Plaintiff's Checklist 17th Judicial Circuit Foreclosure Mediation Program (This document must be submitted to the Program Administrator within 10 business days of receiving a Pre-Mediation Report indicating a case is eligible for the Program.) Please list a contact person for this case. The Program Administrator will contact this person to deal with any issues. The contact person may be an attorney representing the plaintiff. Name: Title: Telephone Number: E-mail address: ____________________________________ ____________________________________ ____________________________________ ____________________________________ Home Loan Information Loan servicer: ________________________________________ 1. Does the plaintiff have a second lien on the home? (If yes, please answer A and B below.) Yes No A. Does the plaintiff or the loan servicer participate in Second Lien Modification Program (2MP)? Yes No B. Does the plaintiff or the loan servicer have another program addressing a second lien? Yes No (If yes, please attach a description of the program to this checklist.) Loss Mitigation 2. Has the lender received a complete packet and all required documents necessary for review? Yes No (If no, please attach an itemized list of the missing documents to this checklist.) 3. Has the plaintiff or loan servicer completed review for all applicable Loss Mitigation options? Yes No A. If yes, the documents in the lender's possession will not expire in the next 35 calendar days except for: _____________________________ which must be updated. (Please attach an itemized list, if necessary.) B. If no, please provide explanation and remember to attach the list of any missing documents. Reinstatement/Redemption: 4. As of __________ Reinstatement Amount is: $________ The Acceptance Due Date is: _________ 5. As of ___________ Redemption Amount is: $ ___________ The Acceptance Due Date is: _________ EXHIBIT FM5 This document is not confidential and may be shared with the court. American LegalNet, Inc. www.FormsWorkFlow.com Relinquishment: 6. Check all the relinquishment options available in this case: Short Sale Deed­in-lieu Cash for Keys Consent Judgment Other (please specify): ___________________________ Loan Modification: 7. Is this loan eligible for HAMP? Yes No 8. Can the servicer identify any pooling and servicing agreement or investor guidelines that limit its authority to apply the HAMP modification process to this loan? Yes No (If yes, please attach the restriction or a description of the restriction including the source of the restriction to this checklist.) 9. Please indicate the owner of the loan and any other box that applies: Fannie Mae Ginnie Mae FHA Loan RHS Loan Freddie Mac Private Investor Owned VA Loan Other: _____________ 10. Is there any reason that the Home Affordable Foreclosure Alternative Program would not apply? Yes No (If yes, please attach explanation to this checklist.) 11. Has the plaintiff or loan servicer issued an offer for a loan modification including any streamlined modification? Yes No (If yes, please attach copies of all offers of modification, along with NPV analysis only if applicable and used.) 12. Has the plaintiff or loan servicer issued a denial of a loan modification? Yes No (If yes, please attach copies of all denials, along with NPV analysis only if applicable and used.) 13. Has the plaintiff or loan servicer issued a denial of a relinquishment request? Yes No (If yes, please attach copies of all denials.) Date:_________________________ Prepared by:_____________________________ Title:_________________________ Phone Number: __________________________ Signature:_____________________ EXHIBIT FM5 This document is not confidential and may be shared with the court. American LegalNet, Inc. www.FormsWorkFlow.com