PROOF OF CLAIM ADDENDUM FOR RESIDENTIAL HOME MORTGAGES PAID THROUGH THE CHAPTER 13 TRUSTEE Debtor Name(s) __________________________________Bk Case #_______________ Address of Mortgaged Property____________________________________________ Legal Description: Lot Block Subdivision Creditor Name____________________________Debtor Acct #___________________ Payment Address ________________________________________________________ City_______________________State________Zip_________Phone_______________ Creditor Attorney Name__________________________________________________ Attorney Address________________________________________________________ City________________________State_______Zip_________Phone_______________ Mortgage Information Current Principal Balance_________________________________________________ Regular Monthly Payment Amount__________________Current Interest Rate_____ Is this a variable interest loan? If yes, date of next adjustment_______________ Are property taxes included in the monthly payment? Is insurance included in the monthly payment? Is the loan due in full and payable in less than 5 years? If yes, due date_________________  Yes  No  Yes  Yes  Yes  No  No  No Arrearage Calculation ________ monthly payments of ___________ ____________ ________ monthly payments of ___________ ____________ ________ monthly payments of ___________ Late fees of _______ per month Escrow shortage: tax amt_________ insur. amt_________ Attorney fees for__________________________________ Other (describe)___________________________________ Other (describe)___________________________________ ____________ ____________ ____________ ____________ ____________ ____________ Total arrearage amount to be cured in plan Signature Date ____________ Phone ***Creditor must notice Trustee of any and all changes to monthly mortgage payment. *** American LegalNet, Inc. www.FormsWorkflow.com