Application for COVID-19 (Natural Disaster) Forbearance
Applicant Informatio n
City State Zip Code Email Address
Sig )elbatpeccA depyT( erutan Date
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Alternatively, you can return this form via email or fax:
E-mail:
Customer.Service@FirstmarkServices.com
Fax: 866.258.923 3
P.O. Box 82522 | Lincoln, NE 68501-2522
Monday through Friday 7:00 am - 8:00 pm CT | 888.538.7378 | www.FirstmarkServices.com
I request to postpone my loan payments due to economic hardship related to the COVID-19 pa ndemic.
I understand that the following terms and conditions apply to this forbearance request:
1. Until my forbearance request is approved, my monthly payment will still be due. Once approved,
I am not required to make payments of principal or interest during the forbearance.
2. This forbearance will cover three continuous monthly payments.
3. Interest will continue to accrue during the forbearance period.
I certify that:
1. The information I have provided as part of this request for forbearance is true and correct.
2. I agree to repay my loan(s) according to the terms of my promissory note(s), regardless of
whether the forbearance is granted.
With the understanding and certification above, I authorize you to place my loan(s) in forbearance.
