Official Form 410S1 Notice of Mortgage Payment Change page 1

2IILFLDO)RUP 410S1 

Notice of Mortgage Payment Change 12/15

If the debtor’s plan provides for payment of postpetition contractual installments on your claim secured by a security interest in the 

debtor’s principal residence, you must use this form to give notice of any changes in the installment payment amount. File this form 

as a supplement to your proof of claim at least 21 days before the new payment amount is due. See Bankruptcy Rule 3002.1. 

Name of creditor: _______________________________________ Court claim no. (if known): _____________________ 

Last 4 digits of any number you use to 

identify the debtor’s account: ____ ____ ____ ____ 

Date of payment change: 

Must be at least 21 days after date 

of this notice 

_____________ 

New total payment:

Principal, interest, and escrow, if any

$ ____________ 

Part 1: Escrow Account Payment Adjustment 

1. Will there be a change in the debtor’s escrow account payment?

 No

Current escrow payment: $ _______________ New escrow payment: $ _______________

Part 2: Mortgage Payment Adjustment

2. Will the debtor’s principal and interest payment change based on an adjustment to the interest rate on the debtor's

variable-rate account?

 No

 Yes. Attach a copy of the rate change notice prepared in a form consistent with applicable nonbankruptcy law. If a notice is not

attached, explain why: _______________________________________________________________________________

__________________________________________________________________________________________________

Current interest rate: _______________% New interest rate: _______________% 

Current principal and interest payment: $ _______________ New principal and interest payment: $ _______________

Part 3: Other Payment Change

3. Will there be a change in the debtor’s mortgage payment for a reason not listed above?

 No

 Yes. Attach a copy of any documents describing the basis for the change, such as a repayment plan or loan modification agreement.

(Court approval may be required before the payment change can take effect.)

Reason for change: ___________________________________________________________________________________

Current mortgage payment: $ _______________ New mortgage payment: $ _______________

Debtor 1 __________________________________________________________________ 

Debtor 2 ________________________________________________________________ 

(Spouse, if filing)

United States Bankruptcy Court for the: __________ District of __________

Case number ___________________________________________ 

Fill in this information to identify the case: 

__________ District of __________

 Yes. Attach a copy of the escrow account statement prepared in a form consistent with applicable nonbankruptcy law. Describe

the basis for the change. If a statement is not attached, explain why: ___________________________________________

__________________________________________________________________________________________________

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Debtor 1 _______________________________________________________ Case number (if known) _____________________________________ First Name Middle Name Last Name

Official Form 410S1 Notice of Mortgage Payment Change page 2

Part 4: Sign Here

The person completing this Notice must sign it. Sign and print your name and your title, if any, and state your address and 

telephone number. 

Check the appropriate box.

 I am the creditor.

 I am the creditor’s authorized agent.

I declare under penalty of perjury that the information provided in this claim is true and correct to the best of my 

knowledge, information, and reasonable belief. 

8_____________________________________________________________ Date ___________________ 

Signature

Print: _________________________________________________________ Title ___________________________

First Name Middle Name Last Name

Company _________________________________________________________

Address _________________________________________________________

Number Street

___________________________________________________

City State ZIP Code

Contact phone ________________________ Email ________________________ 

Keith Yacko Attorney for Creditor 

McMichael Taylor Gray, LLC

3550 Engineering Drive, Suite 260

Peachtree Corners GA 30092

470-289-4347 kyacko@mtglaw.com

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FinalSN Servicing Corporation

323 FIFTH STREET

EUREKA, CA 95501

For Inquiries: (800) 603-0836

Main Office- NMLS ID #5985, Branch Office- NMLS ID #9785

August 23, 2019Analysis Date:

PERCY A MARTIN Loan:

ANGELA MARTIN

16626 TELESCOPE LN

DUMFRIES VA 22026

Property Address:

16626 TELESCOPE LANE

DUMFRIES, VA 22026

Annual Escrow Account Disclosure Statement

Account History

This is a statement of actual activity in your escrow account from Dec 2018 to Sept 2019. Last year's anticipated activity

(payments to and from your escrow account) is next to the actual activity.

Jun 01, 2019

(3,091.02)

2,338.16

1,689.06

584.54

0.00

0.00 0.00

($752.86)

$2,273.60

Payment Information Escrow Balance Calculation

Due Date:

Escrow Balance:

Anticipated Pmts to Escrow:

Anticipated Pmts from Escrow (-):

Anticipated Escrow Balance:

Principal & Interest Pmt:

Escrow Payment:

Other Funds Payment:

Assistance Payment (-):

Total Payment: $2,224.66

0.00

0.00

535.60

1,689.06

Current: Effective Oct 01, 2019:

0.00 0.00Reserve Acct Payment:

Payments to Escrow

Date Anticipated Actual

Payments From Escrow

Anticipated Actual Actual

Escrow Balance

RequiredDescription

Starting Balance 0.00 (1,876.93)

Dec 2018 *505.63 0.00 (1,371.30)

Feb 2019 *1,011.26 0.00 (360.04)

Feb 2019 * Homeowners Policy2,004.00 0.00 (2,364.04)

Mar 2019 *505.63 0.00 (1,858.41)

Apr 2019 *(505.63) 0.00 (2,364.04)

Apr 2019 *505.63 0.00 (1,858.41)

May 2019 *505.63 0.00 (1,352.78)

Jun 2019 *505.63 0.00 (847.15)

Jun 2019 *(505.63) 0.00 (1,352.78)

Jun 2019 * County Tax2,189.19 0.00 (3,541.97)

Jun 2019 * Sewer/Water Tax54.68 0.00 (3,596.65)

Jul 2019 *505.63 0.00 (3,091.02)

Aug 2019 *505.63 0.00 (2,585.39)

Aug 2019 *(505.63) 0.00 (3,091.02)

Anticipated Transactions 0.00 (3,091.02)

Aug 2019 1,753.62 (1,337.40)

Sep 2019 584.54 (752.86)

$0.00 $5,371.94 $0.00 $4,247.87

An asterisk (*) indicates a difference from a previous estimate either in the date or the amount. If you want a further explanation, please call

our toll-free number.

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Last year, we anticipated that payments from your account would be made during this period equaling 0.00. Under

Federal law, your lowest monthly balance should not have exceeded 0.00 or 1/6 of the anticipated payment from the

account, unless your mortgage contract or State law specifies a lower amount. Your mortgage contract and State law are

silent on this issue.

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FinalSN Servicing Corporation

For Inquiries: (800) 603-0836

Main Office- NMLS ID #5985, Branch Office- NMLS ID #9785

August 23, 2019Analysis Date:

PERCY A MARTIN Loan:

Annual Escrow Account Disclosure Statement

Projections for Coming Year

This is an estimate of activity in your escrow account during the coming year based on payments anticipated to be made to and

from your account.

Date Anticipated Payments

To Escrow From Escrow Description

Escrow Balance

Anticipated Required

Starting Balance (752.86) 2,576.47

Oct 2019 535.60 (217.26) 3,112.07

Nov 2019 535.60 318.34 3,647.67

County TaxDec 2019 535.60 2,124.60 (1,270.66) 2,058.67

Sewer/Water TaxDec 2019 54.68 (1,325.34) 2,003.99

Jan 2020 535.60 (789.74) 2,539.59

Homeowners PolicyFeb 2020 535.60 2,004.00 (2,258.14) 1,071.19

Mar 2020 535.60 (1,722.54) 1,606.79

Apr 2020 535.60 (1,186.94) 2,142.39

May 2020 535.60 (651.34) 2,677.99

Jun 2020 535.60 (115.74) 3,213.59

County TaxJul 2020 535.60 2,189.19 (1,769.33) 1,560.00

Sewer/Water TaxJul 2020 54.68 (1,824.01) 1,505.32

Aug 2020 535.60 (1,288.41) 2,040.92

Sep 2020 535.60 (752.81) 2,576.52

$6,427.20 $6,427.15

(Please keep this statement for comparison with the actual activity in your account at the end of the escrow accounting computation year.)

Your escrow balance contains a cushion of 1,071.19. A cushion is an additional amount of funds held in your escrow

Federal law, your lowest monthly balance should not exceed 1,071.19 or 1/6 of the anticipated payment from the account,

unless your mortgage contract or State law specifies a lower amount. Your mortgage contract and State law are silent on

this issue.

balance to prevent the balance from becoming overdrawn when an increase in the disbursement amount occurs. Under

Your ending balance from the last month of the account history (escrow balance anticipated) is (752.86). Your starting

balance (escrow balance required) according to this analysis should be $2,576.47. This means you have a shortage of 3,329.33.

This shortage may be collected from you over a period of 12 months or more unless the shortage is less than 1 month's

deposit, in which case we have the additional option of requesting payment within 30 days. We have decided to do nothing.

We anticipate the total of your coming year bills to be 6,427.15. We divide that amount by the number of payments expected during

the coming year to obtain your escrow payment.

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New Escrow Payment Calculation

Unadjusted Escrow Payment 535.60

Surplus Amount:

Shortage Amount:

0.00

0.00

Rounding Adjustment Amount: 0.00

Escrow Payment: $535.60

NOTICE OF RIGHT TO CANCEL PRIVATE MORTGAGE INSURANCE: If you currently pay private mortgage insurance

premiums, you may have the right to cancel the insurance. In most cases, you have the right to cancel private mortgage insurance if

the principal balance of your loan is 80 percent or less of the current fair market appraised value of your home, and you have a good

payment history on your loan. If you want to learn whether you are eligible to cancel this insurance, please contact us at 323 Fifth

Street, Eureka, Ca 95501 or 800-603-0836.

* Please note if you have autopay/EFT set up on your loan, it is your responsibility to make sure your payment amount is

updated

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CERTIFICATE OF SERVICE

The undersigned hereby certifies under penalty of perjury that he/she is over eighteen (18) years 

of age and that the NOTICE OF MORTGAGE PAYMENT CHANGE in the above captioned 

case was this day served upon the below named persons by mailing, postage prepaid, first class 

mail a copy of such instrument to each person(s), parties, and/or counsel at the addresses shown 

below: 

Via U.S. Mail 

Percy A. Martin 

16626 Telescope Lane 

Dumfries, VA 22026 

Via CM/ECF electronic service: 

Trustee 

/s/ Keith Yacko__ 

Keith Yacko 

Virginia Bar No. 37854 

McMichael Taylor Gray, LLC 

3550 Engineering Drive 

Suite 260 

Peachtree Corners, GA 30092 

470-289-4347 

kyacko@mtglaw.com 

Thomas P. Gorman 

300 N. Washington St. Ste. 400 

Alexandria, VA 22314 

Tommy Andrews, Jr. 

Tommy Andrews, Jr. P.C. 

122 North Alfred St. 

Alexandria, VA 22314 

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