From:

John Doe
c/o corresponding postal service address:

123 Main Avenue City, State [12345]

To:

Servicer 100 Main Street Anywhere City, State

CC: Name and address of Original Note Holder

QUALIFIED WRITTEN REQUEST AND OBJECTION RE: Dispute of Alleged Debt This request should be treated as a Qualified Written Request under TILA and RESPA Notice: RESPA requires you to CEASE AND DESIST all Collection Activities until this request is completely answered. To Whom It May Concern: I am providing this written request to you in order to obtain an updated accounting of the debt that I am alleged to owe the Note Holder as well as to inquire about the servicing of this mortgage and obtain clarification of any sale(s), transfer(s) and legal ownership of my Promissory Note. This written request will also serve purpose to obtain clarification of as any funding sources, beneficial ownership, charges, credits, debits, transactions, reversals, other actions, payments, analysis and records relating to the service of this account from its origination to the present date. (Servicer Name) is the servicer of our mortgage loan at the above address. We dispute the amount you claim is owed according to the monthly billing statement because it appears that the charges applied are inaccurate as certain payments have not been properly applied to the account. We are also uncertain as to who is the legal Note Holder and owner of the deed of trust because the transfer and ownership of our loan appears to have been impacted by recent issues concerning people signing transfer documents without knowledge or authority to do so, resulting in foreclosure moratoriums in many instances. We request that you send us information about the fees, costs, and escrow accounting on our loan as well as information concerning the holder and owner of this mortgage loan. This is a qualified written request pursuant to the Real Estate Settlement and Procedures Act 2605(e). Please also provide or arrange the following: 1) A complete payment history which lists the dates and amounts of all the payments we have made on the loan to date, and shows how each payment was applied or credited (whether to principal, interest, escrow, suspense, or some other treatment);

2) A breakdown of the amount of claimed arrears or delinquencies on the account, including an itemization of all fees and charges you claim are currently due; 3) The payment dates, purpose of payment, and recipient of any and all foreclosure fees and costs that have been charged to the account; 4) The payment dates, purpose of payment, and recipient of all escrow items charged to the account; 5) A copy of any annual escrow statements, and notices of a shortage, deficiency, or surplus, sent within the last three years; 6) The current balance in any suspense account as of [date of request] and the reason why such funds were deposited in the account; 7) The name and address of the owner of the promissory note secured by the deed of trust in the mortgage loan referenced above; 8) The name and address of the entity that is the current Note Holder, or legally possesses the Promissory Note; as well as the names and addresses of each of the entities that have been Note Holders as well as any assignments of the original Promissory Note in sequence to the current Note Holder. 9) The names of all entities to which the promissory note referenced above has been sold or otherwise transferred at any time, and the dates that each sale or transfer of the note occurred; 10) A copy of the note referenced above showing all endorsements that have occurred, together with any allonge that exists to the note; 11) The names of all entities to which this mortgage or deed of trust has been assigned, and the dates that each assignment occurred. If any assignment in blank has occurred, include it in the list of dates with the notation In Blank in place of the name of an entity; 12) A copy of each of the assignments reflecting each assignment referenced in #11, above; 13) A description of all loss mitigation and foreclosure avoidance steps taken in regard to this mortgage loan, including all calculations concerning debt-to-income and net-present-value determinations and all documents regarding loss mitigation and foreclosure avoidance steps taken;

14) I desire to inspect the original wet-ink Promissory Note that I created and made

payable to XXXXXXX. Therefore please arrange a meeting by way of mediator so that I may inspect the Promissory Note in the presence of the Note Holder. Once I inspect the original Promissory Note and am satisfied that it is indeed genuine then I will accept responsibility for the amount due for the mediation services. Thank you for acknowledging and answering this request as required by the Real estate Settlement and Procedures Act 2605(e). Respectfully Submitted,

John Doe