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_____________________________ BORROWER CO-BORROWER Borrower’s name Co-borrower’s name Social Security number Date of birth Social Security number Date of birth Property address (include city, state and zip): I want to: Keep the Property Sell the Property The property is my: Primary Residence Second Home Investment Property The property is: Owner Occupied Renter Occupied Vacant HARDSHIP AFFIDAVIT I (We) am/are requesting review under the Making Home Affordable program. I .

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