UNITED STATES BANKRUPTCY COURT DISTRICT OF NEW JERSEY
Caption in Compliance with D.N.J. LBR 9004-2(c)
In Re:
Case No.: Chapter: Hearing Date: Judge:
__________________ __________________ __________________ __________________
CERTIFICATION RE POST-PETITION PAYMENT HISTORY ON THE NOTE AND MORTGAGE DATED ______________________
__________________________________ of full age, employed as _________________________________________ by _________________________________________, hereby certifies the following information:
BACKGROUND INFORMATION
1. 2. 3. 4. 5. 6. Recorded in ____________________ County, in Book _______________ at Page _______________ Property Address: ____________________________________________________________________________ Mortgage Holder: ____________________________________________________________________________ Mortgagor(s)/ Debtor(s): ______________________________________________________________________ Date debtor(s) petition was filed: ________________________________________________________________ Post-petition payment address: __________________________________________________________________ AMOUNT OF POST-PETITION DEFAULT ( As of _______________ ) 7. 8. 9. Amount of debtor(s) monthly mortgage payment: Amount of debtor(s) monthly late charge: Total monthly payment including late charge: $ _______________ $ _______________ $ _______________
10.
Since the petition date, payments should have been made to the mortgagee. Since the petition date only __________ payment(s) have been made, leaving __________ payment(s) in arrears through the payment due _________________________ . The total amount of post-petition payment default (monthly payments + late charge) is $ __________________ .
Amount Due 1. 2. 3. 4. 5. 6. 7. 8. 9. 10.
TOTAL: $0.00
Date Payment Was Due
How Payment Was Applied (Mo./Yr.)
Amount Received
Date Payment Received
Check or Money Order Number
$0.00
If the monthly payment has changed during the pendency of the case, please explain (attach separate sheet(s) if necessary):
AMOUNT HELD IN SUSPENSE (if any): Principal .................... Interest ....................... Insurance ....................
$ _______________
Effective as of _______________, the current monthly payment is comprised of: ____________________ ____________________ ____________________ (Specify) ________________________________________)
R.E. Taxes .................. ____________________ Late Charge ................. ____________________ Other ........................... ____________________ TOTAL ....................
$0.00 ____________________
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11.
Additional charges and/or advances made post-petition: a) Post-petition bankruptcy fees/costs for within motion: $ _______________ b) Post-petition advances made for taxes: c) Post-petition advances made for insurance: d) Other fees $ _______________ $ _______________ $ _______________
(please specify):______________________________________________________________________________
PRE-PETITION ARREARS:
___________________ to ___________________ ( __________ mos. x $ _______________ /mo. = $ _______________ )
I certify under penalty of perjury that the foregoing is true and correct. ________________________________ Date ________________________________ Signature
rev
rev.6/5/09.jml
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