JLM Corporation

640 N. Tustin Avenue #201
Santa Ana, CA, 92705
ph: (714) 245-7766 fax: (714) 245-7769

Declaration of Default and Request to Record
NOTICE OF DEFAULT

Client Information

Company Name:

Address:

Contact Name:

Phone:

Fax:

Property and Loan Information

Loan Number:

Borrower:

Property Address:

City:

State:

Zip:

Request For Services

Last Known Address:

I declare all sums secured immediately due and payable by reason of the below stated breach:

Past due payments of principle and interest (and impounds, if applicable)

Note is due and payable as of:

Other (please state reason):

FHLMC

FNMA

FHA

CONV

Unpaid principle balance:

Current Interest Rate:

Monthly payment and interest:

Monthly late charge:

Advances:

Total late charges:

Interest paid through date:

Default due date:

Total amount to bring current:

Good through date:

The following documents and information are provided for your use:

	Loan Note			Additional Loan Note(s)
	Deed of Trust/UCC Filing			Modification Agreements
	Assignment(s)			Screen Print(s)/Payment Schedule(s)
	Substitution of Trustee			Document(s) that have not been provided will follow

Unified Sale Information:

Is this to be a unified sale (both real and personal property):

Yes / No

Current Beneficiary:

Notes: