VTB Form W-1 07/2011 UNITED STATES BANKRUPTCY COURT DISTRICT OF VERMONT In re [____________________________], Case # ___________ Chapter 13 REQUEST FOR TRUSTEE APPROVAL OF MORTGAGE MODIFICATION NOW COMES [name of debtor] by and through his/her attorney, [name of attorney], and [name of lender], (hereinafter "Lender") to request the Trustee enter a certificate approving a mortgage modification. In support of this Request, the Debtor and Lender state the following. 1) Check the appropriate box: The above named debtor(s) granted the Lender a mortgage (copy attached as Exhibit A) secured by a loan, evidenced by a promissory note dated [date] payable to [Lender name] in the original amount of $__________ (a copy attached as Exhibit B) on [date], secured by real estate located at [address]. The Lender became holder of the of the note and assignee of mortgage through the following transactions: 2) 3) The debtor(s) filed for relief under Chapter 13 (or 12) on [date]. The Lender affirms that: (A) it is the holder of the promissory note represented by Exhibit A, the obligation of which is secured by the subject mortgage shown on Exhibit B; (B) it has standing to enforce the above referenced promissory note and mortgage and has full authority to modify the terms of the note and mortgage; and (C) the sums due under the note as modified and reflected below are not more than the amount currently due under the loan to be modified. 1 American LegalNet, Inc. www.FormsWorkFlow.com 4) The debtor(s) and [Lender name] have agreed that the above referenced mortgage shall be modified in the following respects: (enumerate changes to mortgage) 5) The Debtor(s) affirm that: (A) the property encumbered by the subject mortgage [is/is not] the debtor's primary residence; (B) the debtor will not receive any cash or incur any new debt through the mortgage modification; (C) the modification will reduce the debtor's monthly mortgage payment by $_____; and (D) as a result of the modification, the debtor will be able to make a payment of $_________ to the Chapter 13 Trustee and this amount is sufficient to fund a Chapter 12 or 13 plan. Date: ______________ ____________________________ Debtor's Name Date: ______________ ____________________________ Joint Debtor's Name Date: ______________ By :_________________________ Attorney For Debtors Date: ______________ Lender's Name By: ___________________________ Authorized Representative of Lender 2 American LegalNet, Inc. www.FormsWorkFlow.com UNITED STATES BANKRUPTCY COURT DISTRICT OF VERMONT In re [____________________________], Case # ___________ Chapter 13 _________________________________________ NOTICE OF REQUEST FOR TRUSTEE APPROVAL OF MORTGAGE MODIFICATION Notice is hereby given to all parties in interest that a request has been made to the Trustee for approval of the above referenced mortgage modification IF YOU OPPOSE THE APPLICATION you must file a written opposition with the Clerk of the Court, on [date]. A copy must also be served on the Debtor, the Debtor's counsel, the Office of the U.S. Trustee, the Chapter 13 Trustee. Addresses for those parties are set forth below. IF AN OPPOSITION IS TIMELY FILED, the Court will hold a hearing on the Application and any opposition at [time] on [date] at the following location: [indicate Rutland or Burlington location], IF NO OPPOSITION IS TIMELY FILED, the Chapter 13 Trustee may issue a Certificate of Approval authorizing the debtor to proceed with the mortgage modification. Dated at [location] this [day] of [month] [year]. ___[Signature of Movant-Attorney]____ [Printed Name of Movant-Attorney] [Address] [E-mail address] [Phone #] [Fax #] Chapter 13 Trustee Jan M. Sensenich P.O. Box 1326 Norwich, VT 05055 U..S. Trustee 74 Chapel St, Ste 200 Albany, NY 12207-2190 Counsel for Debtor [Name of Law Firm, if any] [Street Address or P.O. Box] [City, State, Zip Code] 3 American LegalNet, Inc. www.FormsWorkFlow.com