Assignment of Mortgage Payments Program Application
Please complete this form and fax it to 281-605-5032 .
You may also return this to your Realtor®/investor or other referring party.
You will receive a Paperwork Package and additional instructions by email within 48 hours.
Today’s Date: _____________________________________
REALTOR®/Investor Information
Name: _______________________________________________________
Email: _______________________________________________________
Phone number: ___________________________________ Alternate Number: _________________________________
HOMEOWNER Information
Name: _______________________________________________________
Other Names on the Deed: _______________________________________________________
Other Names on the Loan: _______________________________________________________
Email: _______________________________________________________
Phone number: ___________________________________ Alternate Number: _________________________________
Property Information
Property Address: __________________________________
City: __________________________________________ State: _________________________________________
Zip: __________________________________________ County: ________________________________________
Legal Description (if known):___________________________________________________________________________________________
Mortgage Information
1st mortgage servicer (lender name): ________________________________ Loan No.______________________________________
Loan Type: FHA VA Conventional Private ARM (Select One) Interest Rate: ____________________________
Approximate balance:________________________________ Date last payment made:______________________________
2nd mortgage servicer (lender name): _______________________________ Loan No.______________________________________
Loan Type: FHA VA Conventional Private ARM (Select One) Interest Rate: ____________________________
Approximate balance:________________________________ Date last payment made:______________________________
Other information: __________________________________________________________________________________________________
________________________________________________________________________________________________________________________
Humble Homz, LLC
c/o Charles Gardner
4582E Kingwood Dr-Ste 162
Kingwood, TX 77345
info@humble-homz.com