date Most Recent Loan Payment Received: __________________________________________
Period to Which Most Recent Mortgage Loan Payment Was Applied: _____________________
Date of Default: _______________________________
Total Amount Required to Cure Default as of the Date of this Notice: _____________________
If you choose to reinstate your loan by paying all past due payments and fees, please call the
mortgage company and ask for the total amount required to cure the default and reinstate the
loan.

[Note type of default by inserting one or both of the following two default statements:] (1) Your
mortgage loan payment is currently [insert number of days payment past due] past due and is in
default. (2) Your mortgage loan is in default because [insert type of default other than a past-due
payment]: _____________________________________________________________________
______________________________________________________________________________

Name of Mortgage Lender (if applicable): __________________________________________

Maryland Mortgage Lender License Number (if applicable): ____________________________
Name of Mortgage Loan Originator (if applicable): ___________________________________
Maryland Mortgage Loan Originator License Number (if applicable): _____________________

NOTE: The data contained in this Notice of Intent to Foreclose is electronically filed with
the Commissioner of Financial Regulation in accordance with COMAR 09.03.12.02.
 SCHEDULE 1 TO APPENDIX A-1 (Page 1 of 8)

NOTICE OF INTENT TO
FORECLOSE

PREFILE MEDIATION
PACKET

Contains:

 Notice of Offer to Mediate

 Maryland Foreclosure Process and Time Line
(Prefile Mediation)
 Application for Prefile Mediation
 Instructions for Prefile Mediation
 Documents Required for Prefile Mediation
 SCHEDULE 1 TO APPENDIX A-1 (Page 2 of 8)

NOTICE OF OFFER TO MEDIATE

Owner-Occupied Residential Property
This Notice is Required by Maryland Law (Real Property Article, §7-105.1, Annotated Code of Maryland).

THIS IS AN OFFER FROM YOUR MORTGAGE COMPANY

TO PARTICIPATE IN PREFILE MEDIATION -
BUT YOU MUST ACT QUICKLY

TO ACCEPT THIS OFFER, PLEASE REFER TO THE ATTACHED

APPLICATION, INSTRUCTIONS, AND EXPLANATION OF THE
FORECLOSURE PROCESS AND TIME LINE. YOUR MORTGAGE
COMPANY, AT ITS DISCRETION, MAY CHARGE A FEE THAT IS NO
GREATER THAN $350 FOR PARTICIPATION IN THIS PROGRAM.
YOU ARE NOT REQUIRED TO PAY THE FEE AT THIS TIME.

WHAT IS FORECLOSURE MEDIATION?

Foreclosure mediation is a process that allows you, a representative from your
mortgage company, and a neutral third party mediator from the Maryland Office of
Administrative Hearings to meet and discuss alternatives to foreclosure. The goal
of foreclosure mediation is to help you avoid foreclosure. At mediation, you and
your mortgage company may agree to an option to avoid foreclosure. However,
making a request for foreclosure mediation does not guarantee a loan modification
or other relief.

WHAT IS PREFILE MEDIATION?

There are two types of foreclosure mediation: (1) "Prefile mediation" - mediation
before a foreclosure action is filed in court and (2) "Postfile mediation" - mediation
after a foreclosure action has been filed in court. Your mortgage company is
offering prefile mediation at this time. If you choose to participate in prefile
mediation, please refer to the enclosed application and instructions. If you do not
choose to participate in prefile mediation at this time, you will have the
opportunity to submit a loss mitigation application and, if a foreclosure action is
filed against you, participate in postfile mediation. The goal of both types of
mediation is to help you avoid foreclosure, but prefile mediation happens much
earlier in the foreclosure process.

PLEASE NOTE: If you participate in prefile mediation now, you will not be
able to participate in postfile mediation later unless you and your mortgage
company agree to an additional mediation session and include the terms of
that arrangement in the prefile mediation agreement, if any.
 SCHEDULE 1 TO APPENDIX A-1 (Page 3 of 8)

THE MARYLAND FORECLOSURE

PROCESS AND TIME LINE
Owner-Occupied Property - Prefile Mediation Option
A Notice of Intent to Foreclose is enclosed with this packet. The Notice of Intent to
Foreclose provides information about your mortgage, some of your options under
Maryland law, and what actions you need to take for each option. This is not yet a
foreclosure filing. The timing of the foreclosure process depends on which option you
choose now. The timeline below describes the timing of the process if you choose prefile
mediation. If you do not choose to accept your mortgage company's offer to
participate in mediation now, please refer to the LOSS MITIGATION packet to
review those options.

 Prefile mediation comes before a foreclosure action, if any, is filed in court: A

foreclosure action, called an order to docket or complaint to foreclose (the "OTD"), may
be filed against you in court. If you choose to participate in prefile mediation, the OTD
will not be filed until after you, your mortgage company, and a neutral, third-party from
the Maryland Office of Administrative Hearings ("OAH") meet to discuss, and hopefully
agree to, alternatives to foreclosure.

 Application for Prefile Mediation: You have 25 calendar days from the postage date of
this packet to send the enclosed prefile mediation application to your mortgage company.

 Mortgage Company's Notice to Maryland Office of Administrative Hearings: OAH

is an independent state agency. Once your mortgage company receives your application
for prefile mediation, it has 5 business days to notify OAH. OAH tries to schedule all
mediations as soon as possible. You should check your mail everyday for the Notice of
Mediation from OAH. Additional information about OAH's role in foreclosure
mediation may be found at: http://www.oah.state.md.us/foreclosuremediation.asp.

 Date of Mediation Session: Once OAH receives the notice from your mortgage
company, it must conduct the mediation session within 60 days. This time frame may
seem like a long time, but before the mediation can occur you must first participate in
housing counseling services and submit documents regarding your finances. OAH will
send to the Maryland Department of Housing and Community Development your name,
address, the name of your mortgage company, and your loan number for purposes of
collecting a fee for the mediation from your mortgage company and sending you
information about resources available to you.

 Housing Counseling: In order for you to participate in prefile mediation you must first
participate in housing counseling services. The purpose of housing counseling is to help
you prepare for your mediation session and gather the necessary documents. To find a
housing counselor near you please call 877-462-7555 or visit www.mdhope.org. If
 SCHEDULE 1 TO APPENDIX A-1 (Page 4 of 8)

you have recently participated in housing counseling, please contact your housing
counselor for further guidance.
 Document Exchange: At least 20 days before your mediation session you will be
required to submit documents that will help you, your mortgage company and the
mediator explore options to avoid foreclosure. The list of documents required is included
in this packet. Please begin to gather these documents right away. Your housing
counselor will review this list with you and help you put the package together.

 Mediation that Results in a Prefile Mediation Agreement: If you and your mortgage
company agree to an option other than foreclosure at the mediation session, the mediator
from OAH will draft a "Prefile Mediation Agreement" between you and your mortgage
company.
o Comply with a Prefile Mediation Agreement: If you and your mortgage
company enter a Prefile Mediation Agreement, it is important that you fulfill any
promises you have made under the Agreement.
If you fail to fulfill your promises under the Prefile Mediation Agreement,
depending of the timing of your mediation session, the OTD may be filed as soon
as 45 days after this Notice and packet were mailed and 90 days after you first
missed your mortgage loan payment.
o Required Terms of the Prefile Mediation Agreement:
 The Prefile Mediation Agreement must include the terms of your
agreement with your mortgage company.
 The Prefile Mediation Agreement must include information about how
you may contact your mortgage company with updates about your
financial circumstances that may change your ability to comply with the
terms of the Prefile Mediation Agreement.
 The Prefile Mediation Agreement must include a notice that you are not
entitled to additional foreclosure mediation unless you and your mortgage
company specifically agree and include the terms of this arrangement in
the Prefile Mediation Agreement.
o Mediation that does not Result in a Prefile Mediation Agreement. If you and
your mortgage company fail to come to an agreement, depending on the timing of
your prefile mediation session, the OTD may be filed as soon as 45 days after this
Notice and packet were mailed and your mortgage loan is 90 days past due.
Because you have participated in prefile mediation, you will not have the
opportunity to participate in an additional mediation session after the OTD
is filed, unless you and your mortgage company agree to the additional
session and include the terms of that arrangement in the Prefile Mediation
Agreement.
 SCHEDULE 1 TO APPENDIX A-1 (Page 5 of 8)

APPLICATION FOR PREFILE MEDIATION

*** YOU ONLY HAVE 25 DAYS TO APPLY ***
Name(s) of each Borrower: ______________________________
______________________________

Address of property: ____________________________

____________________________
____________________________
____________________________

Mailing address, if different from address above:

____________________________
____________________________
____________________________
____________________________

Telephone ____________________________
____________________________

Email Address ____________________________

____________________________

Name and Business Address of Borrower's Attorney, if any:

____________________________
____________________________
____________________________
____________________________

I/We, ___________________________, accept the offer of [name of secured party/representative of

secured party] to participate in prefile foreclosure mediation. I/we understand that I/we must contact a
housing counselor as soon as possible and participate in housing counseling services before the mediation
session. I/we understand that my housing counselor will provide me with a certification that I have
satisfied this requirement and I/we must coordinate with my housing counselor to submit information and
documents as directed by the Maryland Office of Administrative Hearings.

I/We, __________________________, certify that I/we live in the property related to this Application
listed in the address above.

_______________________ _______________________
Signature of Borrower Signature of Borrower

_______________________ _______________________
Printed Name Printed Name

_______ _______
Date Date
 SCHEDULE 1 TO APPENDIX A-1 (Page 6 of 8)

If at least one borrower is willing and able to review and sign the Application and the other
borrower(s) is unavailable or unwilling to review or sign the Application, please explain the
circumstances in the space below:

______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________

Please provide a mailing address, telephone number, and email address if known, for any
additional borrowers who have not signed the Application:

_____________________________
_____________________________
_____________________________
_____________________________
 SCHEDULE 1 TO APPENDIX A-1 (Page 7 of 8)

INSTRUCTIONS TO PARTICIPATE IN PREFILE MEDIATION

Read and follow all instructions carefully.
ACT QUICKLY.
 Complete and Sign Prefile Mediation Application. Review the enclosed Application carefully.
Complete all the documents and provide all of the information that is requested.

 Make two copies of the completed and signed Application .

 Mail completed and signed Application to your mortgage company to [the address below] [or in the
enclosed addressed envelope] within calendar 25 days from the postage post mark date of this Notice and
packet:

[If no addressed envelope is included, state name of secured party/representative of secured party and
address at which the secured party/representative of secured party will receive mediation applications.
Add address of law firm acting on behalf of the secured party, if applicable.]

It is best to send any mail relating to prefile mediation certified, return receipt requested.

 Mail a copy of the completed and signed Application to the Maryland Department of Housing and
Community Development at the address below at the same time you mail the Application to your
mortgage company:

Attn: Pre-File Mediation Program, NR

DHCD
100 Community Place
Crownsville, MD 21032

 Keep a copy of the completed and signed Application plus any evidence of mailing.

 Contact and meet with housing counselor. In order to participate in prefile mediation with your
mortgage company, you must participate in housing counseling before the mediation session. You should
contact a housing counselor immediately. To access free housing counseling services, call the
Maryland Hope Hotline at 1-877-462-7555 or www.mdhope.org. If you have participated in housing
counseling recently, contact your housing counselor for further guidance.

 Check your mail for the Notice of Mediation from OAH. Your mortgage company is required to
send notice of your application to the Maryland Office of Administrative Hearings ("OAH") at which the
mediation will be conducted. Once OAH receives notice from your mortgage company that you have
agreed to mediation, the mediation session will be scheduled within 60 days. You may call [insert name
of representative of secured party] to confirm that your mortgage company has received your Application.

 Submit any documents or information in advance of the Prefile Mediation Session, as instructed
by OAH. Your notice of the date, time and place of the Prefile Mediation session will include
instructions from OAH regarding documents and other information that must be submitted at least 20
days before the session. The list of documents required is included in this packet. Start gathering these
documents now.

 Attend the Prefile Mediation session when it is scheduled. Your housing counselor will give you a
certificate of participation in housing counseling. Don’t' forget to bring the certificate with you, along
with any other documents related to your mortgage that your housing counselor recommends.
 SCHEDULE 1 TO APPENDIX A-1 (Page 8 of 8)

Documents Required for Prefile Mediation

Begin gathering and organizing documents now and wait for further directions
from the Maryland Office of Administrative Hearings

A copy of:

 Your signed federal income tax returns (including all schedules and attachments-ALL
PAGES) for the two most recent tax years;

 The most recent bill and proof of payment for property taxes and insurance, only if you
pay directly, and not through your mortgage payment;

 Any previous loan modifications or other agreements with your mortgage company (if
applicable);

 The most recent statement for any other loan you may have on your property, if
applicable (such as a home equity loan or second mortgage), showing the name, mailing
address, and telephone number of your mortgage company;

 Proof of your pay (paystub or benefits statements) issued within the last 30 days,
covering one month of pay;

 Two most recent paystubs or benefits statements (issued within the last 45 days) for any
member of your household whose income is to be counted toward payment of the
mortgage; and

 All pages of your two most recent bank statements issued within the last 60 days.

 A completed Borrower(s) Information Worksheet (This document will be sent from OAH
in its Notice of Mediation and Foreclosure Mediation Instructions.)

PLEASE NOTE: SOME OF THESE DOCUMENTS WILL HAVE TO BE UPDATED AT

THE TIME OF MEDIATION. THE DOCUMENTS ABOVE WILL BE REQUIRED FOR
EACH BORROWER.
 SCHEDULE 2 TO APPENDIX A-1 (Page 1 of 4)

NOTICE OF INTENT TO
FORECLOSE

LOSS MITIGATION
PACKET

Contains:

 Maryland Foreclosure Process and Timeline

(Loss Mitigation/Postfile Mediation)
 Instructions for Loss Mitigation
 Loss Mitigation Application
 SCHEDULE 2 TO APPENDIX A-1 (Page 2 of 4)

THE MARYLAND
FORECLOSURE PROCESS AND TIME LINE
Owner-Occupied Property - Loss Mitigation and Postfile Mediation Option

A Notice of Intent to Foreclose is enclosed with this document. In this Notice you will
find specific information about the mortgage, an application for loss mitigation, and
instructions to complete the application. THIS IS NOT YET A FORECLOSURE
FILING. A foreclosure action, called an order to docket or complaint to foreclose (the
"OTD"), may not be filed against you in court until at least 45 days after the post mark
date of this Notice was mailed and your loan is 90 days past due. The OTD must be filed
in Circuit Court in order to move forward with foreclosure proceedings.

You will receive a copy of the OTD and it will include one of the following affidavits:

1. Preliminary Loss Mitigation Affidavit, which will be filed with the OTD if
the mortgage company has not started or completed the review of your loan
for foreclosure alternatives known as loss mitigation. An application for loss
mitigation will be included in the OTD. Complete and return the
application immediately; OR
2. Final Loss Mitigation Affidavit, which will be filed with the OTD if the
mortgage company believes it has no available alternatives to foreclosure.
This affidavit will come with a “Request for Postfile Foreclosure
Mediation,” an application, and instructions. You have only 25 days to
request foreclosure mediation after you receive these documents. To
request foreclosure mediation you must send the completed application with a
non-refundable fee of $50 to the Circuit Court.

* If the OTD includes a Preliminary Loss Mitigation Affidavit, open all future mail
because you may receive a Final Loss Mitigation Affidavit in as soon as 28 days.

TO ACCESS FREE HOUSING COUNSELING SERVICES,

CALL THE MARYLAND HOPE HOTLINE AT
1-877-462-7555 OR GO TO WWW.MDHOPE.ORG
 SCHEDULE 2 TO APPENDIX A-1 (Page 3 of 4)

Foreclosure Mediation:
You will have the opportunity to request foreclosure mediation after you receive the Final
Loss Mitigation Affidavit. Foreclosure mediation is a process that allows you, a
representative from your mortgage company, and a neutral third party mediator from the
Maryland Office of Administrative Hearings to meet and discuss alternatives to
foreclosure. The goal of foreclosure mediation is to help you avoid foreclosure. At
mediation, you and your mortgage company may agree to an option to avoid foreclosure.
However, making a request for foreclosure mediation does not guarantee a loan
modification or other relief.
 SCHEDULE 2 TO APPENDIX A-1 (Page 4 of 4)

INSTRUCTIONS FOR LOSS MITIGATION

■ Contact [insert name of an agent or employee of the secured party authorized to

modify the terms of the mortgage loan. The agent or employee may be an individual or
group of individuals or a department such as “loss mitigation department”] at [insert the
telephone number of the agent or employee] to discuss options available to avoid
foreclosure.

■ You should seek housing counseling services now. To access free housing
counseling services, call the Maryland HOPE Hotline at 1-877-462-7555 or go to
www.mdhope.org.

■ Complete the enclosed Loss Mitigation Application according to its instructions

and include copies of all requested documents.

■ Mail your completed Loss Mitigation Application and the accompanying

documents using the addressed envelope provided.

■ Keep a copy of your Loss Mitigation Application, accompanying documents, your

mail receipt confirmation, and the date of mailing for your own record.
 APPENDIX B (Page 1 of 2)

NOTICE OF INTENT TO FORECLOSE

(Alternative/Other Liens)
This Notice is Required by Maryland Law (Real Property Article, §7-105.1, Annotated Code of Maryland).

There is a lien against your home that could result in foreclosure. You
are receiving this because you have defaulted on your [list type of lien- such as, by way
of example but not limitation, past-due homeowners' or condominium association fees, or
past-due contractual payments giving rise to a mechanic's lien]. If you do not bring this
default current or otherwise cure this default, a foreclosure action may be filed against
you as early as 45 days from the post mark date of this Notice.

There may be options available to avoid foreclosure, but you must act
immediately. You should seek housing counseling services now.

TO ACCESS FREE HOUSING COUNSELING SERVICES,

CALL THE MARYLAND HOPE HOTLINE AT
1-877-462-7555 OR GO TO WWW.MDHOPE.ORG

Please follow the instructions that are outlined below.

■ Read this entire Notice carefully and act immediately.

■ Contact [insert name of an agent or employee of the agency pursuing the debt
who has authority to reinstate the debt or work out payment arrangements] at
[insert the telephone number of the agent or employee] to discuss options to avoid
foreclosure.

■ [Insert list of options to cure the default with specific instructions, including, but
not limited to contact information and instructions to cure the default]:
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________

■ If you believe you have already made arrangements with the person
contacting you for this debt, please call that person at the number above to
confirm the status of your request.

■ Beware of anyone offering to “save” your home or requesting an upfront fee

before providing assistance. Free resources are available at the Maryland HOPE
 APPENDIX B (Page 2 of 2)

Hotline at 1-877-462-7555 or go to www.MDHOPE.org. If you believe you have

been a victim of a scam, please contact Maryland's office of the Commissioner of
Financial Regulation by calling 410-230-6077 or visiting
www.dllr.state.ms.us/finance.
The following is important information about your mortgage loan:

Date of Notice: ______________________________________

Name of Record Owner: ___________________________________________________
Record Owner's Mailing Address: ___________________________________________
Property Address: ________________________________________________________
Name of Secured Party:
_______________________________________________________
Telephone Number of Secured Party: ________________________________
[This may be the telephone number of the representative of the secured party.]
Lien Position [Indicate whether first or subordinate lien]: _________________________
Date of Receipt of Most Recent Payment on Debt: _______________________________
Date of Default: ______________________________________
[Insert description of the nature of the default such as, by way of example but not
limitation:
“Your homeowners' association fees are currently ___ days past due”]:
____________________
________________________________________________________________________
______
________________________________________________________________________
______

NOTE: The data contained in this Notice of Intent to Foreclose is electronically filed
with the Commissioner of Financial Regulation in accordance with COMAR
09.03.12.02.
 APPENDIX C (Page 1 of 5)

NOTICE OF INTENT TO FORECLOSE

[Not Owner-Occupied Property - Mortgage Loan Default]
This Notice is Required by Maryland Law (Real Property Article, §7-105.1, Annotated Code of Maryland).

You are at risk of losing your property to foreclosure. You have missed one
or more payments on your mortgage loan or you are otherwise in default. If you do not
bring the loan current, otherwise cure the default, or reach an agreement with your
mortgage company to avoid foreclosure (such as a loan modification, repayment plan or
other alternative to foreclosure) a foreclosure action may be filed in court as early as
45 days from the post mark date of this Notice.

Your mortgage company has determined

that you do NOT live in this property.

IF THIS IS YOUR PRIMARY RESIDENCE:

PLEASE CALL ________________________
NOTE: An owner-occupant has additional
options to avoid foreclosure.

Please follow the instructions that are outlined below.

■ Read this entire Notice carefully and act immediately.

■ If you live in this property as your primary residence, please call [insert contact
again for borrower to dispute occupancy determination]. Free resources are
available at the Maryland HOPE Hotline at 1-877-462-7555 or go to
www.MDHOPE.org.

■ Contact [insert name of an agent or employee of the secured party authorized to

modify the terms of the mortgage loan. The agent or employee may be an
individual or group of individuals or a department such as “loss mitigation
department”] at [insert the telephone number of the agent or employee] to discuss
options to avoid foreclosure.

If you have already requested loss mitigation assistance from your mortgage company,
please call your mortgage company at the number above to confirm the status of your
request.
 APPENDIX C (Page 2 of 5)

Beware of anyone offering to “save” your property or requesting an upfront fee before
providing assistance. If you believe you have been a victim of a scam, please Maryland's
office of the Commissioner of Financial Regulation by calling 410-230-6077 or visiting
http://www.dllr.state.md.us/finance/.

If you have funds available to bring your loan current, contact [insert contact person to
provide reinstatement figure and instructions to reinstate the loan] before sending any
money to your mortgage company. When you call, ask for the amount needed to
reinstate your loan.

You may be eligible for certain programs to avoid foreclosure.

Call your mortgage company for more information.
 APPENDIX C (Page 3 of 5)

The following is important information about your mortgage loan:

Date of Notice: ____________________________

Address of Property Subject to This Notice: __________________________________________
Name of Borrower(s): ___________________________________________________________
Mailing Address of Borrower(s): ___________________________________________________
Name of Record Owner (if different from Borrower(s)): ________________________________
Mailing Address of Record Owner (if different from Borrower(s)): ________________________
Name of Secured Party: _________________________________________________________
Telephone Number of Secured Party: _______________________________________________
[If the secured party is a trust, real estate mortgage investment conduit (REMIC), or the like, the
secured party may insert the telephone number of its authorized loan servicer.]

Name of Loan Servicer (if different from Secured Party): _______________________________

Telephone Number of Loan Servicer (if applicable): ___________________________________
Mortgage Loan Number: ______________________________________
Lien Position (Indicate whether first or subordinate lien): _______________________________
Date Most Recent Loan Payment Received: __________________________________________
Period to Which Most Recent Mortgage Loan Payment Was Applied: _____________________

Date of Default: _______________________________

Total Amount Required to Cure Default as of the Date of this Notice: _____________________
(If you wish to reinstate your loan by paying all past due payments and fees, please call the
mortgage company and ask for the total amount required to cure the default and reinstate the
loan.)

[Note type of default by inserting one or both of the following two default statements: (1) Your
mortgage loan payment is currently (insert number of days payment past due) past due and is in
default; (2) Your mortgage loan is in default because (insert type of default other than a past-due
payment)]:_____________________________________________________________________
______________________________________________________________________________

Name of Mortgage Lender (if applicable): __________________________________________

Maryland Mortgage Lender License Number (if applicable): ____________________________
Name of Mortgage Loan Originator (if applicable): ___________________________________
Maryland Mortgage Loan Originator License Number (if applicable): _____________________

NOTE: The data contained in this Notice of Intent to Foreclose is electronically filed with
the Commissioner of Financial Regulation in accordance with COMAR 09.03.12.02
 APPENDIX C (Page 4 of 5)

NOTICE REGARDING
OCCUPANCY DETERMINATION
Based upon inspection or certification of occupancy status through other means (proof
attached, if applicable), it is my belief that this property is not owner-occupied.

AGENT: _______________________

DATE: ________________________
 APPENDIX C (Page 5 of 5)

THE MARYLAND
FORECLOSURE PROCESS AND TIME LINE
[Not Owner-Occupied - Mortgage Loan Default]

A Notice of Intent to Foreclose is enclosed with this document. In the Notice you will
find specific information about your mortgage, an application for loss mitigation, and
instructions to complete the application. THIS IS NOT YET A FORECLOSURE
FILING.

 A foreclosure action, called an order to docket or complaint to foreclose (the

"OTD"), may not be filed against you in court until at least 45 days after this
Notice was mailed and 90 days after you first missed your mortgage loan
payment.
 The OTD must be filed in Circuit Court in order to move forward with foreclosure
proceedings.
 Once the OTD is filed, your mortgage company may proceed with the foreclosure
sale as soon as 45 days after the OTD is served.
 APPENDIX D (Page 1 of 1)

PRELIMINARY LOSS
MITIGATION AFFIDAVIT
Case Number: _____________________
Date of Filing With Court: _____________________
Borrower(s): _____________________
Property Address: _____________________

My name is _______________________. I am authorized to act on behalf of the secured party

who is the holder of the beneficial interest in the mortgage or deed of trust which is secured by
property at the address listed above. The information in this affidavit is derived from records of
the secured party that were made at or near the time of the occurrence of the matters set forth
below by, or from information transmitted by, a person with knowledge of those matters. These
records were produced and/or maintained in the course of the regularly conducted activity of the
secured party as a regular practice of the secured party, and I state the following:

The mortgage loan that is the subject of this foreclosure action may be eligible for loss mitigation
and [check all statements that apply]:

 The loan is currently under loss mitigation analysis, but the analysis has not yet been
completed.

 The secured party or a representative of the secured party has not been able to obtain all
documentation and information necessary to conduct the loss mitigation analysis.

Required additional documentation to complete loss mitigation analysis [list documents

required]:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
_______________________________________________________________

 The secured party or a representative of the secured party has not been able to establish
communication with the borrower.

 Other __________________________________________________________________.

I solemnly affirm under the penalties of perjury and upon personal knowledge based on review of
the records described herein or attached hereto that the contents of this affidavit are true.

___________________________________________ _________________
Signature of Affiant Date
___________________________________________
Print Name and Title of Affiant
 APPENDIX E (Page 1 of 1)

FINAL LOSS MITIGATION AFFIDAVIT

Case Number: _____________________
Date of Filing With Court: _____________________
Borrower(s): _____________________
Property Address: _____________________

My name is _______________________. I am authorized to act on behalf of the secured party

who is the holder of the beneficial interest in the mortgage or deed of trust which is secured by
property at the address listed above. The information in this affidavit is derived from records of
the secured party that were made at or near the time of the occurrence of the matters set forth
below by, or from information transmitted by, a person with knowledge of those matters. These
records were produced and/or maintained in the course of the regularly conducted activity of the
secured party as a regular practice of the secured party, and I state the following:

The secured party conducted a loss mitigation analysis  YES  NO

(Check which applies)

If the secured party conducted a loss mitigation analysis, describe all loss mitigation programs
evaluated, and describe why the borrower(s) did not qualify for each loss mitigation program. If
the secured party did not conduct a loss mitigation analysis, describe all reasons why a loss
mitigation analysis was not conducted, and describe why the borrower(s) did not qualify for a loss
mitigation program:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
________________________________________________

I solemnly affirm under the penalties of perjury and upon personal knowledge based on
review of the records described herein or attached hereto that the contents of this affidavit are
true.

___________________________________________ _________________
Signature of Affiant Date

___________________________________________
Print Name and Title of Affiant
 APPENDIX F (Page 1 of 3)

REQUEST FOR FORECLOSURE MEDIATION

(Instructions)
Name(s) of Homeowner: ____________________ Property Address: ___________________

What is foreclosure mediation?

Foreclosure mediation is a process that allows you, a representative from your mortgage
company, and a neutral third party mediator from the Maryland Office of Administrative
Hearings to meet and discuss alternatives to foreclosure. The goal of foreclosure mediation is to
help you avoid foreclosure. At mediation, you and your mortgage company may agree to an
option to avoid foreclosure. However, making a request for foreclosure mediation does not
guarantee a loan modification or other relief.

INSTRUCTIONS TO PARTICIPATE IN FORECLOSURE MEDIATION:

■ Carefully read all of the documents included in this packet.

■ Application (on next page) – Initial each statement to confirm that you have read and
understand them. Sign and date the Application. Check the “Yes” box if you would like
a Maryland Department of Housing and Community Development representative or a
housing counselor to contact you. Sign and date the Certificate of Service.

■ Make two copies of the Application.

■ Send the original signed Application, Certificate of Service and $50 fee in the envelope
addressed to the Circuit Court. DO NOT SEND CASH. Most Circuit Courts accept
checks or money orders payable to “Clerk of the Circuit Court.” To confirm that your
method of payment will be accepted, consider contacting the Clerk's office in the Circuit
Court of the county in which your property is located. Consider sending your
Application and payment by certified mail or return receipt requested mail.

■ Application and payment by certified mail or return receipt requested mail.

■ Send one copy of the completed Application and Certificate of Service in the envelope
addressed to the foreclosure attorney representing your mortgage company.

■ Keep the second copy for your records.

If you need help filling out this form:

TO ACCESS FREE HOUSING COUNSELING SERVICES,

CALL THE MARYLAND HOPE HOTLINE AT
1-877-462-7555 OR GO TO WWW.MDHOPE.ORG
 APPENDIX F (Page 2 of 3)

REQUEST FOR FORECLOSURE MEDIATION

(Application)
Circuit Court: ________________
Case No.: ________________
Name and Address of the Secured Party
or Representative of Secured Party: _______________________
Name and Address of the Borrower(s): _______________________

Initial each statement below to confirm that you have read and understand them. If you do
not understand the information, please contact the MD Hope Hotline at 877-462-7555 or visit
www.mdhope.org to find a housing counselor or free legal services near you.

____ I am requesting foreclosure mediation to see if I qualify for a loan modification or other
alternative to a foreclosure sale of my home.

____ I have enclosed my $50 fee for filing this Request for Foreclosure Mediation Application. (Make
checks payable to the “Clerk of the Circuit Court.” DO NOT SEND CASH.)
NOTE: If you qualify for free legal services under the Maryland Legal Services
Guidelines, you may request a waiver of your foreclosure mediation fee. You must
submit a completed Request for Waiver of Filing Fee for Foreclosure Mediation form
(available at http://mdcourts.gov/courtforms/circuit/cc080.pdf) together with this request
for foreclosure mediation.

I would like to be contacted by a Department of Housing and Community

Development representative or a housing counselor:
 YES  NO

If so, please provide your preferred contact information: ________________________________

I/We, __________________________, certify that I/we live in the property for which this
Application is being submitted.

_______________________ _______________________
Signature of Borrower Signature of Borrower
_______________________ _______________________
Printed Name Printed Name

_______ _______
Date Date
 APPENDIX F (Page 3 of 3)

If at least one borrower is willing and able to review and sign the Application and the other
borrower(s) is unavailable or unwilling to review or sign the Application, please explain the
circumstances in the space below:

______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________

Please provide a mailing address, telephone number, and email address if known, for any
additional borrowers who have not signed the Application:

_____________________________
_____________________________
_____________________________

CERTIFICATE OF SERVICE
I certify that I have sent a copy of this Request for Foreclosure Mediation to the Clerk of the
Circuit Court and to the secured party, or the representative of the secured party, by regular U.S.
mail, postage pre-paid, at the address listed at the top of this form. I have served the party that
brought this foreclosure action by sending this Request for Foreclosure Mediation by regular
U.S. mail, postage pre-paid, to its foreclosure attorney in (or at the address on) the addressed
envelope provided with this form.

_____________________________________________ _________________
Signature of Borrower Date

_____________________________________________
Print Name
 APPENDIX G (PAGE 1 OF 5)

LOSS MITIGATION APPLICATION

See Instructions corresponding with numbers in brackets {} on form

Loss Mitigation Application page 1 COMPLETE ALL PAGES OF THIS FORM

Loan Number: {1} (at least last 4 digits) Servicer: _{2}__________________________________________
BORROWER {3} CO-BORROWER {4}

Borrower=s Name Co-Borrower=s Name

Social Security No. Date of Birth Social Security No. Date of Birth

Home phone number. with area code Home phone number with area code

Cell or work number with area code Cell or work number with area code

I want to: {5} G Keep the Property G Sell the Property

The property is my: G Primary Residence G Second Home G Investment

The property is: G Owner Occupied G Renter Occupied G Vacant

Mailing address: {6}

Property address (if same as mailing address, just write Asame@ E-mail address

Is the property listed for sale? G Yes G No {7} {8}

Have you received an offer on the property? G Yes G No Have you contacted a housing-counseling agency for help G Yes G No
Date of offer Amount of offer $ ____________ If yes, please complete the following:
Agent=s Name? ______________________________________ Counselor=s Name:
Agent=s Phone Number: Agency Name:
_______________________________ Counselor=s Phone Number:
For Sale by Owner? G Yes G No Counselor=s E-mail:

Who pays the real estate tax bill on your property: {9} Who pays the hazard insurance premium for your property? {10}
G I do G Lender does G Paid by condo or HOA G I do G Lender does G Paid by condo or HOA
Are the taxes current? G Yes G No Is the policy current? G Yes G No
Condominium or HOA fees G Yes G No $ Name of Insurance Co.:
Paid to: Insurance Co. Tel #:

Have you filed for bankruptcy? G Yes G No If yes: G Chapter 7 G Chapter 13 Filing Date: _________________{11}
Has your bankruptcy been discharged? G Yes G No Bankruptcy case number: ____________________________________________

Additional Liens/Mortgages or Judgments on this property: {12}

Lien Holder=s Name/Servicer Balance Contact Number Loan Number

HARDSHIP AFFIDAVIT {13}

I am requesting review under your loss mitigation program.
I am having difficulty making my monthly payment because of financial difficulties created by (check all that apply):

G My household income has been reduced. For example: unemployment, G My monthly debt payments are excessive and I am overextended with
underemployment, reduced pay or hours, decline in business earnings, my creditors. Debt includes credit cards, home equity or other debt.
death, disability or divorce of a borrower or co-borrower.

G My expenses have increased. For example: monthly mortgage G My cash reserves, including all liquid assets, are insufficient to
payment reset, high medical or health care costs, uninsured losses, maintain my current mortgage payment and cover basic living
increased utilities or property taxes. expenses at the same time.
 APPENDIX G (PAGE 2 OF 5)

G Other:

Explanation (continue on back of page 3 if necessary):

INCOME/EXPENSES FOR HOUSEHOLD 1 Number of People in Household: {14}

Monthly Gross Wages {15} $ First Mortgage Payment {26} $ Checking Account(s) {37} $

Overtime {16} $ Second Mortgage Payment $ Checking Account(s) {38} $

{27}

Child Support/ Alimony {17} $ Insurance {28} $ Savings/ Money Market {39} $
/ Separation 2

Social Security / SSDI {18} $ Property Taxes {29} $ CDs {40} $

Other monthly income from $ Credit Cards / Installment $ Stocks / Bonds {41} $
pensions, annuities or Loan(s) (total minimum
retirement plans {19} payment per month) {30}

Tips, commissions, bonus and $ Alimony, child support $ Other Cash on Hand {42} $
self-employed income {20} payments {31}

Rents Received {21} $ Net Rental Expenses {32} $ Other Real Estate (estimated $
value) {43}

Unemployment income {22} $ HOA/Condo Fees / Property $ Other: $

Maintenance {33} {44}

Food Stamps / Welfare {23} $ Car Payments {34} $ Other: $

{45}

Other (investment income, $ Other: $ Do not include the value of life insurance or retirement
royalties, interest, dividends plans when calculating assets (401K, pension funds,
etc.) {24} annuities, IRAs, Keogh plans, etc.)
{35}

Total (Gross Income) {25} $ Total Debt / Expenses {36} $ Total Assets {46} $

INCOME MUST BE DOCUMENTED

1
Include combined monthly income and expenses from the borrower and co-borrower (if any). If this includes income and expenses from a household
member who is not a borrower, please specify using the back of this form if necessary.
2
You are not required to disclose Child Support, Alimony or Separation Maintenance income, unless you choose to have it considered by your servicer.
 APPENDIX G (PAGE 3 OF 5)

LOSS MITIGATION APPLICATION

ACKNOWLEDGMENT AND AGREEMENT
In making this request for consideration under your loss mitigation program, I certify
under penalty of perjury:

1. That all of the information in this document is truthful and the event(s) identified on page
1 is/are the reason that I need to request a modification of the terms of my mortgage loan, short
sale or deed-in-lieu of foreclosure.

2. I understand that the Servicer, , or its agents may

investigate the accuracy of my statements and may require me to provide supporting
documentation. I also understand that knowingly submitting false information may violate the
law.

3. I understand the Servicer will pull a current credit report on all borrowers obligated on
the Note.

4. I understand that if I have intentionally defaulted on my existing mortgage, engaged in

fraud or misrepresented any fact(s) in connection with this document, the Servicer may cancel
any loss mitigation agreement and may pursue foreclosure on my home.

5. That my Property is owner-occupied; I intend to reside in this property for the next
twelve months; I have not received a condemnation notice; and there has been no change in the
ownership of the Property since I signed the documents for the mortgage that I want to modify.

6. I am willing to provide all requested documents and to respond to all Servicer questions
in a timely manner.

7. I understand that the Servicer will use the information in this document to evaluate my
eligibility for a loan modification, short sale, or deed-in-lieu of foreclosure, but the Servicer is not
obligated to offer me assistance based solely on the statements in this document.

8. I am willing to commit to housing counseling if it is determined that my financial

hardship is related to excessive debt.

9. I understand that the Servicer will collect and record personal information, including, but
not limited to, my name, address, telephone number, social security number, credit score, income,
payment history, government monitoring information, and information about account balances
and activity. I understand and consent to the disclosure of my personal information and the terms
of any loss mitigation agreement to any third party that needs this information to process this
application, including but not limited to: any investor, insurer, guarantor or servicer that owns,
insures, guarantees or services my first lien or subordinate liens (if applicable) mortgage loan(s);
any companies that perform support services in conjunction with my mortgage; any HUD-
certified housing counselor; and government regulators.

{47}__________________________________________________________________________
Borrower Signature Date

_____________________________________________________________________________
Co-Borrower Signature Date
 APPENDIX G (PAGE 4 OF 5)

Maryland HOPE Hotline

Call the Maryland HOPE hotline at 1-877-462-7555 or go to www.MDHOPE.org for
information on housing counseling.

Instructions for Completing Loss Mitigation Application

The numbers for each item below correspond to the same numbers in the form above.
{1} Your loan number on your mortgage loan statement.
{2} Your loan “Servicer” is the financial institution that collects your monthly payment.
{3} The borrower section must include information on the person whose name is on the “Note”
for the mortgage loan.
{4} The co-borrower is a second person on the note for the mortgage loan. Do not fill out this
section for someone who is not obligated on the note for the mortgage loan.
{5} For this section you should choose one option for each question.
{6} Please provide a mailing address and a residential “Property” address if different. The
Property address should correspond to the mortgage for which you are submitting a Loss
Mitigation Application.
{7} If your Property is not listed for sale, you do not need to fill out the rest of Section 7. Only
include offers for sale that you received in the past year.
{8} Counselors are available free of charge and can be located on the Maryland Hope website
www.MDHOPE.org.
{9} If your real estate taxes and property insurance are part of the monthly payment that you
make to your servicer, select “lender does.” “HOA” means Homeowner’s Association.
{10} If your hazard insurance premium is part of the monthly payment that you make to your
servicer, select “lender does.” “HOA” means Homeowner’s Association.
{11} The filing date indicates when you officially filed for bankruptcy. Only check the “yes”
box for a discharged bankruptcy if you no longer owe any obligations.
{12} Additional liens include second (or third) mortgages and home equity lines of credit.
{13} Please select as many hardships as apply to your situation. You can use the extra lines to
explain your hardship, though extensive explanations could delay the processing of your
application.
{14} Indicate the total number of people in your household.
{15} Monthly gross wages are what you receive before taxes. Use your most current pay stub to
find this amount.
{16} This amount should be listed on a current pay stub.
{17} If you receive child support, alimony, or separation maintenance income, you are not
required by law to report it. You should only include this amount if you would like it to be
included in the income calculation.
{18} SSDI means Social Security/Disability Income.
{19} Only include if you are retired and collecting income from retired funds.
{20} If reported, this amount will be on your pay stub.
{21} Only include rental income if used as part of your overall income.
{22} You must have at least nine months of unemployment income to report on this form.
 APPENDIX G (PAGE 5 OF 5)

{23} Report the amount indicated on your benefits letter. You must provide a copy of this letter
as documentation of this income.
{24} Add all other income and report sum in this box.
{25} Add all amounts in income column (boxes 15-24) and report sum.
{26} This amount can be found on your statement for your first mortgage.
{27} If applicable, this amount can be found on the statement for your second mortgage or
home equity lines of credit.
{28} This refers only to homeowner’s insurance and should be reported only if you pay this
yourself.
{29} Only report these taxes if you pay them yourself.
{30} Add all credit cards and installment payments and report sum here.
{31} If you are responsible for paying child support or alimony, you must report the amount
here.
{32} Report amount if your total rental income does not cover your total rental expenses.
{33} “HOA” means Homeowner’s Association.
{34} Include car payments only if you are the owner of the vehicle.
{35} Include any other pertinent household expenses.
{36} Add all amounts in expense column (boxes 26-35) and report sum.
{37}-{39} Report amounts for all accounts, if applicable.
{40} “CDs” means certificates of deposit.
{41}-{42} Report amounts for all accounts, if applicable.
{43} Include estimated value for all other properties owned.
{44}-{45} Report any other assets other than the value of life insurance or retirement plans,
including 401K, pension funds, IRAs, Keogh plans, etc.
{46} Add all amounts in assets column (boxes 37-45) and report sum.
{47} Please be sure to read the entire Loss Mitigation Application Acknowledgement and
Agreement before signing. Do not leave off a signature as this will decrease efficient document
processing.
 APPENDIX H-1 (PAGE 1 OF 1)

NOTICE OF FORECLOSURE ACTION

[Owner-Occupied - Preliminary Loss Mitigation Affidavit]

This Notice is Required by Maryland Law (Real Property Article, §7-105.1, Annotated Code of Maryland).

A foreclosure sale of this property may occur as

soon as 68 days from this notice if you do not respond

If you own and live in this home, you may qualify for alternatives to foreclosure, but
you must act quickly.

We have included:
 Preliminary Loss Mitigation Affidavit – this is a legal document completed by your
mortgage company (sometimes referred to as servicer) explaining that they have not completed
an evaluation of your loan for possible alternatives to foreclosure and why.
 Loss Mitigation Application – this is the application that your mortgage company will review
to see if you qualify for alternatives to foreclosure. If you need help completing this form,
please contact a housing counselor (information below).
 Addressed Envelope to mail the Loss Mitigation Application.

YOU ARE NOT ALONE. THERE ARE FREE RESOURCES

AVAILABLE IN MARYLAND.

TO ACCESS FREE HOUSING COUNSELING SERVICES,

CALL THE MARYLAND HOPE HOTLINE AT
1-877-462-7555 OR GO TO WWW.MDHOPE.ORG
What happens if you do nothing?
In 28 days or more, you will receive a Final Loss Mitigation Affidavit, which will include a form to
request FORECLOSURE MEDIATION.
 You qualify for foreclosure mediation only after the Final Loss Mitigation Affidavit has been
filed with the court.
 You will have only 25 days to request foreclosure mediation after you receive the Final Loss
Mitigation Affidavit so it is important that you continue to open your mail.

Beware of anyone offering to “save” your home or requesting an upfront fee before
providing assistance. This is illegal in the State of Maryland. If you believe you have been a
victim of a scam, please contact Maryland's office of the Commissioner of Financial Regulation by
calling 410-230-6077 or visiting http://www.dllr.state.md.us/finance/.

BEFORE YOU MAIL THE LOSS MITIGATION APPLICATION,

MAKE A COPY FOR YOUR RECORDS
 APPENDIX H-2 (PAGE 1 OF 1)

NOTICE OF FORECLOSURE ACTION

[Owner-Occupied - Final Loss Mitigation Affidavit]

This Notice is Required by Maryland Law (Real Property Article, §7-105.1, Annotated Code of Maryland).

A foreclosure sale of this property may occur as

soon as 40 days from this notice if you do not respond

If you own and live in this home, you may request a meeting with your mortgage
company called FORECLOSURE MEDIATION, but you must act quickly.

We have included:
 Request for Foreclosure Mediation – this is the form you need to complete to request
foreclosure mediation. **This form must be sent back within 25 days - DO NOT DELAY**
 Final Loss Mitigation Affidavit – this is a legal document completed by the mortgage
company explaining why they have been unable to offer an alternative to foreclosure.
 2 Addressed envelopes:

o Return to the court the original signed Request for Foreclosure Mediation in the envelope
marked “REQUEST FOR FORECLOSURE MEDIATION”.

o Mail a copy of the Request for Foreclosure Mediation in the envelope addressed to the
foreclosure attorney who represents your mortgage company.

YOU ARE NOT ALONE. THERE ARE FREE RESOURCES

AVAILABLE IN MARYLAND.

TO ACCESS FREE HOUSING COUNSELING SERVICES,

CALL THE MARYLAND HOPE HOTLINE AT
1-877-462-7555 OR GO TO WWW.MDHOPE.ORG

What happens if you do nothing?

If you do not request foreclosure mediation, the mortgage company may foreclose on your home. If
you wish to remain in your home, PLEASE contact the MD Hope Hotline. You need to understand
your options and the consequences of doing nothing.

Beware of anyone offering to “save” your home or requesting an upfront fee before
providing assistance. This is illegal in the State of Maryland. If you believe you have been a
victim of a scam, please contact Maryland's office of the Commissioner of Financial Regulation by
calling 410-230-6077 or visiting http://www.dllr.state.md.us/finance/.

TO REQUEST FORECLOSURE MEDIATION TURN THE PAGE

 APPENDIX H-3 (PAGE 1 OF 1)

NOTICE OF FORECLOSURE ACTION

[Owner-Occupied - Prefile Mediation - No Mediation Agreement]

This Notice is Required by Maryland Law (Real Property Article, §7-105.1, Annotated Code of Maryland).

A foreclosure sale of this property may occur as

soon as 15 days from this notice. You are not entitled
to foreclosure mediation.

We have included the Final Loss Mitigation Affidavit – this is a legal document
completed by the mortgage company explaining why they have been unable to offer
an alternative to foreclosure.

YOU ARE NOT ALONE. THERE ARE FREE RESOURCES

AVAILABLE IN MARYLAND.

TO ACCESS FREE HOUSING COUNSELING SERVICES,

CALL THE MARYLAND HOPE HOTLINE AT
1-877-462-7555 OR GO TO WWW.MDHOPE.ORG
If you have funds available to bring your loan current, contact [insert contact person to
provide reinstatement figure and instructions to reinstate the loan] before sending any
money to your mortgage company. When you call, ask for the amount needed to
reinstate your loan.

Beware of anyone offering to “save” your home or requesting an

upfront fee before providing assistance. This is illegal in the State of Maryland.
If you believe you have been a victim of a scam, please contact Maryland's office of the
Commissioner of Financial Regulation by calling 410-230-6077 or visiting
http://www.dllr.state.md.us/finance/.
 APPENDIX H-4 (PAGE 1 OF 1)

NOTICE OF FORECLOSURE ACTION

[Owner-Occupied - Prefile Mediation - Mediation Agreement]

This Notice is Required by Maryland Law (Real Property Article, §7-105.1, Annotated Code of Maryland).

A foreclosure sale of this property may occur as

soon as 15 days from this notice

**Check the mediation agreement you received at the mediation session

to confirm that no further mediation was provided under the
agreement.

**If your mortgage company agreed to additional mediation in the

prefile mediation agreement, contact [insert secured party contact
person] immediately.
We have included the Final Loss Mitigation Affidavit – this is a legal document
completed by the mortgage company explaining why they have been unable to offer
an alternative to foreclosure.

YOU ARE NOT ALONE. THERE ARE FREE RESOURCES

AVAILABLE IN MARYLAND.

TO ACCESS FREE HOUSING COUNSELING SERVICES,

CALL THE MARYLAND HOPE HOTLINE AT
1-877-462-7555 OR GO TO WWW.MDHOPE.ORG
If you have funds available to bring your loan current, contact [insert contact person to
provide reinstatement figure and instructions to reinstate the loan] before sending any
money to your mortgage company. When you call, ask for the amount needed to
reinstate your loan.

Beware of anyone offering to “save” your home or requesting an

upfront fee before providing assistance. This is illegal in the State of Maryland.
If you believe you have been a victim of a scam, please contact Maryland's office of the
Commissioner of Financial Regulation by calling 410-230-6077 or visiting
http://www.dllr.state.md.us/finance/.
 APPENDIX H-5 (PAGE 1 OF 1)

NOTICE OF FORECLOSURE ACTION

[Not Owner-Occupied]

This Notice is Required by Maryland Law (Real Property Article, §7-105.1, Annotated Code of Maryland).

A foreclosure sale of this property may occur as

soon as 45 days from this notice.

If you have not done so already, you should contact your mortgage company
immediately! Programs may be available through your mortgage company
to prevent foreclosure, but you MUST ACT NOW!

If you have funds available to bring your loan current, contact [insert contact person to
provide reinstatement figure and instructions to reinstate the loan] before sending any
money to your mortgage company. When you call, ask for the amount needed to
reinstate your loan.

Beware of anyone offering to “save” your residential property or

requesting an upfront fee before providing assistance. This is illegal in the
State of Maryland. If you believe you have been a victim of a scam, please contact
Maryland's office of the Commissioner of Financial Regulation by calling 410-230-6077
or visiting http://www.dllr.state.md.us/finance/.
 APPENDIX I (Page 1 of 1)

SECURED PARTY PREFILE FORECLOSURE MEDIATION

REPORT TO OFFICE OF ADMINISTRATIVE HEARINGS

Mortgage Loan Servicer: Name of Borrower:

Loan Number: Property Address:

Mortgage Loan Servicer Billing Contact Information

Name:____________________________________ Name: _________________________________________
LAST FIRST MI LAST FIRST MI
Address:___________________________________ Address:

____________________Zip ____ _______ ZIP

Telephone No.: _______ Telephone No. :

Borrower(s) and Borrower’s Attorney (if applicable)

(#1) Name: ______________________________________ (#2) Name: _________________________________________

LAST FIRST MI LAST FIRST MI

Address:___________________________________ Address:_______________________________________
___________________________________ _______________________________________
_____________________Zip____________ ___________________________Zip_________

Telephone No.:_______________________ Telephone No.:__________________________

(#3) Name: ______________________________________ (#4) Name: _________________________________________

LAST FIRST MI LAST FIRST MI

Address:___________________________________ Address:_______________________________________
___________________________________ _______________________________________
_____________________Zip____________ ___________________________Zip_________

Telephone No.:_______________________ Telephone No.:__________________________

Mail or fax within five (5) business days after receipt of the borrower Prefile Mediation Application to:

OFFICE OF ADMINISTRATIVE HEARINGS

ADMINISTRATIVE LAW BUILDING
11101 GILROY ROAD, UNIT A/CLERK’S OFFICE
HUNT VALLEY, MARYLAND 21031
(410) 229-4246 Fax: (410) 229-4266
MD RELAY: 711 Toll Free (800) 388-8805
 APPENDIX OAH-1 (Page 1 of 5)

PREFILE FORECLOSURE MEDIATION

INSTRUCTIONS
Requirements for Document Exchange
And Important Information Regarding Proceedings

IMPORTANT NOTICE ABOUT YOUR APPLICATION FOR PREFILE

FORECLOSURE MEDIATION:

By law, you are required to provide certain documents and information to the designated
representative of your mortgage company and to the Office of Administrative Hearings (OAH)
prior to the foreclosure mediation. These instructions describe the documents and information
you are required to provide and how and when they must be provided.

NOTE: IF YOU HAVE ALREADY SUBMITTED

DOCUMENTS TO THE OFFICE OF ADMINISTRATIVE
HEARINGS, YOU SHOULD NOT SEND A DUPLICATE
COPY OF THE DOCUMENTS.
1. The borrower(s) shall provide:

(a) Prior to the foreclosure mediation, a copy of:

■ a completed Borrower(s) Information Worksheet (attached);

■ the borrower(s)’ Prefile Foreclosure Mediation Application (copy of the

one you sent) and any other loss mitigation application that you have
submitted to your lender;

■ each borrower’s signed federal income tax returns (including all schedules
and attachments-ALL PAGES) for the two most recent tax years;

■ the most recent bill and proof of payment for property taxes and insurance,
only if borrower pays directly, and not through your mortgage payment;

■ any previous loan modifications (if applicable); and

■ the most recent statement for any other loan borrower may have on the
property, if applicable (such as a home equity loan or second mortgage),
showing the name, mailing address, and telephone number of the lender(s)
in question;
 APPENDIX OAH-1 (Page 2 of 5)

(b) At the foreclosure mediation, a copy of:

■ proof of each borrower’s pay (paystub or benefits statements) issued

within the last 30 days, covering one month of pay;

■ two most recent paystubs or benefits statements (issued within the last 45
days) for any member of the borrower’s household whose income is to be
counted toward payment of the mortgage; and

■ all pages of each borrower’s two most recent bank statements issued
within the preceding 60 days.

2. The lender, or representative of the lender, shall provide to OAH and borrower(s) if not
already provided:

■ name and contact information (telephone number, mailing and e-mail

address) of the individual(s) who will represent the secured party at the
foreclosure mediation and will either have authority to settle or be able to
readily contact someone with authority to settle the matter at foreclosure
mediation (only need to provide to OAH);

■ Notice of Intent to Foreclose;

■ borrower(s)’ payment history;

■ correspondence log of account activities, including servicer contacts with

borrower(s), from the time the loan went into default until the date of
submission; and

■ separately as to each loss mitigation option considered for the borrower(s),

documentation of the basis for denial including:

- the specific data inputs and their sources

- an explanation of each specific factor relied upon
- relevant portion(s) of investor guidelines
- property valuation, if any

3. Timing/Method of Sending.

Documents and information required to be provided to the other party and to the Office
of Administrative Hearings must be by one of the following methods at the times indicated:
 APPENDIX OAH-1 (Page 3 of 5)

• First-class U.S. mail, postage paid – send no later than 23 days before the
scheduled date of the foreclosure mediation.

• Next-day air service or hand delivery – ensure delivery no later than 20 days
before the scheduled date of the foreclosure mediation.

• By electronic delivery as directed by the Office of Administrative Hearings.

4. Newly Acquired Documents or Information.

If you get new information or documents after the initial disclosure, use the following
instructions to disclose:

• If the new documents or information are obtained seven or more days prior to the
scheduled date of the foreclosure mediation, the party obtaining the new material shall
deliver to the other party and the Office of Administrative Hearings the newly obtained
documents or information within one day of receipt by sending the materials by first class
U.S. mail, postage paid, or by sending via a next-day air service or hand delivery.

• If the new documents or information are obtained six or fewer days prior to the
scheduled date of the foreclosure mediation, the party obtaining the new material shall
deliver it to the other party by facsimile or hand delivery and to the Office of
Administrative Hearings at the time of the foreclosure mediation.

5. Addresses.

• The borrower(s) shall send all required documents and information to the lender, or
representative of the lender, at the address of the lender, or representative of the lender indicated
in the Instructions to the Application for Prefile Mediation.

• The lender, or representative of the lender, shall send all required documents and
information to the borrower(s) at the borrower(s) address set forth on the Application for Prefile
Foreclosure Mediation completed by the borrower(s).

• Each party shall send all required documents to:

Maryland Office of Administrative Hearings

Attn: Foreclosure Unit
11101 Gilroy Road
Hunt Valley, Maryland 21031

6. Bring Documents to the Foreclosure Mediation.

Prior to the prefile mediation, the borrower is required to participate in housing

counseling. The borrower is required by law to bring to the mediation session the housing
counseling certificate, signed by the housing counselor who has provided housing
counseling services to the borrower. Each party shall bring copies of all documents they have
provided to the other party to the scheduled foreclosure mediation.
 APPENDIX OAH-1 (Page 4 of 5)

7. Other Important Information Regarding Foreclosure Mediation.

• Authority to Settle:

The person representing the secured party must have authority to settle or be able to
readily contact a person with authority to settle the matter.

• Postponement Rules:

(a). A request for postponement shall be considered only if the party

requesting the postponement establishes good cause for the postponement.

(b). Except as provided in paragraph (d) below, a request for postponement

shall be made in writing and filed with the Office of Administrative Hearings and mailed to the
other party not less than five days before the scheduled foreclosure mediation.

(c). Documentation of the reasons for the postponement may be required from
the party making the request.

(d). Emergency Request for Postponement:

i. For purposes of this paragraph, “emergency” means a sudden,

unforeseen occurrence requiring immediate attention that arises within five days of the
foreclosure mediation date.

ii. In an emergency, a request for postponement may be made by

telephone.

(e). When practicable, all parties to the proceeding shall be contacted before a
ruling on a postponement request is made by the Office of Administrative Hearings.

IF YOU HAVE QUESTIONS REGARDING THIS MATTER,

CALL THE OAH, FORECLOSURE UNIT, AT 410-229-4246
 APPENDIX OAH-1 (Page 5 of 5)

BORROWER(S) INFORMATION WORKSHEET

(FORM TO BE SUBMITTED WITH DOCUMENT EXCHANGE)

OAH Case Number: ______________ Name of Borrower: ____________

A. Household Expenses B. Your Monthly Income

Fixed Monthly Expenses Payment Net Income (after
Gross Income
Mortgage $ taxes and deductions
Second Mortgage $
Condo/Homeowner $ $
$
Association Fees
Gas and Electric $
C. Spouse/Partner’s
Heating Oil $
Monthly Income
Water and Sewer $
Phone $ Net Income (after
Gross Income
Car Payment 1 $ taxes and deductions
Car Payment 2 $
$ $
Auto Insurance $
Life Insurance $
D. Other Household
Medical Insurance $
Monthly Income
Alimony/Child Support $
Alarm System $ Net Income (after
Gross Income
Property Taxes/Insurance $ taxes and deductions
Other/ Credit Card Payment(s)
from Section E
$ $ $
Sub-Total $
E. Credit Cards and Other Debt
Variable Monthly Expenses Payment

Groceries $ Creditor Name Payment Balance

Eating Out $ $ $
Gas $ $ $
Bus/Taxi/Parking Fees $ $ $
Car Repairs $ $ $
Toiletries/Hair Care $ $ $
Medical Expenses $ Total $ $
Day Care/Babysitters $
Internet/Cable Television $ F. Surplus/Deficit
Clothing/ Laundry $
Cigarettes/Alcohol $ Total Net Monthly Household
Income (B+C+D)
$
Church/Charity $
Entertainment/Lottery $
- Total Monthly Expenses (A) $
Pet care/food $
Cell Phone $
= Monthly Surplus/Deficit $
Tuition/Education $
Other $
Sub-Total $

Total Monthly Expenses $

 APPENDIX OAH -2 (Page 1 of 5)

FORECLOSURE MEDIATION INSTRUCTIONS

Requirements for Document Exchange
and Important Information Regarding Proceedings

IMPORTANT NOTICE ABOUT YOUR REQUEST FOR FORECLOSURE

MEDIATION:

By law, you are required to provide certain documents and information to the designated
representative of your mortgage company and to the Office of Administrative Hearings (OAH)
prior to the foreclosure mediation. These instructions describe the documents and information
you are required to provide and how and when they must be provided.

NOTE: IF YOU HAVE ALREADY SUBMITTED

DOCUMENTS TO THE OFFICE OF ADMINISTRATIVE
HEARINGS, YOU SHOULD NOT SEND A DUPLICATE
COPY OF THE DOCUMENTS.
1. The borrower(s) shall provide:

(a) Prior to the foreclosure mediation, a copy of:

■ a completed Borrower(s) Information Worksheet (attached);

■ the borrower(s)’ Request for Foreclosure Mediation Application (copy of

the one you sent);

■ each borrower’s signed federal income tax returns (including all schedules
and attachments-ALL PAGES) for the two most recent tax years;

■ the most recent bill and proof of payment for property taxes and insurance,
only if borrower pays directly, and not through your mortgage payment;

■ any previous loan modifications (if applicable); and

■ the most recent statement for any other loan borrower may have on the
property, if applicable (such as a home equity loan or second mortgage),
showing the name, mailing address, and telephone number of the lender(s)
in question;
 APPENDIX OAH -2 (Page 2 of 5)

(b) At the foreclosure mediation, a copy of:

■ proof of each borrower’s pay (paystub or benefits statements) issued

within the last 30 days, covering one month of pay;

■ two most recent paystubs or benefits statements (issued within the last 45
days) for any member of the borrower’s household whose income is to be
counted toward payment of the mortgage; and

■ all pages of each borrower’s two most recent bank statements issued
within the preceding 60 days.

2. The lender, or representative of the lender, shall provide to OAH and borrower(s) if not
already provided:

■ borrower(s)’ Loss Mitigation Application (only need to provide to OAH);

■ name and contact information (telephone number, mailing and e-mail

address) of the individual(s) who will represent the secured party at the
foreclosure mediation and will either have authority to settle or be able to
readily contact someone with authority to settle the matter at foreclosure
mediation (only need to provide to OAH);

■ Notice of Intent to Foreclose;

■ Order to Docket (including attachments);

■ Final Loss Mitigation Affidavit;

■ borrower(s)’ payment history;

■ correspondence log of account activities, including servicer contacts with

borrower(s), from the time the loan went into default until the date of
submission; and

■ separately as to each loss mitigation option considered for the borrower(s),

documentation of the basis for denial including:

- the specific data inputs and their sources

- an explanation of each specific factor relied upon
- relevant portion(s) of investor guidelines
- property valuation, if any
 APPENDIX OAH -2 (Page 3 of 5)

3. Timing/Method of Sending.

Documents and information required to be provided to the other party and to the Office
of Administrative Hearings must be by one of the following methods at the times indicated:

• First-class U.S. mail, postage paid – send no later than 23 days before the
scheduled date of the foreclosure mediation.

• Next-day air service or hand delivery – ensure delivery no later than 20 days
before the scheduled date of the foreclosure mediation.

• By electronic delivery as directed by the Office of Administrative Hearings.

4. Newly Acquired Documents or Information.

If you get new information or documents after the initial disclosure, use the following
instructions to disclose:

• If the new documents or information are obtained seven or more days prior to the
scheduled date of the foreclosure mediation, the party obtaining the new material shall
deliver to the other party and the Office of Administrative Hearings the newly obtained
documents or information within one day of receipt by sending the materials by first class
U.S. mail, postage paid, or by sending via a next-day air service or hand delivery.

• If the new documents or information are obtained six or fewer days prior to the
scheduled date of the foreclosure mediation, the party obtaining the new material shall
deliver it to the other party by facsimile or hand delivery and to the Office of
Administrative Hearings at the time of the foreclosure mediation.

5. Addresses.

• The borrower(s) shall send all required documents and information to the lender, or
representative of the lender, at the address of the lender, or representative of the lender, set forth
in the Final Loss Mitigation Affidavit filed with the court.

• The lender, or representative of the lender, shall send all required documents and
information to the borrower(s) at the borrower(s) address set forth on the Request for Foreclosure
Mediation form completed by the borrower(s).

• Each party shall send all required documents to:

Maryland Office of Administrative Hearings

Attn: Foreclosure Unit
11101 Gilroy Road
Hunt Valley, Maryland 21031

6. Bring Documents to the Foreclosure Mediation.

Each party shall bring copies of all documents they have provided to the other party to
the scheduled foreclosure mediation.
 APPENDIX OAH -2 (Page 4 of 5)

7. Other Important Information Regarding Foreclosure Mediation.

• Authority to Settle:

The person representing the secured party must have authority to settle or be able to
readily contact a person with authority to settle the matter.

• Postponement Rules:

(a). A request for postponement shall be considered only if the party

requesting the postponement establishes good cause for the postponement.

(b). Except as provided in paragraph (d) below, a request for postponement

shall be made in writing and filed with the Office of Administrative Hearings and mailed to the
other party not less than five days before the scheduled foreclosure mediation.

(c). Documentation of the reasons for the postponement may be required from
the party making the request.

(d). Emergency Request for Postponement:

i. For purposes of this paragraph, “emergency” means a sudden,

unforeseen occurrence requiring immediate attention that arises within five (5) days of the
foreclosure mediation date.

ii. In an emergency, a request for postponement may be made by

telephone.

(e). When practicable, all parties to the proceeding shall be contacted before a
ruling on a postponement request is made by the Office of Administrative Hearings.

IF YOU HAVE QUESTIONS REGARDING THIS MATTER,

CALL THE OAH, FORECLOSURE UNIT, AT 410-229-4246
 APPENDIX OAH -2 (Page 5 of 5)

BORROWER(S) INFORMATION WORKSHEET

(FORM TO BE SUBMITTED WITH DOCUMENT EXCHANGE)

OAH Case Number: ______________ Name of Borrower: ____________

A. Household Expenses B. Your Monthly Income

Fixed Monthly Expenses Payment Net Income (after
Gross Income
Mortgage $ taxes and deductions
Second Mortgage $
Condo/Homeowner $ $
$
Association Fees
Gas and Electric $
C. Spouse/Partner’s
Heating Oil $
Monthly Income
Water and Sewer $
Phone $ Net Income (after
Gross Income
Car Payment 1 $ taxes and deductions
Car Payment 2 $
$ $
Auto Insurance $
Life Insurance $
D. Other Household
Medical Insurance $
Monthly Income
Alimony/Child Support $
Alarm System $ Net Income (after
Gross Income
Property Taxes/Insurance $ taxes and deductions
Other/ Credit Card Payment(s)
from Section E
$ $ $
Sub-Total $
E. Credit Cards and Other Debt
Variable Monthly Expenses Payment

Groceries $ Creditor Name Payment Balance

Eating Out $ $ $
Gas $ $ $
Bus/Taxi/Parking Fees $ $ $
Car Repairs $ $ $
Toiletries/Hair Care $ $ $
Medical Expenses $ Total $ $
Day Care/Babysitters $
Internet/Cable Television $ F. Surplus/Deficit
Clothing/ Laundry $
Cigarettes/Alcohol $ Total Net Monthly Household
Income (B+C+D)
$
Church/Charity $
Entertainment/Lottery $
- Total Monthly Expenses (A) $
Pet care/food $
Cell Phone $
= Monthly Surplus/Deficit $
Tuition/Education $
Other $
Sub-Total $

Total Monthly Expenses $

 APPENDIX OAH-3 (Page 1 of 3)

Office of Administrative Hearings

11101 Gilroy Road
Hunt Valley, Maryland 21031
Phone: (410) 229-4246 Fax: 229-4266
MD RELAY: 711 Toll Free: (800)388-8805

Foreclosure Mediation Checklist - Prefile Mediation

OAH Case Number: _________________

Foreclosure Mediation Date/Time: ________________
Name of Secured Party: __________________________
Name of Borrower: ______________________________
Loan No.: ______________________________________
Additional Parties present: _______________________
_______________________________________________
_______________________________________________

PART I - PRELIMINARY MATTERS

 Housing Counseling

 Certification of housing counseling services received.

 No certification of housing counseling services received. Check below, as

applicable.

 Secured party accepted certification executed by borrower(s). See

attached form.

 Secured party waived housing counseling certification. See attached

form.

PART II - OPTIONS FOR RESOLUTION

 Retention

 Refinance
 APPENDIX OAH-3 (Page 2 of 3)

 Over-equity refinance

 Forbearance agreement

 Property rent-back

 Loan modification

 Payment in full [of delinquency amount, fees and penalties as of the date of the
mediation session] (reinstate loan)

 Other
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________

 Liquidation - Tax implications discussed for each option

 Structured liquidation agreement

 Short sale

 Deed in lieu of foreclosure

 Cash for keys

 Private auction

 Other
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________

 Deficiency balance

 Further mediation - preservation of additional or postfile mediation

_________________________________________
Borrower: ________________________________

_________________________________________
Borrower: ________________________________
 APPENDIX OAH-3 (Page 3 of 3)

_________________________________________
Secured Party: _____________________________
_________________________________________

_________________________________________
Representative of Secured Party: ______________
________________________________________

_________________________________________
Other Party: _______________________________

_________________________________________
Other Party: _______________________________
 APPENDIX OAH-4 (Page 1 of 2)

Office of Administrative Hearings

11101 Gilroy Road
Hunt Valley, Maryland 21031
Phone: (410) 229-4246 Fax: 229-4266
MD RELAY: 711 Toll Free: (800)388-8805

Foreclosure Mediation Checklist - Postfile Mediation

Circuirt Court Case No. : ________________________

OAH Case Number: ____________________________
Foreclosure Mediation Date/Time: ________________
Name of Secured Party: __________________________
Name of Borrower: ______________________________
Loan No.: ______________________________________
Additional Parties present: _______________________
_______________________________________________
_______________________________________________

OPTIONS FOR RESOLUTION

 Retention

 Refinance

 Over-equity refinance

 Forbearance agreement

 Property rent-back

 Loan modification

 Payment in full [of delinquency amount, fees and penalties as of the date of the
mediation session] (reinstate loan)

 Other
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
 APPENDIX OAH-4 (Page 2 of 2)

 Liquidation - Tax implications discussed

 Structured liquidation agreement

 Short sale

 Deed in lieu of foreclosure

 Cash for keys

 Private auction

 Other
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________

 Deficiency balance

_________________________________________
Borrower: ________________________________

_________________________________________
Borrower: ________________________________

_________________________________________
Secured Party: _____________________________
_________________________________________

_________________________________________
Representative of Secured Party: ______________
________________________________________

_________________________________________
Other Party: _______________________________

_________________________________________
Other Party: _______________________________
 APPENDIX OAH-5 (Page 1 of 1)

Office of Administrative Hearings

11101 Gilroy Road
Hunt Valley, Maryland 21031
Phone: (410) 229-4246 Fax: 229-4266
MD RELAY: 711 Toll Free: (800)388-8805

Borrower Certification of Housing Counseling

OAH Case Number: _________________
Foreclosure Mediation Date/Time: ________________
Name of Secured Party: __________________________
Name of Borrower: ______________________________
Loan No.: ______________________________________

I/We certify that we participated in housing counseling on [insert date] with [insert name
of housing counselor].

Borrower: ________________________________

_________________________________________
Borrower: ________________________________
 APPENDIX OAH-6 (Page 1 of 1)

Office of Administrative Hearings

11101 Gilroy Road
Hunt Valley, Maryland 21031
Phone: (410) 229-4246 Fax: 229-4266
MD RELAY: 711 Toll Free: (800)388-8805

Secured Party Waiver of Housing Counseling

OAH Case Number: _________________
Foreclosure Mediation Date/Time: ________________
Name of Secured Party: __________________________
Name of Borrower: ______________________________
Loan No.: ______________________________________

[NAME OF SECURED PARTY] waives the receipt of housing counseling certification.

________________________________
Secured Party
Name:___________________________
Position:_________________________

or

________________________________
Representative of Secured Party
Name: __________________________
Position:_________________________