Dear Client, Photo ID Driver s license or Maryland State issued photo ID PLEASE COMPLETE/SIGN AND RETURN THESE ENCLOSED FORMS

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1 Dear Client, Thank you for choosing Neighborhood Housing Services of Baltimore, Inc. for your homeownership retention and financial needs. To schedule an individual counseling appointment with a Homeownership Advisor, please forward copies (no originals) of the following documents to the office. You may provide these items via fax, , US mail or personal delivery to the NHS of Baltimore office. Please retain the copy of the NHS of Baltimore Privacy Policy, Conflict of Interest, Complaint policies and Resource referral included. For more information contact Kira Gardner-Marshall at ext IF YOU HAVE AN ORDER TO DOCKET OR FORECLOSURE SALE DATE YOU MUST CALL A HOMEOWNERSHIP ADVISOR IMMEDIATELY. IF YOU ARE NOT THE HOMEOWNER PLEASE CONTACT OUR OFFICE BEFORE SUBMITTING THIS APPLICATION. ALL APPLICATIONS CAN BE E-FAXED TO Most recent mortgage statements, collection notices, legal notices Last 2 months of checking and/or savings statements Last 3 pay stubs, current Social Security award, Retirement, Pension, Annuity statement If self-employed, provide federal tax return with all attachments for the last three most recent years If self-employed, provide profit & loss statement (year-to-date). W2 s for the last two most recent years Federal Tax returns filed for the last two most recent years Hardship letter Copy of most recent utility bill Property of recent property tax bill Recent Home Owners Association statement (if applicable) Credit report fee - Single Bureau Individual Report $6.70; Joint Report $ PAYABLE THRU PAYPAL OR CHECK, MONEY ORDER PAYABLE TO NHSB. Photo ID Driver s license or Maryland State issued photo ID PLEASE COMPLETE/SIGN AND RETURN THESE ENCLOSED FORMS Client Intake forms pages 1 and 2 Budget form NHS of Baltimore, Inc. Disclosure NHS of Baltimore Hold Harmless Authorization Authorization to speak to your Lender/Servicer Authorization to pull your credit report 2012 Area median income disclosure Foreclosure mitigation counseling agreement Privacy Policy You may bring settlement folder received at closing with you for the counseling appointment. For question or concerns, please contact a homeownership advisor. Sincerely, Neighborhood Housing Services of Baltimore, Inc.

2 CLIENT INAKE FORM - DEFAULT AND DELINQUENCY DATA PLEASE PRINT INTAKE DATE TIME INTAKE STAFF YES NO Have you spoken with any other Counseling Agency? If yes, provide name of agency. YES NO Have you filed for bankruptcy or are you currently in bankruptcy? YES NO Have you spoken with Mortgage Lender/Servicer? Date of last contact: YES NO Do you want to remain in your home? Are you living in the property? YES NO YES NO If no, is your home currently listed for sale? Rental? YES NO YES NO Do you live in Baltimore County? YES NO Have you received: Notice of Intent to Foreclose? Date Order to Docket YES NO Date YES NO Do you currently have a trial modification? YES NO Have you submitted a loss mitigation (foreclosure) application to your lender? If so, when. CLIENT 1: Name Date of Birth Social Security Number Current Employer Hire Date Position Annual Income CLIENT 2: Name Date of Birth Social Security Number Current Employer Hire Date Position Annual Income

3 Home Address: City State Zip Code How Long? Home Phone: Cell Phone Address Number of People in Household Ages TYPE OF HOME Single Family Condo Townhome Co-Op 2-4 Unit Number of Months Past Due Date of Last Payment CAUSE OF DELINQUENCY: Loss of Income Reduction in Income Medical Issues Increase in Expense Death of Family member Divorce/Separation Increase in Mortgage Payment Poor budget management skills Business Venture Failure Other Is this a permanent or temporary situation?

4 MORTGAE LOAN DETAILS 1st Mortgage Lender/Servicer Loan Number Date loan was obtained $ $ % Amount Borrowed Balance Rate Mortgage Payment Homeowners Insurance Policy Amount Phone Number TYPE OF MORTGAGE: FHA CONVENTIONAL VA FIXED ARM INTEREST ONLY Current Property Value Who pays the property taxes? Do you pay HOA Fees? YES NO HOA Monthly Amount 2nd Mortgage Lender/Servicer Loan Number Date loan was obtained $ % $ Loan Balance Interest Rate Mortgage Payment TYPE OF MORTGAGE: FIXED ARM CONVENTIONAL INTEREST ONLY $ Current Property Value

5 DEMOGRAPHICS: CLIENT 1: MALE FEMALE AMERICAN INDIAN / ALASKAN NATIVE ASIAN BLACK / AFRICAN AMERICAN NATIVE HAWAIIAN / OTHER PACIFIC ISLANDER WHITE AMERICAN INDIAN / ALASKAN NATIVE / WHITE ASIAN AND WHITE BLACK / AFRICAN AMERICAN AND WHITE AMERICAN INDIAN / ALASKAN NATIVE AND BLACK / AFRICAN AMERICAN OTHER NOT AVAILABLE YES NO HISPANIC ETHNICITY CLIENT 2: MALE FEMALE AMERICAN INDIAN / ALASKAN NATIVE ASIAN BLACK / AFRICAN AMERICAN NATIVE HAWAIIAN / OTHER PACIFIC ISLANDER WHITE AMERICAN INDIAN / ALASKAN NATIVE / WHITE ASIAN AND WHITE BLACK / AFRICAN AMERICAN AND WHITE AMERICAN INDIAN / ALASKAN NATIVE AND BLACK / AFRICAN AMERICAN OTHER NOT AVAILABLE YES NO HISPANIC ETHNICITY HOUSEHOLD TYPE: SINGLE ADULT / NON ELDERLY FEMALE HEADED SINGLE FAMILY MALE HEADED SINGLE FAMILY MARRIED WITHOUT CHILDREN MARRIED WITHOUT CHILDREN TWO OR MORE UNRELATED ADULTS OTHER FOREIGN BORN. ARE YOU A US CITIZEN? I/We have received a copy of the NHS of Baltimore, Inc. Privacy Policy, Disclosure, Hold Harmless/Authorization Agreement, Complaint Policy, Conflict of Interest Policy, Referral List (HCA/Lender) Borrower Signature: Co-Borrower Signature: Date:

6 Lender / Servicer Date Lender / Servicer Fax Number NHS of Baltimore From RE: Pages (including cover sheet) Borrower(s) Last Name Borrower(s) First Name Loan Number Borrower(s) Last Name Borrower(s) First Name Property Address City, State, Zip I hereby authorize you, your investors, affiliates, agents, representatives and assign to release and provide any and all information regarding my mortgage loan to Neighborhood Housing Services of Baltimore, Inc. I further give you permission to discuss my mortgage account with the Housing Counselors and to permit the Housing Counselors to speak on my behalf. A photographic or carbon copy of this authorization (being a photographic or carbon copy of the signature (s) of the undersigned) may be deemed to by the equivalent of the original and may be used as a duplicate original. This authority will remain in effect until I notify you to cancel such authorization. Your prompt reply will help to expedite my request for assistance. Borrower Signature: Date Print Name Social Security Number Co-Borrower Signature: Date Print Name Social Security Number Counselor Signature Date

7 HOUSEHOLD BUDGETING WORKSHEET TOTAL MONTHLY GROSS INCOME TOTAL MONTHLY NET INCOME HOUSING EXPENSES RENT OR 1ST MORTGAGE PAYMENT RENT OR 2ND MORTGAGE PAYMENT UTILITIES CONDOMINIUM/HOA FEE RENTER S INSURANCE WATER/SEWER (MONTHLY) TOTAL AUTO EXPENSES CAR PAYMENT GAS INSURANCE MAINTENANCE TOLLS, EZ PASS PARKING TOTAL DEBTS CREDITOR #1 CREDITOR #2 CREDITOR #3 CREDITOR #4 TOTAL DISCRETIONARY CHURCH, TITHES AND OFFERINGS CHARITABLE CONTRRIBUTIONS GROCERIES LUNCHES, MEALS OUT CHILDCARE SCHOOL TUITION/SUPPLIES SCHOOL ACTIVITIES MEDICAL BILLS AND CO-PAYS PRESCRIPTION MEDICINES PET SUPPLIES & VET EXAMS ENTERTAINMENT (ALCOHOL, BOOKS, MUSIC, MOVIES, VACATION, SPORTS, CONCERTS, ETC,)

8 NEWSPAPER, MAGAZINE SUBSCRIPTIONS CABLE LANDLINE PHONE CELL PHONE INTERNET CLOTHING PERSONAL CARE ITEMS (TOILETRIES, ETC.) HAIR CARE, NAILS, ETC GIFTS, HOLIDAYS MEMBERSHIPS, UNION DUES OTHER TOTAL MONTHLY EXPENSES TOTALS HOUSING AUTO DEBTS DISCRETIONARY TOTAL EXPENSES MONTHLY SURPLUS / SHORTAGE Total Net Income Minus Total Expenses Equal Monthly Surplus or Shortage TIP: The monthly Surplus is the amount available for savings. If there is a shortage or break even, you must reduce your discretionary spending. Purchasing at an affordable level, setting goals and establishing reserve savings for emergencies and unexpected changes in income is the key to sustaining home ownership.

9 FY 2015 AREA MEDIAN FAMILY INCOME LIMITS VERIFIABLE CERTIFICATION INCOME LIMITS EFFECTIVE: March 6, 2015 AREA MEDIAN FAMILY INCOME: $89, SOURCE U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT In order to qualify as an individual or household eligible to participate in Community Development Block Grant Program (CDBG) assisted activities, you must certify your current family or household annual (gross) income. Please check the income in the box below that accurately indicates the annual (gross) income of your family (for all CDBG non-housing, non-area benefit national objective activities) or household (for all CDBG l/m housing national objective activities). BALTIMORE, MARYLAND FFY 2015 Income Limit Area Median Family Income FFY 2015 Income Limit Category 1 Person 2 Person 3 Person 4 Person 5 Person 6 Person 7 Person 8 Person Extremely Low Income Limits 30% of Median $18,550 $21,200 $23,850 $26,500 $28,650 $32,570 $36,730 $40,890 Baltimore City $89,600 Very Low Income Limits 50% of Median $30,950 $35,400 $39,800 $44,200 $47,750 $51,300 $54,850 $58,350 Low Income Limits 80% of Median $46,100 $52,650 $59,250 $65,800 $71,100 $76,350 $81,600 $86,900 I hereby certify that the information checked above is my current annual family or household gross income (select one). The income certified above is subject to verification and the Federal False Claims Act, 31 U.S.C. #3739 et. seq. Signature Date Print Name Signature Date Print Name

10 FORECLOSURE MITIGATION COUNSELING AGREEMENT PART I I understand that (NHSB) provides foreclosure mitigation counseling after which I will receive a written action plan consisting of recommendations for handling my finances, possibly including referrals to other housing agencies as appropriate. I understand that (NHSB) receives Congressional funds through the National Foreclosure Mitigation Counseling (NFMC) program and, as such, is required to share some of my personal information with NFMC program administrators or their agents for purposes of program monitoring, compliance and evaluation. I give permission for NFMC program administrators and/or their agents to follow-up for the purpose of program evaluation. I acknowledge that I have received a copy of (NHSB) s Privacy Policy, Conflict of Interest Policy and Services Disclosure. Part II I may be referred to other housing services of the organization or another agency or agencies as appropriate that may be able to assist with particular concerns that have been identified. I understand that I am not obligated to use any of the services offered to me. A counselor may answer questions and provide information, but not give legal advice. If I want legal advice, I will be referred for appropriate assistance. I understand the (NHSB) provides information and education on numerous loan products and housing programs and I further understand that the housing counseling I receive from (NHSB) in no way obligates me to choose any of these loan products or housing programs. Signature Date Print Name Signature Date Print Name

11 NEIGHBOROOD HOUSING SERVICES OF BALTIMORE DISCLOSURE STATEMENT Neighborhood Housing Services of Baltimore is a nonprofit organization with a mission to create and sustain homeownership in the Baltimore metro region. To assist residents and potential resident of Maryland, we offer the following products and services. Lending Products Home Buyer Education Pre-purchase Counseling Post-Purchase Counseling Post-Purchase Education Foreclosure Prevention Counseling Fast Track Financial Fitness These products are available to any customer that requests them; however, NHS of Baltimore, Inc. does not mandate that any client utilize any service other than those specified during intake. Clients are not obligated to receive any other services offered by the organization or its exclusive partners. CLIENT STATEMENT I have read the above mentioned disclosure and understand that I am under no obligation and have not been steered toward any of the above products or services. Signature Date Print Name Signature Date Print Name Counselor Signature Date

12 HOLD HARMLESS AGREEMENT AND AUTHORIZATION I (we) agree to hold harmless and indemnify Neighborhood Housing Services of Baltimore, Inc. and its employees, member officers and directors in connection with acts performed by them which would reasonably be associated with consultation, technical advice, financial counseling, loan processing, property inspection, construction management and other related activities. I (we) further agree to indemnify, hold and save harmless the City of Baltimore and its Department of Housing and Community Development; and the State of Maryland and its Department of Housing and Community Development, from any and all losses, claims or damages of every nature or description arising out of or in connection with this contract. I (we) authorize the staff of Neighborhood Housing Services of Baltimore, Inc., to obtain specific reports and verifications such as personal credit reports, income and asset information, etc. from any organization or entity that may be involved during the counseling process. I (we) understand that a photocopy of this form will serve as authorization. DATED THIS Month Date Year Signature Printed Name Social Security Number Signature Printed Name Social Security Number

13 CREDIT REPORT AUTHORIZATION (BORROWER) Borrower: First Middle Last Co-Borrower: First Middle Last Address: City State Zip Borrower Social Security Number: - - Co-Borrower Social Security Number (if both named on mortgage) - - Borrower Date of Birth: - - Co-Borrower Date of Birth: - - I (We) hereby give permission to pull my (our) credit report for the purposes of my (our) application for assistance in regards to my (our) home or my (our) mortgage loan. Both Signatures are required if joint report is requested: Signature Date Print Name Signature Date Print Name

14 PRIVACY POLICY AND PRACTICES OF NEIGHBORHOOD HOUSING SERVICES OF BALTIMORE, INC. We at Neighborhood Housing Services of Baltimore, Inc., value your trust and are committed to the responsible management, use and protection of personal information. This notice describes our policy regarding the collection and disclosure of personal information. Personal information, as used in this notice, means information that identifies an individual personally and is not otherwise publicly available information. It includes personal financial information such as credit history, income, employment history, financial assets, bank account information and financial debts. It also includes your social security number and other information that you have provided us on any applications or forms that you have completed. INFORMATION WE COLLECT We collect personal information to support our lending operations, financial fitness counseling and to aid you in shopping for and obtaining a home mortgage from a conventional lender. We collect personal information about you from the following sources: Information that we receive from you on applications or other forms. Information about your transactions with us, our affiliates or others. Information we receive from a consumer reporting agency. Information that we receive from personal and employment references. INFORMATION WE DISCLOSE We may disclose the following kinds of personal information about you: Information we receive from you on applications or other forms, such as your name, address, social security number employer, occupation, assets, debts and income. Information about your transactions with us, our affiliates or others, such as your account balance, payment history and parties to your transactions. Information we receive from a consumer reporting agency, such as your credit bureau reports, your credit history and your creditworthiness. TO WHOM DO WE DISCLOSE We may disclose your personal information to the following types of unaffiliated third parties: Financial service providers, such as companies engaged in providing home mortgage or home equity loan. Others, such as nonprofit organizations involved in community development, but only for program review, auditing, research and oversight purposes. CONFIDENTIALITY AND SECURITY We restrict access to personal information about you to those of our employees who need to know that information to provide products and services to you and to help them do their jobs, including underwriting and servicing of loans, making loan decisions, aiding you in obtaining loans from others, and financial counseling. We maintain physical and electronic security procedures to safeguard the confidentiality and integrity of personal information in our possession and to guard against unauthorized access. We use locked files, user authentication and detection software to protect your information. Our safeguards comply with federal regulations to guard your personal information. IF YOU WANT MORE INFORMATION If you want more information regarding our Privacy Policy please contact us at or write to Neighborhood Housing Services, 25 E. 20th Street, Suite 170 Baltimore, Maryland

15 PRIVACY POLICIES By signing below, I hereby affirm that I have received the Privacy Policy for Neighborhood Housing Services of Baltimore, Inc. (NHSB). Client Signature Print Name Date Client Signature Print Name Date Rev. April 2015

16 GENERAL CONFLICT OF INTEREST POLICY APPLICATION OF POLICY This policy applies to board members, employees, relatives of employees, and certain volunteers of Neighborhood Housing Services of Baltimore, Inc. (NHS), hereafter referred to as Staff. A volunteer is covered under this policy if that person has been granted significant independent decision making authority with respect to financial or other resources of the organization. Clients of NHS are hereinafter referred to as interested parties. DETERMINING A CONFLICT OF INTEREST A conflict of interest may exist when the interests or concerns of Staff may be seen as competing with the interests or concerns of an Interested Party. There are a variety of situations, which raise conflict of interest concerns including, but not limited to, the following: FINANCIAL INTERESTS A conflict may exist where Staff directly or indirectly benefits or profits as a result of a decision or transaction entered into with an Interested Party. Examples include situations where: Staff contracts to purchase or lease goods, services, or property from an Interested Party; Staff purchases an ownership interest in or invests in property owned by an Interested Party; Staff is provided with a gift, gratuity, or favor of a substantial nature from a person or business entity for referring an Interested Party to that person or business entity; OTHER INTERESTS A conflict may also exist where Staff obtains a non-financial benefit or advantage that they would not have obtained absent their relationship with an Interested Party. Examples include: Staff seeks to make use of confidential information obtained from an Interested Party for their own benefit or for the benefit of a relative, business associate, or other organization; or Staff seeks to take advantage of an opportunity or enables a relative, business associate or other organization to take advantage of an opportunity which they have reason to believe would be of interest to an Interested Party.

17 GENERAL CONFLICT OF INTEREST POLICY DISCLOSURE OF ACTUAL OR POTENTIAL CONFLICTS OF INTEREST Staff is under a continuing obligation to disclose any actual or potential conflict of interest as soon as it is known or reasonably should be known. Staff shall complete a disclosure statement at such time as an actual or potential conflict arises and shall be provided to the Chief Executive Officer of the organization. For board members, the disclosure statement shall be provided to the President (Chairman) of the Board. The President s (Chairman s) disclosure statement shall be provided to the Secretary of the Board. Copies shall also be provided to the Chief Executive Officer of the organization. In the case of volunteers with significant decision making authority, the disclosure statements shall be provided to the Chief Executive Officer of the organization. The Chief Executive Officer s disclosure statement shall be provided to the President (Chairman) of the board. The Secretary of the Board shall file copies of all disclosure statements with the official corporate records of the organization. Interested parties who believe that a conflict of interest may or does exist as a result of Staff's interaction with said interested party, may file a formal written complaint with the Chief Executive Officer of NHS. Whenever there is reason to believe that an actual or potential conflict of interest exists between Staff of NHS and an interested party, the board of directors shall determine the appropriate organizational response. This shall include, but not necessarily be limited to, invoking the procedures described below, with respect to a specific proposed action or transaction. PROCEDURES FOR ADDRESSING CONFLICTS OF INTEREST - SPECIFIC TRANSACTIONS Where an actual or potential conflict exists between Staff of NHS and an interested party with respect to a specific proposed action or transaction, Staff shall refrain from the proposed action or transaction until such time as the proposed action or transaction has been approved by the disinterested members of the board of directors of the organization. The following procedures shall apply: Staff who has an actual or potential conflict of interest with respect to a proposed action or transaction of the corporation shall not participate in any way in, or be present during, the deliberations and decision making of the organization with respect to such action or transaction. Staff may, upon request, be available to answer questions or provide material factual information about the proposed action or transaction.

18 GENERAL CONFLICT OF INTEREST POLICY The disinterested members of the board of directors may approve the proposed action or transaction upon finding that it is in the best interests of the corporation. The board shall consider whether the terms of the proposed transaction are fair and reasonable to the organization and whether it would be possible, with reasonable effort, to find a more advantageous arrangement with an entity that is not an interested party. Approval by the disinterested members of the board of directors shall be by vote of a majority of directors in attendance at a meeting at which a quorum is present. An interested party shall not be counted for purposes of determining whether a quorum is present, or for purposes of determining what constitutes a majority vote of directors in attendance. The minutes of the meeting shall reflect that the conflict disclosure was made, the vote taken and, where applicable, the abstention from voting and participation by the interested party. VIOLATIONS OF CONFLICT OF INTEREST POLICY If the board of directors has reason to believe that Staff has failed to disclose an actual or potential conflict of interest, it shall inform the person of the basis for such belief and take the appropriate action. Rev. April 2015

19 COMPLAINT PROCESS Clients of Neighborhood Housing Services of Baltimore, Inc., (NHS), from time to time, may not be completely satisfied with the level of service provided and may wish to file a formal complaint. If the nature of the complaint deals with the services provided by a third party, such as a lender or contractor, then the complaint should be submitted directly to the appropriate party with a copy to NHS. While we are not able to exert influence over third party providers, we are always striving to work with only those businesses that provide the highest quality of service to our clients. Lender complaints can be filed with the Commissioner of Consumer Credit while contractor complaints will be governed by the "Arbitration" clause of the Contract entered into between the contractor and the client. If your complaint deals specifically with NHS, the following steps must be taken. You must provide, in writing, a complete explanation outlining the nature of the complaint including any NHS employees involved. You must also provide a phone number where you may be reached during the day should additional questions be necessary. The written complaint must be delivered, either via mail or in person, to the attention of the Chief Operating Officer of Neighborhood Housing Services of Baltimore at 25 E.20 th Street Suite 170 Baltimore, MD Upon receipt of your complaint, the Chief Operating Officer will investigate and respond in writing within ten (10) days. If your complaint is not resolved to your satisfaction, you my request a review by the Executive Director of NHS. The request for the Executive Director's review must also be made in writing and delivered to the address listed above. Upon receipt of the request, the Executive Director will review the complaint and issue a written response within ten (10) days. The decision of the Executive Director shall be viewed as final. Rev. April 2015