Qualified Written Request Under RESPA

QUALIFIED WRITTEN REQUEST UNDER RESPA

IMPORTANT: SENDING INSTRUCTIONS

Send via Certified Mail, Return Receipt Requested to the servicer's designated address for qualified written requests/notices of error.

☐ Verify servicer's correct QWR address (often different from payment address)
☐ Keep copies of all documents sent
☐ Retain certified mail receipt and return receipt
☐ Note date sent and date received by servicer

QUALIFIED WRITTEN REQUEST

Date: [DATE]

VIA CERTIFIED MAIL, RETURN RECEIPT REQUESTED

[MORTGAGE SERVICER NAME]
[QWR/Notice of Error Address]
[CITY, STATE ZIP]

RE: QUALIFIED WRITTEN REQUEST PURSUANT TO RESPA
Borrower Name(s): [BORROWER NAME(S)]
Property Address: [PROPERTY ADDRESS]
Loan Number: [LOAN NUMBER]
Last Four Digits of SSN: [XXXX]

Dear Sir or Madam:

This is a "Qualified Written Request" under Section 6 of the Real Estate Settlement Procedures Act (RESPA), 12 U.S.C. Section 2605(e), and a Request for Information and Notice of Error under CFPB Regulation X, 12 CFR Sections 1024.35 and 1024.36.

I am the borrower on the above-referenced mortgage loan. I am writing to request information regarding my mortgage account and to notify you of errors I believe exist in the servicing of my loan.

SECTION I: BORROWER IDENTIFICATION

Full Legal Name(s): [BORROWER NAME(S)]
Property Address: [PROPERTY STREET ADDRESS]
[CITY, STATE ZIP]
Mailing Address (if different): [MAILING ADDRESS]
Loan/Account Number: [LOAN NUMBER]
Original Lender: [ORIGINAL LENDER NAME]
Current Servicer: [CURRENT SERVICER NAME]
Telephone: [PHONE NUMBER]
Email: [EMAIL ADDRESS]

SECTION II: NOTICE OF ERRORS (12 CFR Section 1024.35)

I believe the following errors have occurred in the servicing of my mortgage loan. Please investigate and correct each error:

Error Category (Check all that apply):

☐ Payment Application Errors
Payments have not been properly applied to my account. Specifically: [DESCRIBE SPECIFIC PAYMENTS, DATES, AND AMOUNTS]

☐ Escrow Account Errors
My escrow account has been incorrectly calculated or administered. Specifically: [DESCRIBE ERROR]

☐ Fee Assessment Errors
Improper fees have been assessed to my account, including: [LIST SPECIFIC FEES, DATES, AND AMOUNTS]

☐ Payoff Statement Errors
The payoff statement provided was inaccurate. Specifically: [DESCRIBE INACCURACY]

☐ Failure to Provide Required Notices
You failed to provide: [DESCRIBE MISSING NOTICES]

☐ Failure to Accept Conforming Payment
You refused to accept my conforming payment on [DATE]. [DESCRIBE CIRCUMSTANCES]

☐ Transfer of Servicing Errors
Errors occurred during the transfer of my loan servicing. Specifically: [DESCRIBE ERRORS]

☐ Loss Mitigation Application Errors
Errors occurred in processing my loss mitigation application, including: [DESCRIBE ERRORS]

☐ Other Servicing Errors
[DESCRIBE OTHER ERRORS]

Detailed Description of Errors:

[PROVIDE DETAILED NARRATIVE OF ALL ERRORS, INCLUDING DATES, AMOUNTS, AND CIRCUMSTANCES. BE SPECIFIC AND CHRONOLOGICAL.]

SECTION III: REQUEST FOR INFORMATION (12 CFR Section 1024.36)

Pursuant to 12 CFR Section 1024.36, I request the following information regarding my mortgage loan:

A. Loan Documentation

☐ 1. A complete copy of the original promissory note, including all endorsements and allonges
☐ 2. A complete copy of the mortgage/deed of trust
☐ 3. All assignments of the mortgage, recorded and unrecorded
☐ 4. All modifications, amendments, or riders to the note and mortgage
☐ 5. A copy of the original loan application
☐ 6. All closing documents from the original loan transaction
☐ 7. The current loan servicer's authority to service the loan

B. Payment History and Account Information

☐ 8. A complete payment history from loan origination to present, showing:

• Date of each payment received
• Amount of each payment
• Allocation of each payment (principal, interest, escrow, fees)
• Any late charges assessed
• Any fees assessed

☐ 9. Current account balance, including:

• Principal balance
• Accrued interest
• Escrow balance
• Any fees or advances outstanding

☐ 10. Current interest rate and, if applicable, adjustable rate information

C. Escrow Account Information

☐ 11. A complete escrow account history from loan origination to present
☐ 12. Current escrow analysis showing:

• Items paid from escrow
• Amounts paid
• Projected escrow requirements
  ☐ 13. Copies of all escrow analysis statements provided

D. Default and Foreclosure Information

☐ 14. All default notices sent to borrower
☐ 15. All acceleration notices sent to borrower
☐ 16. The date the loan was referred to foreclosure
☐ 17. All foreclosure-related fees and costs assessed
☐ 18. The current reinstatement amount

E. Loss Mitigation Information

☐ 19. All loss mitigation applications submitted
☐ 20. All loss mitigation decisions and the reasons for any denials
☐ 21. Documentation of all loss mitigation options evaluated
☐ 22. Any net present value (NPV) calculations performed

F. Correspondence and Communications

☐ 23. Copies of all correspondence between servicer and borrower
☐ 24. Notes and records of all telephone communications
☐ 25. Copies of all Qualified Written Requests/Notices of Error previously submitted and responses

G. Ownership Information

☐ 26. The name, address, and telephone number of the current owner or assignee of the mortgage loan
☐ 27. The name and contact information for the master servicer (if different from servicer)
☐ 28. The name of the trust or securitized pool (if applicable)

SECTION IV: REQUIRED RESPONSE TIMEFRAMES

Please be advised of your legal obligations under RESPA and Regulation X:

For Notice of Error (12 CFR Section 1024.35):

• Acknowledge receipt within 5 business days
• Respond within 30 business days (may be extended by 15 days with notice)
• For payoff statement errors: 7 business days

For Request for Information (12 CFR Section 1024.36):

• Acknowledge receipt within 5 business days
• Respond within 30 business days (may be extended by 15 days with notice)
• For identity of loan owner: 10 business days

SECTION V: PROTECTIONS AND RESTRICTIONS

During the pendency of this Qualified Written Request, you are prohibited from:

1. Reporting negative information to credit bureaus related to the disputed amounts
2. Charging fees related to the QWR response
3. Providing information that is inaccurate or incomplete

SECTION VI: CONSEQUENCES OF NON-COMPLIANCE

Failure to respond appropriately to this Qualified Written Request may result in:

1. Actual damages suffered as a result of non-compliance
2. Statutory damages of up to $2,000 for a pattern or practice of non-compliance
3. Costs and reasonable attorney's fees
4. Additional remedies under state law

SECTION VII: PRESERVATION OF RIGHTS

Nothing in this request shall be construed as an admission of the validity of any debt, waiver of any defense, or acknowledgment of any amount owed. All rights and defenses are expressly reserved.

ATTACHMENTS

The following documents are attached to support this request:

☐ Copy of mortgage statement
☐ Payment records/canceled checks
☐ Prior correspondence with servicer
☐ Loss mitigation application documents
☐ Other: [DESCRIBE]

BORROWER SIGNATURE

I certify that the information provided in this Qualified Written Request is true and accurate to the best of my knowledge.

_________________________________
[BORROWER NAME]
Date: _______________

_________________________________
[CO-BORROWER NAME] (if applicable)
Date: _______________

CONTACT INFORMATION FOR RESPONSE

Please send your response to:

[BORROWER NAME]
[MAILING ADDRESS]
[CITY, STATE ZIP]
[TELEPHONE]
[EMAIL]

STATE-SPECIFIC NOTES

CALIFORNIA

• California Civil Code Section 2924.10 requires additional notice provisions
• California Homeowner Bill of Rights provides state-law remedies in addition to RESPA
• Servicer must provide single point of contact upon request

TEXAS

• Texas Property Code Section 51.0025 requires servicer to provide monthly statements
• Texas Finance Code Chapter 392 provides additional debt collection protections
• Note: Texas is primarily a non-judicial foreclosure state

FLORIDA

• Florida Statute Section 494.00791 provides additional servicer requirements
• Florida Consumer Collection Practices Act provides additional protections
• All foreclosures in Florida are judicial and require court action

NEW YORK

• New York Banking Law Section 595-a requires additional servicer disclosures
• New York Real Property Law Section 1304 requires 90-day pre-foreclosure notice
• Mandatory settlement conferences under CPLR 3408

TRACKING LOG

This template is provided for educational and informational purposes only. Federal law requires servicers to respond to QWRs, but responses may vary. Consult with a licensed attorney if you do not receive a timely or adequate response.