UNIFORM BORROWER ASSISTANCE FORM

If you are experiencing a temporary or long-term hardship and need help, you must complete and submit this form along
with other required documentation to be considered for available solutions. On this page, you must disclose information
about (1) you and your intentions to either keep or transition out of your home; (2) the property’s status; (3) bankruptcy;
and (4) your credit counseling agency.
On Page 2, you must disclose information about all of your income, expenses and assets. Page 2 also lists the required
income documentation that you must submit in support of your request for assistance. Then on Page 3, you must
complete the Hardship Affidavit in which you disclose the nature of your hardship. The Hardship Affidavit informs you of
the required documentation that you must submit in support of your hardship claim.
NOTICE: In addition, when you sign and date this form, you will make important certifications, representations and
agreements, including certifying that all of the information in this Borrower Assistance Form is accurate and truthful
and any identified hardship has contributed to your submission of this request for mortgage relief.
REMINDER: The Borrower Response Package you need to return consists of: (1) this completed, signed and dated
Borrower Assistance Form; (2) completed and signed IRS Form 4506T-EZ (4506T for self-employed borrowers or
borrowers with rental income); (3) required income documentation; and (4) required hardship documentation.

Loan Number ͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺ (usually found on your monthly mortgage statement)

Servicer’s Name ͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺ
I want to: Keep the Property Vacate the Property Sell the Property Undecided

The property is currently: My Primary Residence A Second Home An Investment Property

The property is currently: Owner Occupied Renter Occupied Vacant

BORROWER CO-BORROWER
BORROWER’S NAME CO-BORROWER’S NAME

SOCIAL SECURITY NUMBER DATE OF BIRTH SOCIAL SECURITY NUMBER 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

MAILING ADDRESS

PROPERTY ADDRESS (IF SAME AS MAILING ADDRESS, JUST WRITE SAME) EMAIL ADDRESS

Is the property listed for sale? Yes No Have you contacted a credit counseling agency for help?
If yes, what was the listing date? Yes No
If property has been listed for sale, have you received an offer on the If yes, please complete the counselor contact information below:
property? Yes No Counselor’s Name:
Date of offer: Amount of Offer: $ Agency’s Name:
Agent’s Name:
Counselor’s Phone Number:
Agent’s Phone Number:
For Sale by Owner? Yes No Counselor’s Email Address:
Do you have condominium or homeowner association (HOA) fees? Yes No
Total monthly amount: $ Name and address that fees are paid to:

Have you filed for bankruptcy? Yes No If yes: Chapter 7 Chapter 11 Chapter 12 Chapter 13
If yes, what is the filing Date: Has your bankruptcy been discharged? Yes No Bankruptcy case number:

Is any Borrower an active duty service member? Yes No

Has any Borrower been deployed away from his/her primary residence or received a Permanent Change of Station order? Yes No
Is any Borrower the surviving spouse of a deceased service member who was on active duty at the time of death? Yes No

Fannie Mae/Freddie Mac Form 710 Page 1 of 4 June 2014

UNIFORM BORROWER ASSISTANCE FORM
Monthly Household Income Debt Household Assets(associated with the
property and/or borrower(s)excluding
retirement funds)
Gross wages $ First Mortgage Payment $ Checking Account(s) $
Overtime $ Second Mortgage Payment $ Checking Account(s) $
Child Support / Alimony* $ Homeowner’s Insurance $ Savings / Money Market $
Non-taxable social security/SSDI $ Property Taxes $ CDs $
Taxable SS benefits or other monthly $ Credit Cards / Installment Loan(s) (total $ Stocks / Bonds $
income from annuities or retirement minimum payment per month)
plans

Tips, commissions, bonus and self- $ Alimony, child support payments $ Other Cash on Hand $
employed income
Rents Received $ Car Lease Payments $ Other Real Estate (estimated value) $
Unemployment Income $ HOA/Condo Fees/Property Maintenance $ Other $
Food Stamps/Welfare $ Mortgage Payments on other properties $ $
Other $ Other $ $
Total (Gross income) $0 Total Household Expenses and Debt $0 Total Assets $0
Payments
Any other liens (mortgage liens, mec hanics liens, tax liens, etc.)
Lien Holder’s Name Balance and Interest Rate Loan Number Lien Holder’s Phone N umber

Required Income Documentation

Do you earn a salary or hourly wage? Are you self-employed?
For each borrower who is a salaried employee or For each borrower who receives self-employed income, include a complete, signed
paid by the hour, include paystub(s) reflecting the individual federal income tax return and, as applicable, the business tax return; AND
most recent 30 days’ or four weeks' earnings and either the most recent signed and dated quarterly or year-to-date profit/loss statement
documentation reflecting year-to-date earnings, if that reflects activity for the most recent three months; OR copies of bank statements for
not reported on the paystubs (e.g. signed letter or the business account for the last two months evidencing continuation of business
printout from employer). activity.
Do you have any additional sources of incom e? Provide for each borrower as applicable:
“Other Earned Income” such as bonuses, co mmissions, housing allowance, tips, or overtime:
Reliable third-party documentation des cribing the amount and nature of the income (e.g., paystub, employment contract or pr intouts
documenting tip income).
Social Security, disability or death benefits , pension, public assistance, or adoption assistance:
Documentation showing the amount an d frequency of the benefits, such as letters, exhibits, disability policy or benefits statement from the
provider, and
Documentation showing the receipt of payment, such as copies of the two most recent bank statements showing deposit amo unts.
Rental income:
Copy of the most recent f iled federal ta x return with all schedules, including Schedule E—Supplement Income and Loss. Renta l income for
qualifying purposes will b e 75% of the g ross rent you reported reduced by the monthly debt service on the property, if applicabl e; or
If rental income is not reported on Sche dule E – Supplemental Income and Loss, provide a copy of the current lease agreement with either
bank statements or cancelled rent chec ks demonstrating receipt of rent.
Investment income:
Copies of the two most recent investment statements or bank statements supporting receipt of this income.
Alimony, child support, or se paration maintenance payments as qualifying income:*
Copy of divorce decree, s eparation agreement, or other written legal agreement filed with a court, or court decree that states the amount
of the alimony, child support, or separa tion maintenance payments and the period of time over which the payments will be received, and
Copies of your two most recent bank st atements or other third-party documents showing receipt of payment.

*Notice: Alimony, child support, o r separate ma intenance income need not be revealed if you do not choose to have it considered for repaying
this loan.

Fannie Mae/Freddie Mac Form 710 Page 2 of 4 June 2014

UNIFORM BORROWER ASSISTANCE FORM
HARDSHIP AFFIDAVIT
I am requesting review of my current financial situation to determine whether I qualify for temporary or permanent mortgage loan relief
options. Date Hardship Began is:
I believe that my situation is:
Short-term (under 6 months) Medium-term (6 – 12 months) Long-term or Permanent Hardship (greater than 12 months)
I am having difficulty making my monthly payment because of reason set forth below:
(Please check the primary reason and submit required documentation demonstrating your primary hardship)
If Your Hardship is: Then the Required Hardship Documentation is:
Unemployment No hardship documentation required
Reduction in Income: a hardship that No hardship documentation required
has caused a decrease in your income
due to circumstances outside your
control (e.g., elimination of overtime,
reduction in regular working hours, a
reduction in base pay)
Increase in Housing Expenses: a No hardship documentation required
hardship that has caused an increase in
your housing expenses due to
circumstances outside your control
Divorce or legal separation; Separation Divorce decree signed by the court; OR
of Borrowers unrelated by marriage, Separation agreement signed by the court; OR
civil union or similar domestic Current credit report evidencing divorce, separation, or non-occupying
partnership under applicable law borrower has a different address; OR
Recorded quitclaim deed evidencing that the non-occupying Borrower or co-
Borrower has relinquished all rights to the property
Death of a borrower or death of either Death certificate; OR
the primary or secondary wage earner Obituary or newspaper article reporting the death
in the household
Long-term or permanent disability; Proof of monthly insurance benefits or government assistance (if applicable); OR
Serious illness of a borrower/co- Written statement or other documentation verifying disability or illness; OR
borrower or dependent family member Doctor’s certificate of illness or disability; OR
Medical bills
None of the above shall require providing detailed medical information.
Disaster (natural or man-made) Insurance claim; OR
adversely impacting the property or Federal Emergency Management Agency grant or Small Business Administration
Borrower’s place of employment loan; OR
Borrower or Employer property located in a federally declared disaster area
Distant employment transfer / Relocation For active duty service members: Notice of Permanent Change of Station (PCS) or
actual PCS orders.
For employment transfers/new employment:
Copy of signed offer letter or notice from employer showing transfer to a new
employment location; OR
Paystub from new employer
In addition to the above, documentation that reflects the amount of any relocation
assistance provided, if applicable (not required for those with PCS orders).
Business Failure Tax return from the previous year (including all schedules) AND
Proof of business failure supported by one of the following:
Bankruptcy filing for the business; OR
Two months recent bank statements for the business account evidencing
cessation of business activity; OR
Most recent signed and dated quarterly or year-to-date profit and loss
statement
Other: a hardship that is not covered Written explanation describing the details of the hardship and relevant
above documentation

Fannie Mae/Freddie Mac Form 710 Page 3 of 4 June 2014

 Borrower/Co-Borrower Acknowledgement and Agreement
I certify, acknowledge, and agree to the following:
1. All of the information in this Borrower Assistance Form is truthful and the hardship that I have identified
contributed to my need for mortgage relief.
2. The accuracy of my statements may be reviewed by the Servicer, owner or guarantor of my mortgage, their
agent(s), or an authorized third party*, and I may be required to provide additional supporting documentation. I
will provide all requested documents and will respond timely to all Servicer, or authorized third party*,
communications.
3. Knowingly submitting false information may violate Federal and other applicable law.
4. If I have intentionally defaulted on my existing mortgage, engaged in fraud or misrepresented any fact(s) in
connection with this request for mortgage relief or if I do not provide all required documentation, the Servicer
may cancel any mortgage relief granted and may pursue foreclosure on my home and/or pursue any available
legal remedies.
5. The Servicer is not obligated to offer me assistance based solely on the representations in this document or
other documentation submitted in connection with my request.
6. I may be eligible for a trial period plan, repayment plan, or forbearance plan. If I am eligible for one of these
plans, I agree that:
a. All the terms of this Acknowledgment and Agreement are incorporated into such plan by reference as
if set forth in such plan in full.
b. My first timely payment under the plan will serve as acceptance of the terms set forth in the notice of
the plan sent by the Servicer.
c. The Servicer’s acceptance of any payments under the plan will not be a waiver of any acceleration of
my loan or foreclosure action that has occurred and will not cure my default unless such payments are
sufficient to completely cure my entire default under my loan.
d. Payments due under a trial period plan for a modification will contain escrow amounts. If I was not
previously required to pay escrow amounts, and my trial period plan contains escrow amounts, I agree
to the establishment of an escrow account and agree that any prior waiver is revoked. Payments due
under a repayment plan or forbearance plan may or may not contain escrow amounts. If I was not
previously required to pay escrow amounts and my repayment plan or forbearance plan contains
escrow amounts, I agree to the establishment of an escrow account and agree that any prior escrow
waiver is revoked.
7. A condemnation notice has not been issued for the property.
8. The Servicer or authorized third party* will obtain a current credit report on all borrowers obligated on the
Note.
9. The Servicer or authorized third party* will collect and record personal information that I submit in this
Borrower Response Package and during the evaluation process. This personal information may include, but is
not limited to: (a) my name, address, telephone number, (b) my social security number, (c) my credit score, (d)
my income, and (e) my payment history and information about my account balances and activity. I understand
and consent to the Servicer or authorized third party*, as well as any investor or guarantor (such as Fannie
Mae or Freddie Mac), disclosing my personal information and the terms of any relief or foreclosure alternative
that I receive to the following:
a. Any investor, insurer, guarantor, or servicer that owns, insures, guarantees, or services my first lien or
subordinate lien (if applicable) mortgage loan(s) or any companies that perform support services to
them; and
b. The U.S. Department of Treasury, Fannie Mae and Freddie Mac, in conjunction with their
responsibilities under the Making Home Affordable program, or any companies that perform support
services to them.
10. I consent to being contacted concerning this request for mortgage assistance at any telephone number,
including mobile telephone number, or email address I have provided to the Lender/Servicer/ or authorized
third party*. By checking this box, I also consent to being contacted by text messaging.

Borrower Signature Date Co-Borrower Signature Date

*An authorized third party may include, but is not limited to, a counseling agency, Housing Finance Agency (HFA) or
other similar entity that is assisting me in obtaining a foreclosure prevention alternative.

Fannie Mae/Freddie Mac Form 710 Page 4 of 4 June 2014

Form 4506T-EZ Short Form Request for Individual Tax Return Transcript
OMB No. 1545-2154
(Rev. August 2014)
a Request may not be processed if the form is incomplete or illegible.
Department of the Treasury
Internal Revenue Service a For more information about Form 4506T-EZ, visit www.irs.gov/form4506tez.
Tip. Use Form 4506T-EZ to order a 1040 series tax return transcript free of charge, or you can quickly request transcripts by using our automated self-help
service tools. Please visit us at IRS.gov and click on “Get Transcript of Your Tax Records” under “Tools” or call 1-800-908-9946.
1a Name shown on tax return. If a joint return, enter the name shown first. 1b First social security number or individual taxpayer
identification number on tax return

2a If a joint return, enter spouse’s name shown on tax return. 2b Second social security number or individual
taxpayer identification number if joint tax return

3 Current name, address (including apt., room, or suite no.), city, state, and ZIP code (see instructions)

4 Previous address shown on the last return filed if different from line 3 (see instructions)

5 If the transcript is to be mailed to a third party (such as a mortgage company), enter the third party’s name, address, and telephone number. The
IRS has no control over what the third party does with the tax information.
Third party name Telephone number

M&T Bank c/o DataVerify 1-800-724-1633

Address (including apt., room, or suite no.), city, state, and ZIP code

875 Greentree Rd., 8 Parkway Center, Pittsburgh, PA 15220

Caution. If the tax transcript is being mailed to a third party, ensure that you have filled in line 6 before signing. Sign and date the form once you have
filled in this line. Completing this step helps to protect your privacy. Once the IRS discloses your IRS transcript to the third party listed on line 5, the
IRS has no control over what the third party does with the information. If you would like to limit the third party's authority to disclose your transcript
information, you can specify this limitation in your written agreement with the third party.

6 Year(s) requested. Enter the year(s) of the return transcript you are requesting (for example, “2008”). Most requests will be processed within
10 business days.
2013 2014

Note. If the IRS is unable to locate a return that matches the taxpayer identity information provided above, or if IRS records indicate that the return has
not been filed, the IRS will notify you or the third party that it was unable to locate a return, or that a return was not filed, whichever is applicable.

Caution. Do not sign this form unless all applicable lines have been completed.

Signature of taxpayer(s). I declare that I am the taxpayer whose name is shown on either line 1a or 2a. If the request applies to a joint return, either
spouse must sign. Note. For transcripts being sent to a third party, this form must be received within 120 days of the signature date.
Phone number of taxpayer
on line 1a or 2a
F

Sign
Signature (see instructions) Date
Here
F

Spouse’s signature Date

For Privacy Act and Paperwork Reduction Act Notice, see page 2. Cat. No. 54185S Form 4506T-EZ (Rev. 08-2014)
Form 4506T-EZ (Rev. 08-2014) Page 2
Section references are to the Internal Revenue If you filed an Mail or fax to the Transcripts of jointly filed tax returns may
Code unless otherwise noted. individual return “Internal Revenue be furnished to either spouse. Only one
signature is required. Sign Form 4506T-EZ
Future Developments and lived in: Service” at:
exactly as your name appeared on the original
For the latest information about developments Alabama, Kentucky, return. If you changed your name, also sign
related to Form 4506T-EZ, such as legislation Louisiana, your current name.
enacted after it was published, go to Mississippi,
www.irs.gov/form4506tez. Tennessee, Texas, a Privacy Act and Paperwork Reduction Act
Caution. Do not sign this form unless all foreign country, Notice. We ask for the information on this
applicable lines have been completed. American Samoa, RAIVS Team form to establish your right to gain access to
Puerto Rico, Guam, Stop 6716 AUSC the requested tax information under the
Purpose of form. Individuals can use Form Austin, TX 73301 Internal Revenue Code. We need this
4506T-EZ to request a tax return transcript for the Commonwealth
512-460-2272 information to properly identify the tax
the current and the prior three years that of the Northern
information and respond to your request. If
includes most lines of the original tax return. Mariana Islands, the you request a transcript, sections 6103 and
The tax return transcript will not show U.S. Virgin Islands, or 6109 require you to provide this information,
payments, penalty assessments, or A.P.O. or F.P.O. including your SSN. If you do not provide this
adjustments made to the originally filed address information, we may not be able to process
return. You can also designate (on line 5) a your request. Providing false or fraudulent
third party (such as a mortgage company) to Alaska, Arizona, information may subject you to penalties.
receive a transcript. Form 4506T-EZ cannot Arkansas, California,
be used by taxpayers who file Form 1040 Routine uses of this information include
Colorado, Hawaii,
based on a tax year beginning in one calendar giving it to the Department of Justice for civil
Idaho, Illinois, and criminal litigation, and cities, states, the
year and ending in the following year (fiscal Indiana, Iowa,
tax year). Taxpayers using a fiscal tax year District of Columbia, and U.S.
Kansas, Michigan, RAIVS Team commonwealths and possessions for use in
must file Form 4506-T, Request for Transcript Minnesota, Montana, Stop 37106 administering their tax laws. We may also
of Tax Return, to request a return transcript. Nebraska, Nevada, Fresno, CA 93888 disclose this information to other countries
Use Form 4506-T to request tax return New Mexico, North 559-456-7227 under a tax treaty, to federal and state
transcripts, tax account information, W-2 Dakota, Oklahoma, agencies to enforce federal nontax criminal
information, 1099 information, verification of Oregon, South laws, or to federal law enforcement and
non-filing, and record of account. Dakota, Utah, intelligence agencies to combat terrorism.
Automated transcript request. You can Washington, You are not required to provide the
quickly request transcripts by using our Wisconsin, Wyoming information requested on a form that is
automated self-help service tools. Please visit subject to the Paperwork Reduction Act
us at IRS.gov and click on “Get Transcript of Connecticut,
unless the form displays a valid OMB control
Your Tax Records” under “Tools” or call Delaware, District of
number. Books or records relating to a form
1-800-908-9946. Columbia, Florida, or its instructions must be retained as long as
Where to file. Mail or fax Form 4506T-EZ to Georgia, Maine, their contents may become material in the
the address below for the state you lived in Maryland, administration of any Internal Revenue law.
Massachusetts, RAIVS Team Generally, tax returns and return information
when the return was filed.
Missouri, New Stop 6705 P-6 are confidential, as required by section 6103.
If you are requesting more than one Kansas City, MO
Hampshire, New The time needed to complete and file Form
transcript or other product and the chart 64999
below shows two different addresses, send Jersey, New York, 4506T-EZ will vary depending on individual
816-292-6102
your request to the address based on the North Carolina, Ohio, circumstances. The estimated average time
address of your most recent return. Pennsylvania, Rhode is: Learning about the law or the form, 9
Island, South min.; Preparing the form, 18 min.; and
Carolina, Vermont, Copying, assembling, and sending the form
Virginia, West Virginia to the IRS, 20 min.
If you have comments concerning the
Line 1b. Enter your employer identification
accuracy of these time estimates or
number (EIN) if your request relates to a
suggestions for making Form 4506T-EZ
business return. Otherwise, enter the first
simpler, we would be happy to hear from you.
social security number (SSN) or your
You can write to:
individual taxpayer identification number (ITIN)
shown on the return. For example, if you are Internal Revenue Service
requesting Form 1040 that includes Schedule Tax Forms and Publications Division
C (Form 1040), enter your SSN. 1111 Constitution Ave. NW, IR-6526
Washington, DC 20224
Line 3. Enter your current address. If you use
a P.O. box, include it on this line. Do not send the form to this address.
Line 4. Enter the address shown on the last Instead, see Where to file on this page.
return filed if different from the address
entered on line 3.
Note. If the address on lines 3 and 4 are
different and you have not changed your
address with the IRS, file Form 8822, Change
of Address.
Signature and date. Form 4506T-EZ must be
signed and dated by the taxpayer listed on
line 1a or 2a. If you completed line 5
requesting the information be sent to a third
party, the IRS must receive Form 4506T-EZ
within 120 days of the date signed by the
taxpayer or it will be rejected. Ensure that all
applicable lines are completed before signing.