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LL.M. Real Property
Land Development

Florida Bar

New York Bar

District Of Columbia Bar
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NOTE: An asterisk (*) indicates REQUIRED information. The use of the Internet or this form for communication with the firm or any individual member of the firm does not establish an attorney-client relationship. Confidential or time-sensitive information should not be sent through this form
Street Address
How would you like
to be contacted?
Email Fax Phone Postal Mail
Brief description of legal issue
      11.  Where did you find / how do you know about your loan offices?:
12. Loan Information:  
a.  Name of Mortgage Company?
b. Monthly payment amount?  $  Loan balance (if known)?

c. Number of payments past due?  When last payment made?

d. Have your payments ever been refused?:  Yes   No
Has the bank ever accepted a partial payment:  Yes   No
e. Term of mortgage (in months):
f. Interest rate:    Is the interest rate  fixed 
 adjustable Negative  AM
g. Did you provide income documents (W-2, 1099, Paystubs, etc.) to the Mortgage Broker when you applied for the loan?:  Yes   No
h. Do you have a stated income or no document loan?:  Yes   No
i. Does the mortgage include escrow for taxes and insurance?   Yes   No
If no, then are you current on your taxes and homeowner’s insurance? :  Yes   No
j.   Did you provide the Title Agent with an owner’s policy of title insurance?:  Yes   No
k.  Are you current on your HOA/Condo dues?  Yes   No
l. Is this a re-finance?:  Yes   No
If yes, when was the last refinance?:
Has there been more than one refinance; and, if so, when?:
If yes, did you get cash out at closing?:  Yes   No How much? $ 
      If you got cash out at closing, what was it used for:
m. What type of loan did you have before you re-financed?
Old interest rate:
n. Do you have a second mortgage?:  Yes   No
If yes, are you current on that mortgage?:  Yes   No
o. List all names on mortgages:
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Before the Following Courts

United States Supreme Court

U.S. Claims Court

U.S. Tax Court

U.S. Court of Appeals

U.S. Court of international Trade

U.S. Court of Military Appeals

U.S. Federal District Court

For The S.D.F.L. M.D.F.L.

E.D.N.Y. and W.D.N.Y
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Contact us

5341 W. Atlantic Ave  Suite 303 Delray Beach FL - 33484
PHONE - 561-455-0280   FAX - 561-455-0281 CELLULAR - 561-305-5214