Fillable Dear Homeowner, Thank you for requesting assistance for (RIHousing)

Fill Online, Printable, Fillable, Blank Dear Homeowner, Thank you for requesting assistance for (RIHousing) Form

Use Fill to complete blank online RIHOUSING pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

Dear Homeowner, Thank you for requesting assistance for (RIHousing)

On average this form takes 80 minutes to complete

The Dear Homeowner, Thank you for requesting assistance for (RIHousing) form is 21 pages long and contains:

  • 13 signatures
  • 122 check-boxes
  • 212 other fields

Country of origin: US
File type: PDF

Use our library of forms to quickly fill and sign your RIHousing forms online.

BROWSE RIHOUSING FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
Dear Homeowner,
Thank you for requesting assistance for foreclosure prevention by RIHousing.
To complete your request, you must first fill out our Financial Information Package and send us the
required documents which are needed to process your request for assistance. Please use the
required documents checklist attached. Please do not send original documents. You can send the
completed application and required documents packet to us by facsimile, mail, or e-mail.
You may also simply drop them off at our office:
RIHousing HelpCenter
44 Washington Street
Providence, RI 02903
Fax: 401-450-1373
Please return your financial information packet as soon as possible, as this is a time-sensitive
process.
Once we have received your application packet, you will be assigned to a HUD Counselor. The HUD
Counselor will follow up with you to review your options and/or discuss additional information that
may be needed.
If you have any questions or need any assistance with the application, please contact us at:
(401) 457-1130.
TTY: (401) 450-1394.
Thank you for reaching out to the RIHousing HelpCenter.
Sincerely,
RIHousing HelpCenter
NOTE: If you have an impairment, disability, language barrier, or otherwise require an alternative means of
completing this form or accessing information about our housing counseling program, please inform our
housing counselor program staff so alternative accommodations may be arranged.
REQUIRED DOCUMENTS CHECKLIST
Please DO NOT Send Originals
Single-sided Copies Please
1. Most recent pay stubs – 30 consecutive days of pay stubs for all borrowers/ contributors (person
other than mortgage holder). Contributors must send signed and dated contribution amount letter.
2. Proof of all other sources of income for borrowers/contributors (SSI, SSDI, child support, rental
income etc.) Most recent benefit award letter for all SSI, SSDI, TDI and/or Unemployment income
being received. If receiving Government Assistance (ex. SNAP), please include the Quarterly Benefit
Statement. Rental income leases.
3. Two years of recent Federal Tax Returns – signed tax returns for the last two years (personal and
business) with all schedules and W-2’s. If no tax returns, then a letter, signed and dates, explaining
why no taxes were filed.
4. Two months of recent bank statements from all saving & checking accounts, all pages, front and
back, for the last two months (personal and business). Transaction history is not acceptable.
5. Self-employed borrowers must provide most recent quarterly or year-to-date Profit & Loss
Statement. Statement must be signed and dated.
6. Most recent utility bill – at least one gas, electric, or cable bill.
7. Most recent mortgage statement with loan number and lender/servicer contact information.
8. Delinquency letters/notices – mediation, conciliation, tax sale, or foreclosure notices, if applicable.
9. Property tax bill – only if current mortgage payment does not include an escrow payment.
10. Homeowners Insurance Policy – declaration page(s). Only if current mortgage payment does not
include and escrow payment.
11. Bankruptcy discharge notice, if applicable.
12. Court Orders – Final Divorce Decree, Alimony, and Child support payments, if applicable
13. Homeowners Association Fee Statement, if applicable.
14. Help Center Authorization, Dodd Frank, 4506T, Homeowner/Counselor Agreement, and Consent
to the Use of Tax Return Information Forms – signed and dated by all borrowers (pgs. 7-13)
15. Hardship Letter – signed and dated by all borrowers (pg. 6).
16. Copy of Drivers License or State ID
Page 1/13
Borrower Information
Number of people in household.
Financial Information
Name
Relationship to Applicant
Age
BORROWER
CO-BORROWER
Borrower’s Name
Social Security Number
- -
Date of Birth (month/day/year)
/ /
Social Security Number
- -
Date of Birth (month/day/year)
/ /
Primary Phone Number With Area Code
( ) -
Secondary Phone Number
Email Address
Mailing Address
Present Address (If Same As Mailing Address, Write Same)
Married Unmarried (includes single, divorced, widowed) Separated
Yrs School
Military Status: N/A Active Veteran
Are you a US Citizen? Yes No
Are you a Permanent Resident Alien? Yes No
Page 2/13
Employment Information
BORROWER
CO-BORROWER
Employed Unemployed Self-employed
Employed Unemployed Self-employed
Employer
Employer
Work Phone Number With Area Code
( ) -
Work Phone Number With Area Code
( ) -
# Of Years at Current or Most Recent Job
# Of Years at Current or Most Recent Job
Position/Title
Position/Title
Property Information
Single Family
Multi-family (1-4 Units)
Condo
Property Purchase Date
Property Condition:
Excellent Good
Fair
Poor
Estimated Property Value
I want to: Keep the Property Sell the Property
Is the property listed for sale?Yes No
For Sale by Owner? Yes No
Agent’s Name:
Agent’s Phone Number:
Have you received an offer on the property? Yes No
Date of Offer Amount of Offer $
Have you received a foreclosure sale date? Yes
Foreclosure Date No
Have you received a notice of Mediation or Conciliation?
Yes No
Have you filed for bankruptcy? Yes No
If yes: Chapter 7 Chapter 13 Filing Date:
Has your bankruptcy been discharged? Yes
No Bankruptcy Case Number: Attorney:
Page 3/13
Mortgage Information
First Mortgage Lender/Servicer Name
First Mortgage Loan Number
Balance
Interest Rate
Monthly Payment Amount (Principal, Interest, Taxes, and Insurance)
Monthly Mortgage Insurance Payment (If Applicable)
Are you current on your First Mortgage? Yes No
If yes, are you in danger of falling delinquent? Yes No
Has your mortgage ever been modified or have you entered into a forbearance plan? Yes
No
Have you received Hardest Hit Funds in the past: Yes No
Who pays the real estate tax bill on your property?
Who pays hazard insurance policy for your property?
Are the taxes current? Yes No
Is the policy current? Yes No
Condominium or HOA Fee: Yes $ No
Paid to:
Do you have a second mortgage/ Home Equity Loan? Yes No
If yes, provide detail below.
Second Mortgage Lender/Servicer Name
Second Mortgage Loan Number
Balance
Interest Rate
Monthly Payment Amount (Principal, Interest, Taxes, and Insurance)
Monthly Mortgage Insurance Payment (If Applicable)
List other Liens/Mortgages or Judgments on this property, please name the person(s), company or firm and their telephone numbers.
Lien Holder’s Name/Servicer Balance
Contact Number Loan Number
Page 4/13
Information for Government Monitoring Purposes
The following information is requested by the federal government in order to monitor compliance with federal statutes that prohibit discrimination in housing. You are not
required to furnish this information, but are encouraged to do so. The law provides that a lender or servicer may not discriminate either on the basis
of this information, or on whether you choose to furnish it. If you furnish the information, please provide both ethnicity and race. For race, you may check more than one
designation. If you do not furnish ethnicity, race, or sex, the lender or servicer is required to note the information on the basis of visual observation or surname if you have made
this request for a loan or grant in person. If you do not wish to furnish the information, please check the box below.
BORROWER
I do not wish to furnish this information
CO-BORROWER
I do not wish to furnish this information
Ethnicity:
Hispanic or Latino Not Hispanic or Latino
Ethnicity:
Hispanic or Latino Not Hispanic or Latino
Race:
American Indian or Alaska Native
Asian Black or African American
Native Hawaiian or Other Pacific Islander White
Race:
American Indian or Alaska Native
Asian Black or African American
Native Hawaiian or Other Pacific Islander White
Sex:
Female Male
Sex:
Female Male
Page 5/13
Monthly Income/Expenses For Household
Page 6/13
Hardship Affidavit
Explanation (Required):
If additional space is needed for Explanation, please include an additional page.
HelpCenter Authorization / Disclosure
I understand that RIHousing provides foreclosure prevention counseling (“Counseling”) and I request that RIHousing provide me
such assistance. An overview of the range of Counseling services that I am entitled to receive is set forth on Attachment A. I
understand that I have a choice with respect to HUD-approved counseling agencies, and I am not required to use RIHousing to
provide counseling.
I authorize RIHousing to contact my mortgage lender or servicer (collectively,
the “Mortgagee”) on my behalf regarding any loan secured by my property located at
the “Loan”) and to obtain from such Mortgagee any information regarding my Loan that RIHousing deems necessary to provide
the Counseling.
I have provided RIHousing information regarding my personal finances and authorize RIHousing to obtain a credit report on me
in order to provide the Counseling (this information, along with the information obtained from the Mortgagee, the “Financial
Information”).
I understand and agree that RIHousing will use the Financial Information to evaluate my options regarding the Loan and to develop an
action plan consisting of recommendations for handling of the Loan and my finances, which will be presented to me.
I authorize RIHousing to share the Financial Information with the Mortgagee and to discuss the Loan and the Financial Information
with the Mortgagee. I understand that I may or may not be present during these discussions.
I may be referred to other housing services of RIHousing or another agency or agencies as appropriate that may be able to assist with
particular issues that have been identified. I understand that I am not obligated to use any of the services offered to me. I understand
that RIHousing provides a variety of lending and mortgage products, including: mortgage loans to low- and moderate-income
homebuyers and homeowners; home repair loans; septic system replacement loans; sewer tie- in loans; lead abatement loans; and
loans for home modification to assist disabled residents. The loans described above may also be originated by participating lenders or
third-party brokers, who are compensated by RIHousing for their origination services. I further understand that I am not obligated to
use or receive any other products or services from RIHousing or its participating lenders or brokers.
RIHousing offers a variety of mortgage-related services, including first-time homebuyer training and landlord training. I
understand that I am not obligated to use or receive any of these other services from RIHousing. If I already receive mortgage-
related services from RIHousing, I understand that I am not obligated to use RIHousing for Counseling services and may choose
from among HUD-approved housing counseling agencies.
I understand that RIHousing’s HelpCenter is a U.S. Department of Housing and Urban Development (“HUD”) certified counseling
agency and that, as such, RIHousing may receive federal funds from HUD or another funding source. Due to the nature of these
relationships, RIHousing may be required to make information relating to my loan, my financial information, and any other information
in my counseling file available to HUD or another funding source for program monitoring and compliance purposes. Further, I authorize
RIHousing, HUD, or any other funding source to contact me for program evaluation purposes.
I understand that a counselor may answer questions and provide information, but not provide legal advice. Counseling is not a
substitute for legal advice. If I want legal advice, I will be referred for appropriate assistance.
I acknowledge that I have received a copy of RIHousing’s Privacy Policy.
Loan Number
Name (printed) Signature Date
Name (printed) Signature Date
Page 7/13
click to sign
signature
click to edit
click to sign
signature
click to edit
Attachment A
Outline of Counseling Services
The following is an outline of the Counseling Services which are provided as part of this program.
1. The Intake Counselor reviews the homeowner’s financial situation. In order to complete this review, the counselor obtains a credit
report and collects income and expense documentation. This allows the Counselor to analyze the homeowner’s financial capacity
and determine if there is a hardship.
2. If, based upon this intake and initial file, mortgage fraud is suspected, we may refer the case to the Consumer Protection Division
of the Rhode Island Attorney General and the Rhode Island Department of Business Regulation.
3. Based on the review of the information developed through the intake, and any supplemental information submitted, we will work
with you to develop an action plan to seek relief, including steps you may need to take to control household expenses, and any
additional documents you must submit.
4. We will review your situation to determine potential eligibility for loss mitigation options using investors and lender’s
proprietary programs.
5. If appropriate, we will inform you of other local programs and resources that may be available to assist you. Examples of
these services and programs include Food Stamps, Heating Assistance programs, Community Action Program agencies,
alternative housing options, financial management assistance (through Money Management International), legal assistance
(through Rhode Island Legal Services or the Rhode Island Bar Association), and the like.
6. If appropriate, we will assist you in preparing a hardship letter for submission to your lender/servicer to support your request for a
work out option. We will maintain communication with you and your lender/servicer to monitor the status of your loan workout
request and to ensure that all necessary documentation is submitted on time.
7. We will review and evaluate any written work out proposal you receive from your lender/servicer to help you determine whether
to accept the proposal.
8. We will ask you whether you have been offered questionable mortgage foreclosure prevention assistance, including proposals
that guarantee a successful outcome; require payment in advance of the provision of assistance; require that you stop making
mortgage payment or require redirection of your mortgage payments to someone other than your lender/servicer; involve signing
over title to your home to a third-party. If we suspect that improper practices are present we will report the practices to the
Consumer Division of the Rhode Island Attorney General and the Loan Modification Scam alert website.
Page 8/13
Page 9/13
Form
4506-T
(June 2019)
Department of the Treasury
Internal Revenue Service
Request for Transcript of Tax Return
▶
Do not sign this form unless all applicable lines have been completed.
▶
Request may be rejected if the form is incomplete or illegible.
▶
For more information about Form 4506-T, visit www.irs.gov/form4506t.
OMB No. 1545-1872
Tip. Use Form 4506-T to order a transcript or other return information free of charge. See the product list below. You can quickly request transcripts by using
our automated self-help service tools. Please visit us at IRS.gov and click on “Get a Tax Transcript...” under “Tools” or call 1-800-908-9946. If you need a copy
of your return, use Form 4506, Request for Copy of Tax Return. There is a fee to get a copy of your return.
1a Name shown on tax return. If a joint return, enter the name
shown first.
1b First social security number on tax return, individual taxpayer identification
number, or employer identification number (see instructions)
2a If a joint return, enter spouse’s name shown on tax return.
2b Second social security number or individual taxpayer
identification number if joint tax return
3 Current name, address (including apt., room, or suite no.), city, state, and ZIP code (see instructions)
4 Previous address shown on the last return filed if different from line 3 (see instructions)
5 Customer file number (if applicable) (see instructions)
Note: Effective July 2019, the IRS will mail tax transcript requests only to your address of record. See What’s New under Future Developments on
Page 2 for additional information.
6
Transcript requested. Enter the tax form number here (1040, 1065, 1120, etc.) and check the appropriate box below. Enter only one tax form
number per request.
▶
a Return Transcript, which includes most of the line items of a tax return as filed with the IRS. A tax return transcript does not reflect
changes made to the account after the return is processed. Transcripts are only available for the following returns: Form 1040 series,
Form 1065, Form 1120, Form 1120-A, Form 1120-H, Form 1120-L, and Form 1120S. Return transcripts are available for the current year
and returns processed during the prior 3 processing years. Most requests will be processed within 10 business days . . . . . .
b
Account Transcript, which contains information on the financial status of the account, such as payments made on the account, penalty
assessments, and adjustments made by you or the IRS after the return was filed. Return information is limited to items such as tax liability
and estimated tax payments. Account transcripts are available for most returns. Most requests will be processed within 10 business days .
c Record of Account, which provides the most detailed information as it is a combination of the Return Transcript and the Account
Transcript. Available for current year and 3 prior tax years. Most requests will be processed within 10 business days . . . . . .
7 Verification of Nonfiling, which is proof from the IRS that you did not file a return for the year. Current year requests are only available
after June 15th. There are no availability restrictions on prior year requests. Most requests will be processed within 10 business days . .
8
Form W-2, Form 1099 series, Form 1098 series, or Form 5498 series transcript. The IRS can provide a transcript that includes data from
these information returns. State or local information is not included with the Form W-2 information. The IRS may be able to provide this
transcript information for up to 10 years. Information for the current year is generally not available until the year after it is filed with the IRS. For
example, W-2 information for 2016, filed in 2017, will likely not be available from the IRS until 2018. If you need W-2 information for retirement
purposes, you should contact the Social Security Administration at 1-800-772-1213. Most requests will be processed within 10 business days .
Caution: If you need a copy of Form W-2 or Form 1099, you should first contact the payer. To get a copy of the Form W-2 or Form 1099 filed
with your return, you must use Form 4506 and request a copy of your return, which includes all attachments.
9 Year or period requested. Enter the ending date of the year or period, using the mm/dd/yyyy format. If you are requesting more than four
years or periods, you must attach another Form 4506-T. For requests relating to quarterly tax returns, such as Form 941, you must enter
each quarter or tax period separately.
Caution: Do not sign this form unless all applicable lines have been completed.
Signature of taxpayer(s). I declare that I am either the taxpayer whose name is shown on line 1a or 2a, or a person authorized to obtain the tax
information requested. If the request applies to a joint return, at least one spouse must sign. If signed by a corporate officer, 1 percent or more
shareholder, partner, managing member, guardian, tax matters partner, executor, receiver, administrator, trustee, or party other than the taxpayer, I
certify that I have the authority to execute Form 4506-T on behalf of the taxpayer. Note: This form must be received by IRS within 120 days of the
signature date.
Signatory attests that he/she has read the attestation clause and upon so reading declares that he/she
has the authority to sign the Form 4506-T. See instructions.
Phone number of taxpayer on line
1a or 2a
Sign
Here
▲
Signature (see instructions) Date
▲
Title (if line 1a above is a corporation, partnership, estate, or trust)
▲
Spouse’s signature Date
For Privacy Act and Paperwork Reduction Act Notice, see page 2.
Cat. No. 37667N
Form 4506-T (Rev. 6-2019)
/ / / / / / / /
Page 10/13
Form 4506-T (Rev. 6-2019)
Page 2
Section references are to the Internal Revenue Code unless
otherwise noted.
Future Developments
For the latest information about Form 4506-T and its
instructions, go to www.irs.gov/form4506t. Information about
any recent developments affecting Form 4506-T (such as
legislation enacted after we released it) will be posted on that
page.
What’s New. As part of its ongoing efforts to protect
taxpayer data, the Internal Revenue Service announced that
in July 2019, it will stop all third-party mailings of requested
transcripts. After this date masked Tax Transcripts will only
be mailed to the taxpayer’s address of record.
If a third-party is unable to accept a Tax Transcript mailed to
the taxpayer, they may either contract with an existing IVES
participant or become an IVES participant themselves. For
additional information about the IVES program, go to
www.irs.gov and search IVES.
General Instructions
Caution: Do not sign this form unless all applicable lines
have been completed.
Purpose of form. Use Form 4506-T to request tax return
information. Taxpayers using a tax year beginning in one
calendar year and ending in the following year (fiscal tax year)
must file Form 4506-T to request a return transcript.
Note: If you are unsure of which type of transcript you need,
request the Record of Account, as it provides the most
detailed information.
Customer File Number. The transcripts provided by the IRS
have been modified to protect taxpayers' privacy. Transcripts
only display partial personal information, such as the last four
digits of the taxpayer's Social Security Number. Full financial
and tax information, such as wages and taxable income, are
shown on the transcript.
An optional Customer File Number field is available to use
when requesting a transcript. This number will print on the
transcript. See Line 5 instructions for specific requirements.
The customer file number is an optional field and not
required.
Tip. Use Form 4506, Request for Copy of Tax Return, to
request copies of tax returns.
Automated transcript request. You can quickly request
transcripts by using our automated self-help service tools.
Please visit us at IRS.gov and click on “Get a Tax
Transcript...” under “Tools” or call 1-800-908-9946.
Where to file. Mail or fax Form 4506-T to the address below
for the state you lived in, or the state your business was in,
when that return was filed. There are two address charts: one
for individual transcripts (Form 1040 series and Form W-2)
and one for all other transcripts.
If you are requesting more than one transcript or other
product and the chart below shows two different addresses,
send your request to the address based on the address of
your most recent return.
Chart for individual transcripts
(Form 1040 series and Form W-2
and Form 1099)
If you filed an
individual return and
lived in:
Mail or fax to:
Alabama, Kentucky, Louisiana,
Mississippi, Tennessee,
Texas, a foreign country,
American Samoa, Puerto Rico,
Guam, the Commonwealth of
the Northern Mariana Islands,
the U.S. Virgin Islands, or
A.P.O. or F.P.O. address
Internal Revenue Service
RAIVS Team
Stop 6716 AUSC
Austin, TX 73301
855-587-9604
Alaska, Arizona, Arkansas,
California, Colorado, Hawaii,
Idaho, Illinois, Indiana, Iowa,
Kansas, Michigan, Minnesota,
Montana, Nebraska, Nevada,
New Mexico, North Dakota,
Oklahoma, Oregon, South
Dakota, Utah, Washington,
Wisconsin, Wyoming
Internal Revenue Service
RAIVS Team
Stop 37106
Fresno, CA 93888
855-800-8105
Connecticut, Delaware, District
of Columbia, Florida, Georgia,
Maine, Maryland,
Massachusetts, Missouri, New
Hampshire, New Jersey, New
York, North Carolina, Ohio,
Pennsylvania, Rhode Island,
South Carolina, Vermont,
Virginia, West Virginia
Internal Revenue Service
RAIVS Team
Stop 6705 S-2
Kansas City, MO 64999
855-821-0094
Chart for all other transcripts
If you lived in
or your business was
in:
Mail or fax to:
Alabama, Alaska, Arizona,
Arkansas, California,
Colorado, Connecticut,
Delaware, District of
Columbia, Florida, Georgia,
Hawaii, Idaho, Illinois,
Indiana, Iowa, Kansas,
Kentucky, Louisiana,
Maryland, Michigan,
Minnesota, Mississippi,
Missouri, Montana,
Nebraska, Nevada, New
Jersey, New Mexico, North
Carolina, North Dakota, Ohio,
Oklahoma, Oregon, Rhode
Island, South Carolina, South
Dakota, Tennessee, Texas,
Utah, Virginia, Washington,
West Virginia, Wisconsin,
Wyoming, a foreign country,
American Samoa, Puerto
Rico, Guam, the
Commonwealth of the
Northern Mariana Islands,
the U.S. Virgin Islands,
A.P.O. or F.P.O. address
Internal Revenue Service
RAIVS Team
P.O. Box 9941
Mail Stop 6734
Ogden, UT 84409
855-298-1145
Maine, Massachusetts, New
Hampshire, New York,
Pennsylvania, Vermont
Internal Revenue Service
RAIVS Team
Stop 6705 S-2
Kansas City, MO 64999
855-821-0094
Line 1b. Enter your employer identification number (EIN) if
your request relates to a business return. Otherwise, enter the
first social security number (SSN) or your individual taxpayer
identification number (ITIN) shown on the return. For
example, if you are requesting Form 1040 that includes
Schedule C (Form 1040), enter your SSN.
Line 3. Enter your current address. If you use a P.O. box,
include it on this line.
Line 4. Enter the address shown on the last return filed if
different from the address entered on line 3.
Note: If the addresses on lines 3 and 4 are different and you
have not changed your address with the IRS, file Form 8822,
Change of Address. For a business address, file Form 8822-
B, Change of Address or Responsible Party — Business.
Line 5b. Enter up to 10 numeric characters to create a unique
customer file number that will appear on the transcript. The
customer file number should not contain an SSN.
Completion of this line is not required.
Note. If you use an SSN, name or combination of both, we
will not input the information and the customer file number
will reflect a generic entry of “9999999999” on the transcript.
Line 6. Enter only one tax form number per request.
Signature and date. Form 4506-T must be signed and dated
by the taxpayer listed on line 1a or 2a. The IRS must receive
Form 4506-T within 120 days of the date signed by the
taxpayer or it will be rejected. Ensure that all applicable lines
are completed before signing.
▲
!
CAUTION
You must check the box in the signature area
to acknowledge you have the authority to sign
and request the information. The form will not
be processed and returned to you if the
box is unchecked.
Individuals. Transcripts of jointly filed tax returns may be
furnished to either spouse. Only one signature is required.
Sign Form 4506-T exactly as your name appeared on the
original return. If you changed your name, also sign your
current name.
Corporations. Generally, Form 4506-T can be signed by:
(1) an officer having legal authority to bind the corporation, (2)
any person designated by the board of directors or other
governing body, or (3) any officer or employee on written
request by any principal officer and attested to by the
secretary or other officer. A bona fide shareholder of record
owning 1 percent or more of the outstanding stock of the
corporation may submit a Form 4506-T but must provide
documentation to support the requester's right to receive the
information.
Partnerships. Generally, Form 4506-T can be signed by
any person who was a member of the partnership during any
part of the tax period requested on line 9.
All others. See section 6103(e) if the taxpayer has died, is
insolvent, is a dissolved corporation, or if a trustee, guardian,
executor, receiver, or administrator is acting for the taxpayer.
Note: If you are Heir at law, Next of kin, or Beneficiary you
must be able to establish a material interest in the estate or
trust.
Documentation. For entities other than individuals, you
must attach the authorization document. For example, this
could be the letter from the principal officer authorizing an
employee of the corporation or the letters testamentary
authorizing an individual to act for an estate.
Signature by a representative. A representative can sign
Form 4506-T for a taxpayer only if the taxpayer has
specifically delegated this authority to the representative on
Form 2848, line 5. The representative must attach Form 2848
showing the delegation to Form 4506-T.
Privacy Act and Paperwork Reduction Act Notice. We ask
for the information on this form to establish your right to gain
access to the requested tax information under the Internal
Revenue Code. We need this information to properly identify
the tax information and respond to your request. You are not
required to request any transcript; if you do request a
transcript, sections 6103 and 6109 and their regulations
require you to provide this information, including your SSN or
EIN. If you do not provide this information, we may not be
able to process your request. Providing false or fraudulent
information may subject you to penalties.
Routine uses of this information include giving it to the
Department of Justice for civil and criminal litigation, and
cities, states, the District of Columbia, and U.S.
commonwealths and possessions for use in administering
their tax laws. We may also disclose this information to other
countries under a tax treaty, to federal and state agencies to
enforce federal nontax criminal laws, or to federal law
enforcement and intelligence agencies to combat terrorism.
You are not required to provide the information requested
on a form that is subject to the Paperwork Reduction Act
unless the form displays a valid OMB control number. Books
or records relating to a form or its instructions must be
retained as long as their contents may become material in the
administration of any Internal Revenue law. Generally, tax
returns and return information are confidential, as required by
section 6103.
The time needed to complete and file Form 4506-T will
vary depending on individual circumstances. The estimated
average time is: Learning about the law or the form, 10
min.; Preparing the form, 12 min.; and Copying,
assembling, and sending the form to the IRS, 20 min.
If you have comments concerning the accuracy of these
time estimates or suggestions for making Form 4506-T
simpler, we would be happy to hear from you. You can write
to:
Internal Revenue Service
Tax Forms and Publications Division
1111 Constitution Ave. NW, IR-6526
Washington, DC 20224
Do not send the form to this address. Instead, see Where
to file on this page.
Page 11/13
RIHousing Help Center | 44 Washington Street Providence, RI 02903 | 401 457-1130
Homeowner/Counselor Agreement
The RIHousing Help Center and its counselors agree to provide the following services:
• Develop
ment of a financial budget to determine homeowner’s income, expenses and affordability
• Analysis of the mortgage default, including the amount and cause of default
• Presentation and explanation of reasonable options available to the homeowner
• Submit homeowner’s file to the lender for review for all retention and/or liquidation options available, based on
the homeowner’s eligibility and needs
• Communicate with the mortgage servicer and/or investor and provide the homeowner with requests for any
additional/updated information as needed
• Timely completion of action plan
• Explanation of collection and foreclosure process
• Identify and provide homeowner with information on additional resources that may be available
• Confidentiality, honesty, respect and professionalism in all services
• The HelpCenter cannot control the lender’s processing time or decision
• The HelpCenter cannot and does not provide legal advice or representation. The informational services provided
by the HelpCenter are not a substitute for legal advice. The HelpCenter encourages homeowners to contact an
attorney if they feel they need legal advice or services
I/We ______ _____________________________ agree to the following terms of service:
I/We
will always provide honest and complete information to my/our counselor, whether verbally or in writing.
I/We will be on time for appointments and understand that if I/we are late for an appointment, the appointment may have
to be rescheduled
I/We will call within 24 hours of any future scheduled appointment(s) if I/we will be unable to attend an appointment.
I/We will follow up with our mortgage servicer and/or investor, on a bi-weekly basis, and provide the counselor with any
updates as well as provide the counselor with any correspondence or requests for any additional documentation.
I/We will provide all necessary documentation and follow-up information within 72 hours from the time requested.
I/We will contact the counselor about any changes in my/our situation immediately.
I/We will make an appointment with my/our counselor should any follow up face to face meeting be needed.
I/We understand that RIHousing will provide one counseling session per calendar year.
I/We understand that breaking this agreement may cause the HelpCenter to terminate its service assistance to me/us.
I/We understand that the HelpCenter is not providing legal advice or representation, and that the informational services
provided by the HelpCenter are not a substitute for legal advice. I/We understand that I/we should contact an attorney if
we wish to receive legal advice or services.
_____________
_________________ ______________
Homeowner Date
___________
___________________ ______________
Homeowner Date
___________
___________________ ______________
Homeowner Date
___________
___________________ ______________
Counselor Date
___________
___________________ ______________
Counselor Date
Page 12/13
Consent to the Use of Tax Return Information
I understand, acknowledge, and agree that Rhode Island Housing and Mortgage Finance Corporation and its
affiliates, agents, service providers, successors and assigns (collectively, “RIHousing”) can obtain, use, and share my
tax return information with the Loan Participants for the purpose of providing me with foreclosure prevention
counseling or as otherwise permitted by applicable law, including state and federal privacy and data security laws.
The Loan Participants include any actual or potential owners of my loan, or acquirers of any beneficial or other
interest in my loan, any mortgage insurer, guarantor, any servicers or service providers for these parties and any of
the aforementioned parties’ successors and assigns.
I understand that RIHousing’s HelpCenter is a housing counseling agency that is approved by the United States
Department of Housing and Urban Development (“HUD”). I acknowledge and agree that RIHousing can share
my tax return information with HUD for its program monitoring and compliance purposes.
Acknowledgment: By signing below I hereby acknowledge and agree that I have read and understood the
information that is set forth above.
______________________
______________________
Borrower Signature Date
_______________________________
_____________
Co-Borrower Signature Date
© 2019 The Mortgage Industry Standards Maintenance Organization. All rights reserved
Page 13/13
Rev. Jan-19
WHAT DOES RIHOUSING DO WITH YOUR
PERSONAL INFORMATION?
Why?
Financial companies choose how they share your personal information. Federal law gives
customers the right to limit some but not all sharing. Federal law also gives customers the right to
view personal records, and to correct a record that is inaccurate or incomplete. Federal law
requires us to tell you how we collect, share, and protect your personal information.
We provide this notice to customers at the time of application for RIHousing programs, products,
or services, and annually thereafter. From time to time, we may revise this notice to reflect
changes in the law or changes in our policies. Please read this notice carefully to understand what
we do.
What?
The types of personal information we collect and share depend on the product or service you have
with us. This information can include:
▪
Social Security Number
▪
Income
▪
Account balance
▪
Payment history
▪
Credit history
▪
Credit score
▪
Date of birth
▪
Medical information and blood lead level test results (for lead hazard reduction programs)
When you are no longer our customer, we continue to share your information as described in this
notice.
How?
All financial companies need to share customers’ personal information to run their everyday
business. In the section below, we list the reasons financial companies can share their customers’
personal information; the reason RIHousing chooses to share; and whether you can limit this
sharing.
Reasons we can share your personal information
Does RIHousing share?
Can you limit this
sharing?*
For our everyday business purposes – such as to process
your transactions, maintain your account(s), respond to court
orders and legal investigations, or report to credit bureaus
Yes
No
For our marketing purposes – to offer our products and
services to you
Yes
No
For joint marketing with other financial companies
No
N/A
For our affiliates’ everyday business purposes – information
about your transactions and experiences
No
N/A
For our affiliates’ everyday business purposes – information
about your creditworthiness
No
N/A
For nonaffiliates to market to you
No
N/A
*If N/A, RIHousing does not share your personal information so your ability to limit is not applicable.
Questions?
Call (800) 854-1180 or (401) 457-1180
FACTS
Who we are
Who is providing
this notice?
Rhode Island Housing and Mortgage Finance Corporation (“RIHousing”)
What we do
How does
RIHousing protect
my personal
information?
To protect your personal information from unauthorized access and use, we use security measures
that comply with federal and state law and regulation. These measures include computer
safeguards and secured files and buildings.
How does
RIHousing collect
my personal
information?
We collect your personal information, for example, when you:
▪
Apply for financing
▪
Give us your contact information
▪
Give us your employment history
▪
Give us your income information
▪
Show us your driver’s license
We also collect your personal information from government agencies, public sources, and others,
such as credit bureaus, affiliates, or other companies.
Why can’t I limit all
sharing?
Federal law gives you the right to limit only:
▪
Sharing for affiliates’ everyday business purposes – information about your
creditworthiness
▪
Affiliates from using your information to market to you
▪
Sharing for nonaffiliates to market to you
Definitions
Affiliates
Companies related by common ownership and control. They can be financial and nonfinancial
companies.
▪
Our affiliates include Rhode Island Housing Development Corporation, Rhode Island Housing
Equity Corporation, Rhode Island Housing Equity Pool, L.P., and Rhode Island Housing Equity
Pool-I, L.P.
Nonaffiliates
Companies not related by common ownership or control. They can be financial or nonfinancial
companies.
▪
RIHousing does not share your personal information with nonaffiliates so they can
market to you.
Joint marketing
A formal agreement between nonaffiliated financial companies that together market financial
products or services to you.
▪
RIHousing does not jointly market.
Other important information
Service providers with whom we share information for everyday business purposes may include coupon or statement
printers, billing services, payment processing companies, mail, print, and telephone service companies, insurers, property
inspection firms, government agencies, attorneys, laboratories, community action programs, auditors, quality control
vendors, consultants, or other service providers.
Provisions pertaining to protected medical information
In the context of carrying out certain residential lead hazard reduction programs, RIHousing may receive certain medical
information. A customer’s rights with respect to protected medical information include (a) the right to request
restrictions on certain uses and disclosures, subject to denial by RIHousing; (b) the right to receive confidential
communications of the information; (c) the right to inspect and copy the information; (d) the right to amend the
information; (e) the right to receive an accounting of disclosures of the information; and (f) the right to obtain a paper
copy of this notice upon request. A customer may complain to RIHousing if they believe their privacy rights have been
violated by writing a letter addressed to RIHousing, 44 Washington Street, Providence, RI 02903,
ATTN: Lead Program. A customer will not be retaliated against for filing a complaint.
click to sign
signature
click to edit
click to sign
signature
click to edit
Fax
To: HelpCenter
Fax: 401-450-1373
From:
Pages:
Date:
Re: HelpCenter Financial Information Package
Comments:
click to sign
signature
click to edit
click to sign
signature
click to edit
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

Dear Homeowner, Thank you for requesting assistance for (RIHousing)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 28 June 2021

Message

View Audit Log
Print With Audit Log
Duplicate Document