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THE CIRCUIT COURT OF THE ELEVENTH JUDICIAL MCLEAN COUNTY, ILLINOIS FORECLOSURE MEDIATION PROGRAM PLAINTITFF’S QUESTIONNAIRE FORM Exhibit Page 1 of 4 Plaintiff’s Name: v. Defendant’s Name: Case Number: A. Plaintiff Contact Information Please list a contact person for this case. The Program Coordinator will contact this person to deal with scheduling and other issues. The contact person may be an attorney representing the plaintiff. Name: Address: Telephone Number: Email address: B. Standing Specify what basis Plaintiff asserts that it is entitled to enforce the negotiable instrument: If not already attached to the complaint, please attach any documentation evidencing standing and capacity of the Plaintiff to file suit including: a copy of the loan note and any riders, a copy of each and every endorsement of the loan note or in the case of bearer paper, a copy of all documents showing the date of the transfer of possession, and a copy of each assignment of the mortgage/deed of trust. C. Estimated Amount Owed on the Home Loan Original Loan Amount: Amount in Default: Late Fees: Other Advances: Attorney Fees: Court Cost/Fees: Please attach a copy of the Truth in Lending statement, a copy of the final settlement statement and a copy of the payment history. ---PAGE BREAK--- THE CIRCUIT COURT OF THE ELEVENTH JUDICIAL MCLEAN COUNTY, ILLINOIS FORECLOSURE MEDIATION PROGRAM PLAINTITFF’S QUESTIONNAIRE FORM Exhibit Page 2 of 4 D. Loan Modification Eligibility 1. Who is the loan servicer? 2. Does the servicer participate in HAMP?  Yes  No 3. If yes, does a pooling and servicing agreement, investor guideline, or any other agreement, limit in any way any step in the HAMP modification process?  Yes  No Please attach the pooling and servicing agreement and investor guidelines.i Mark it as a response to question C3. 4. Please indicate the owner and/or type of loan at issue:  Fannie Mae  FHA Loan  Private Investor Owned  Freddie Mac  VA Loan  Ginnie Mae  RHS Loan 5. Has the plaintiff or the loan servicer considered defendant(s) for a loan modification? If yes, please attach the decision concerning the modification considered. 6. Does the plaintiff or the loan servicer offer any private loan modification options?  Yes  No If yes, please provide, if practicable, a description of the program(s) by attaching it to this questionnaire; mark it as response to question 6. 7. Is there any reason that the Home Affordable Foreclosure Alternative Program (HAFA) would not apply?  Yes  No If yes, please describe any 8. Does the plaintiff have a second lien on the home?  Yes  No A. If yes, does plaintiff or the loan servicer participate in Second Lien Modification Program (2MP)?  Yes  No B. If no, does plaintiff or the loan servicer have another program for addressing a second lien?  Yes  No If yes, please attach a description the program. Mark it as a response to question 8B. ---PAGE BREAK--- THE CIRCUIT COURT OF THE ELEVENTH JUDICIAL MCLEAN COUNTY, ILLINOIS FORECLOSURE MEDIATION PROGRAM PLAINTITFF’S QUESTIONNAIRE FORM Exhibit Page 3 of 4 E. NPV Advances/Escrow Past Due: Loan Product Description (ARM/Internet Only, Fixed One Step Variable, etc.): Current Fair Market Value of Property: Current Interest Payment: Current Interest Rate: Current Mortgage Payment: Current Principal Payment: Current Unpaid Balance (UPB): Future Interest and Advanced Escrow: Home Price Appreciation Forecast: insurance payment: real estate taxes: Months Past Due: Next ARM reset date: Original Amortization Term: Original Interest Rate: Original Loan Amount: Past Due Interest: Principal and interest payment before modification: Projected Foreclosure & REO Disposition Costs: Projected Home Price Appreciation: Projected Months to Foreclosure Sale: Projected Months to Re-default: Projected Months to REO Sale: Projected Re-default Rate after a Modification: Real Estate Owned (REO) Stigma Discount: Remaining Mortgage Term (in months): ---PAGE BREAK--- THE CIRCUIT COURT OF THE ELEVENTH JUDICIAL MCLEAN COUNTY, ILLINOIS FORECLOSURE MEDIATION PROGRAM PLAINTITFF’S QUESTIONNAIRE FORM Exhibit Page 4 of 4 F. Is there any other information that you believe would be helpful in reaching a solution? If you need more space, please attach additional sheets that are labeled with a response to the appropriate letter and number. G. Prepared By: Title: Telephone Number: (Signature) (Date)