<p>DIVERSION PROGRAM – Materials/Action Plan Court Call Number ____ Conference Number ______</p><p>Homeowner (First & Last Name): ______Contact Phone Number: ______</p><p>Next Appointment Date & Time: ______Next Conference Date & time: ______</p><p>Spoke to: B Lukens __ M Robinson __ OHCD __ Default. Judgment __ FTA __ Excused __</p><p>Documents marked must be provided to housing counselor by ______</p><p>Counselor’s Name: ______Phone Number: ______Ext: ______</p><p>Email address: ______Agency Name: ______</p><p>If you fail to provide the requested documents by the date required you may not have another chance to negotiate with your bank within the Diversion program. From Homeowner:  Picture ID  Hardship Letter (current, dated and signed)  Current proof of ALL household income: four (4) most recent pay stubs, Unemployment determination letter, award letter(s) (SS, SSI, SSD), Food Stamps letter of benefits, Cash Assistance letter of benefits, Child support payment history and court order, Spouse support, etc.  If Self-employed, Current monthly Profit and Lost statement signed and dated.  Two (2) most recent statements of ALL bank accounts, all pages including blank pages (no screen print outs or summaries). A statement of “no bank account” if none exist.  Two (2) most recent Tax returns, all pages and Schedules. The 2nd page of 1040 form signed. A statement of “no Tax filing.” if none filed.  Most current Utility Bills, PECO and PGW (reflecting homeowner’s name)  Non-borrower contribution letter signed and dated.  Deed, Mortgage Complaint, Note, Act 91 or 6. If not escrowed:  Real Estate Taxes information (proof of payment or current payment plan)  Current Homeowner insurance Declaration Page</p><p>If selling the property: Listing agreement, listing history, Agreement of Sale (signed offer), HUD (Estimate closing Statements)</p><p>From Counselor:  REVISED, Financial statement sheet/ Crisis Budget  RMA or 710 form  Dodd-Frank form  HEMAP Application  IRS form 4506-T  Third Party Letter of Authorization</p><p>Other Documents, circle as needed: Divorce documents (Decree, Settlement), Death Certificate, Quit Claim Deed, Wills, Administrator of The Estate docs, Bankruptcy Docs, etc. Other: ______</p><p>Comments: ______</p><p>______</p><p> Lender attorney must have all required documents at least 14 days before the next conference date.  You are required to attend your next conference as scheduled. In case of an emergency please call the hotline at 215-334-4663 and your housing counselor.  If you have trouble locating these documents, or if you are not able to get copies of any of them, please notify your housing counselor as soon as possible.  You must work together with your counselor so that you are both prepared for the next conference. </p><p>Revd. 01/07/14 HOMEOWNER’S SIGNATURE: ______DATE: ______</p><p>Revd. 01/07/14</p>