Representative filling out form *

Client ID *

Section 1: Basic Information

Owner First Name

Owner Last Name

Street Address

City

State

Country

Postal code

Middle Name

Phone

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Section 1: Basic Information - Cont.

Is there a mortgage on the property? *

Section 1: Basic Information - Cont.

Loan Number

Lender Name

Section 2: Property Details & Situation

What is the client's relationship to the property?

Sole-owner

Co-owner

Relative of the owner

Legal personal representative (executor for probate)

Is the property facing foreclosure?

Is an auction scheduled?

Auction Date / Foreclosure Deadline

What is the estimated payoff amount?

What is the estimated reinstatement amount (if applicable)?

Has a bankruptcy already been filed?

Provide Bankruptcy Details

Bankruptcy District

Bankruptcy Case Number

Bankruptcy Filing Date

Bankruptcy Chapter Filed

Is bankruptcy assistance needed?

Section 4: Bankruptcy Assistance

Date of birth

Last 4 Digits of SSN

Which chapter of bankruptcy is being filed?

Has credit counseling been completed within the last 180 days?

Attach the certificate of completion

Explain why:

How will bankruptcy filing fee be paid?

Enter proposed installment amounts and dates (Form 103A will be populated)

Proposed Amount 1

Proposed Date 1

Proposed Amount 2

Proposed Date 2

Proposed Amount 3

Proposed Date 3

Proposed Amount 4

Proposed Date 4

Proposed Amount Total

Does the client own any business property?

Provide the business name and address

Are there any hazardous properties that require immediate attention?

Describe the issue and location

Is the property involved in probate?

Has a personal representative been appointed?

Is probate assistance needed (financial or filing help)?

Does the client need help becoming the personal representative?

Probate Assistance

Decedent Information

What is the decedent’s full name?

What was the decedent’s date of death?

What was the decedent’s primary address?

What other names did the decedent use (if any)?

What was the decedent’s age at the time of death?

Will and Testacy Status

Did the decedent leave a valid will?

Enter the will’s date

Are there any codicils (amendments) to the will?

List codicil (amendment) dates

Is the original will available?

Explain why original is not available

Has the will been probated in another state or country?

Provide the state or country

Heirs and Interested Parties

List all known heirs or interested parties

Do all heirs agree on the distribution of the estate?

Are there any unknown heirs?

Personal Representative Appointment

Who will serve as the personal representative of the estate?

What is the personal representative’s address?

Street
City
State
Zip

What is the personal representative’s contact information?

Email
Phone

Do all people with equal or higher priority agree to this appointment?

Bond and Administration Type

Is a bond required for the personal representative?

What type of administration are you requesting?

Outstanding Debts and Liens

Does the estate have any outstanding debts or liens?

Provide details of any outstanding debts or liens

Section 2: Final

Is the client working with an attorney?

Is the client working with a real estate agent?

Section 5: Transaction Goals

What is your goal for the property?

What is the client's current annual income?

If selling, what is the client's target profit?

Is there a relocation plan in place?

Enter your desired city and state

Does the property need any repairs or updates?

Describe the repairs or updates needed

Final Administrative questions

How will required documents be signed?

Manual

Digital

Client Contract Start Date

Client Contract Expected End Date