Free FORM 4001-1 – Post-Petition Payment History - Pennsylvania

Clear

Save As...
LOCAL BANKRUPTCY FORM 4001-1

IN THE UNITED STATES BANKRUPTCY COURT FOR THE MIDDLE DISTRICT OF PENNSYLVANIA IN RE: : : : : : CHAPTER 13 CASE NO. -bk-

Debtor(s)

POST-PETITION PAYMENT HISTORY NOTE AND MORTGAGE DATED ______________________ Recorded on __________, in ___________________ County, in Book _____, at Page______. Property Address: __________________________________________________________________ Mortgage Servicer: __________________________________________________________________ Post-petition mailing address for Debtor(s) to send payment: __________________________________________________________________ Mortgagor(s)/Debtor(s): ____________________________________________________________ Payments are contractually due: Monthly____ Semi-monthly_____ Bi-weekly______ Other _______________

Each Monthly Payment is comprised of: Principal and Interest....... ____________________ R.E. Taxes...................... ____________________ Insurance........................ ____________________ Late Charge.................... ____________________ Other.............................. ____________________ (Specify: ______________________) TOTAL......................... ____________________ POST-PETITION PAYMENTS (Petition was filed on ________________)

Payment amount due

Date payment was due

Date payment was received

Amount received

Check number

How payment was applied (mo./yr.)

[Continue on attached sheets if necessary] TOTAL NUMBER OF POST-PETITION PAYMENTS PAST DUE: _____________as of _________________. TOTAL AMOUNT OF POST-PETITION ARREARS: _______________ as of _______________.

Dated: _________________

______________________________ Counsel

______________________________ Mortgage Company

(2)