Foreclosure Intake Form

Formulario en Español

Assistance from CED Law may be available for households facing Foreclosures/Lot Rent eviction. To request assistance from CED Law, please complete an intake form here. If you are seeking both rental & legal assistance, please complete both forms.

EMAP eligibility requirements:

Yes, Am I a homeowner and do I live in the home I am applying for?
Yes, I experienced a decrease in income due to a Covid -19 Impact?
Yes, I meet the income AMI criteria to be eligible for my household size and county? (under 150% AMI)
- Check this link: https://www.huduser.gov/portal/datasets/il/il2022/select_Geography_haf.odn
At the time of purchasing/refinancing my home, the loan was not a jumbo-loan (outside of the conforming loan limits for a 1-4 unit household per county).

Ready to apply?
Please complete the Colorado Emergency Mortgage Assistance Program (EMAP) Application before filling out this form.

If you have already filled out the EMAP application, please have your Case ID handy.

Homeowner Information

First name*

Last name*

Date of birth*

Phone number*

Email*

Number of individuals currently in your household*

Have you submitted an application through the state of Colorado (DOLA)? *This must be completed before you can be considered for foreclosure assistance. *

Street address*

City*

State/Region*

Postal code

County*

What is your preferred method of communication?*

If other method of communication

Income: What is your annual income?

Currently own and occupy a primary residence in Colorado

Yes, I own and occupy a residence

Yes, I own and occupy a mobile home

No, I do not own a residence

Demographic Information

What is your racial identity?*

What is your ethnicity?*

Non-Hispanic or Non-Latin(a)(o)(x)

Hispanic or Latin(a)(o)(x)

Prefer not to Answer

Please select all that apply

One or more household members has a disability

One or more household members is 62 years old or older

Household is currently experiencing homelessness

One or more household members is on active duty or a military veteran

None of the above

Is there minor children in household

Has primary applicant been unemployed for 90 days or more

Pronouns

Preferred language

Other preferred language

Lender/Landlord Information

Lender/Landlord's company*

Lender/Landlord's contact name*

Lender/Landlord's email*

Lender/Landlord's phone number*

What communications, if any, have you had with your lender/landlord?

Delinquency Notice

Have you received a notice for nonpayment? (foreclosure, eviction, utility shut off, lien)*

Legal Notice

Do you have an upcoming court date and time?*

Yes

Additional Information

Do you receive mortgage assistance of any kind?*

If yes, please describe:

Who filled out this intake form?*

If you selected other for who filled out this form please specify:

Anything else we should know? Please specify what type of help you are seeking.

Have you been approached by another party in regards for the sale of your house?

Yes

If you selected "Yes" above, please tell us who approached you about the sale of your house.

How did you hear about CEDP?*

If you selected an "other" option above, please tell us who referred you to our site.

Landlord Company

Ticket description*

Ticket name*