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Proof of Claim QUESTIONNAIRE

    SecuredUnsecured Deficiency

    Debtor/Creditor Information

    First Name MI Last Name

    List full legal business name as it should appear on the Proof of Claim.

    Claim

    $

    Date the Outstanding Balance was calculated

    YesNo
    YesNo
    $

    YesNo
    $

    Security/Loan Details

    MortgageAuto Loan
     
    Recorded MortgageCert. of TitleUCC Filing

    Date Debtor Executed the Agreement

    Year Make and Mode

    Please include NADA or other basis for valuation


    $0.00

    If negative value listed, the Proof of Claim will include a value of "$0.00."

     
    MotorVehicleOther

    For Office Use Only

    RealEstateOther

    For Office Use Only

    Security/Loan Details

    Please submit all related documents through our secure dropbox located at this link.

    Please note:Multiple documents may be submitted at once simply by using either the"Shift" or "Ctl" keys.

    Loan Summary
    Note
    Security Agreement
    Mortgage
    Certificate of Title
    Notice of Bankruptcy Filing
    NADA Valuation
    Other:

    Please provide any specific instructions/alterations to this Proof of Claim. If none, then please leave blank.