Client intake petition

14-Day Program Client Intake Petition

Introductory enrollment is limited to credit card debt, student loans, home loans, and car loans.

Save or resume this intake

The system stores a saved draft so that you can return and finish this intake later.

Draft reference

Draft access code

Client information

First name *

Last name *

Email *

Phone *

Mailing address

City

State where you reside *

Postal code

Obligation and transaction information

Obligation type *

Lender *

Servicer

Trustee, if known

Account number and/or loan number *

Original agreement amount

Current balance

Property addressEnter only the property street address, city, state, and postal code. Do not enter parcel, unit, lot, or block numbers.

Was there a loan modification? *

Original transaction: If there was a loan modification, the original transaction is the transaction identified with respect to this document. Complete the following original-transaction fields.

Original-transaction lender

Original account and/or loan number

Original-transaction date

How was the transaction processed? *

Bank that processed the transaction

When an organization utilized a bank to process the transaction, identify that bank. Under such circumstances, the bank is identified in law as an intermediary or custodian.

Date the promise-to-pay note, otherwise known as the promissory note, was initiated or deposited *

Transaction or relationship description

Existing CLOCEST member?

Mortgage-backed security information

Is the note associated with a mortgage-backed security?

Securitization trustee

Securitization trust name

Trust or pool name and/or number associated with the account

If the note is associated with a mortgage-backed security, contact the organization and request the securitization trustee and securitization trust information. If the financial institution or its servicer states that it does not know what is being requested, ask for the name or number of the mortgage-backed-security trust or pool associated with the account and the name, address, and appropriate contact information for the trustee.

Authority requiring the information: 12 C.F.R. § 1024.36(a) and (d), including Official Interpretations 36(a)-1 and 36(a)-2(ii), recognizes an information request submitted by the borrower’s authorized agent. When the mortgage loan is held in a trust, the servicer’s response identifies, as applicable, the trust name and the trustee’s name, address, and appropriate contact information. An express request for the trust or pool name or number requires that identifying information in the circumstances addressed by Official Interpretation 36(a)-2(ii). 12 U.S.C. § 2605(k)(1)(D) requires a servicer of a federally related mortgage to respond within 10 business days to a borrower’s request for the identity, address, and other relevant contact information of the owner or assignee. 15 U.S.C. § 1641(f)(2) requires the servicer, upon the obligor’s written request, to provide the name, address, and telephone number of the owner of the obligation or master servicer, to the best knowledge of the servicer.

Client authorization and signature

This intake operates as the client’s grant to SATCOMM of a limited Power of Attorney for SATCOMM to communicate on the client’s behalf. The Power of Attorney is limited in scope with respect to the alleged debt identified in this intake.

This is not a validation request. It is a verification under the common and ordinary meaning of verify or verification and/or an authentication under the common and ordinary meaning of authenticate or authentication, as prescribed in law.

The client may withdraw consent and/or the limited Power of Attorney at any time by providing 15 business days’ advance notice.

Choose how to sign * Handwritten signature Electronic signature

Signature date *

Program documents

14-Day Program accession

Common-Law trust

CLOCEST White Paper