* Required Information
*  First_Name *  State *  Last_Name *  City *  Address *  Email
How is your Credit	Good
	Average
	Bad Average
INCOME	Income-1 Income-2 Total Income
Per Hour
Salary
Self Employed
	=
ABOUT THE PROPERTY
Property Modified
Date of purchase
Lien 1
Lien 2
Notes
Payment missed X Months late = Balance owed
X     =
Option	Keep Home
	Short Sale
	Foreclosure
Total Net income	$   X 35% Top ratio =
EXPENSES:
Home Mortgage
Second Mortgage
Credit Card
Auto Insurance
Auto Payment
Food
Cable
Electric
Gas
Phone charge
Fuel Expense
Health Insurance
Misc
PG&E
Total Expense	$
Bottom ratio
Notes