Non-Delegated Loan Modification Request Form Performing Loans

Non-Delegated Loan Modification Request Form
Performing Loans (Not Delinquent)
Not for Home Affordable Modification / Refinance Loans
Use this form to submit a request for approval of a non-delegated performing loan modification. The criteria
listed below will help you identify if you need to complete this form or if approval by PMI is not required.
Criteria Yes/No Comments
1 Is the new loan a fully amortizing fixed Yes Continue to next question.
rate /fixed payment ARM with a term
equal or greater than 5-years No Complete this form and submit to PMI.
2 Has a new verbal VOE been performed Yes Continue to next question.
No Complete this form and submit to PMI.
3 For loans up to $417,000: Is the
Yes Complete this form and submit to PMI
modified unpaid principal balance (UPB)
greater than the 104% to a maximum of
$5,000 over the original UPB
No Continue to next question.
For loans greater than $417,000: Is the
modified unpaid principal balance (UPB)
greater than the 104% to a maximum of
$10,000 over the original UPB
4 If the P&I increased by 20% have you
verified the borrower’s capacity by
getting a VOI and VOE, a recent W-2 , a
current credit report to verify
outstanding debts, and ensure the DTI is
not greater than 50%
Yes
No
Approval is not required, please submit as
delegated. See http://www.pmius.com/servicers/servicingforms.html
for
additional information and reporting
requirements.
Complete this form and submit to PMI.
Servicer Contact Information
Company Name
Address
Name
Phone #
Fax #
Email
Loan Information
Certificate #
Contract ID # (pool)
Property Address
Servicer Loan #
Borrower Name(s)
Property Address
Investor Name
Investor Loan #
Next Payment Due Date
(before modification)
NonDelegated Performing Loan Mod Request Form Jun2010.doc Page 1

Existing Loan Terms
Modified Loan Terms
Loan Type*
Loan Type
Original UPB $ Modified UPB $
Remaining term before
modification
Modified Term
Original Maturity Date
Modified Maturity Date
Interest Rate % Modified Interest Rate %
P&I Payment $ P&I Payment $
PITI $ PITI $
Occupancy Type **
Interest Only term (yrs)
Periodic ARM cap %
Capitalization Amount $
First payment due date
Borrower Cash
* e.g. 3/1 ARM, 5/1 ARM, Fixed Rate, etc.
Contribution $
** Owner occupied, Second Home or Investor DTI%
Comments:
The undersigned Lender represents and certifies that the above information is correct and complete and
acknowledges that the continuation of mortgage insurance coverage by PMI is provided in reliance upon and
program representations.
Name Date / /
Title
Contact Us
Phone
800.288.1970 x6626
Fax 925.658.6546
E-mail
uwoperations@pmigroup.com
Website www.pmi-us.com/homeownership
PMI Use Only
Approved
Denied Name Date / /
Comments:
NonDelegated Performing Loan Mod Request Form Jun2010.doc Page 2