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Forms

The following is a collection of forms which may require completion, depending on your individual situation.  If you plan to initiate counseling remotely (by telephone or email), please complete the appropriate forms and fax, email or standard mail them to:

 

Email: laurie.powell@wpcog.org
Mail: PO Box 9026, Hickory, NC  28603  Attn: Laurie Powell

 

Otherwise, the required forms may be completed during your first counseling session.

Intake Questionnaire
This form is used to gather information needed by WPCOG to begin loss mitigation counseling.

Fillable Budget Worksheet
This Excel Spreadsheet may be used to calculate your household budget.

WPCOG Third Party Release

This document is required for a WPCOG counselor to speak to your lender on your behalf.

Request for Modification and Affidavit (RMA)
This form is used to request a modification through the  Making Home Affordable Program.

Request for Transcript of Tax Return
Use form 4506-T to order a transcript or other return information free of Charge from the IRS.

Dodd-Frank Certification
The information in this form is requested by the federal government in accordance with the Dodd-Frank Wall Street Reform and Consumer Protection Act (Pub. L. 111-203).

Sample Profit and Loss Statement for Self-Employed Homeowners
A year-to-date income statement or most recent three complete months.