Official Form 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

 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: ___________________________________________

__________________________________________________________________________________________________

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 __________ (State)

Case number ___________________________________________

Fill in this information to identify the case:

Official Form 410S1 Notice of Mortgage Payment Change page 1

Escrow Analysis

Chalet Properties III, LLC. 3-1

3319

1,709.38

473.24 450.13

Willie E. Parker 

Eastern VA

17-11751-BFK

08 01 2019

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

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.

û_____________________________________________________________ Date ____/_____/________

Signature

Print: _________________________________________________________ Title ___________________________

First Name Middle Name Last Name

Company _________________________________________________________

Address _________________________________________________________

Number Street

___________________________________________________

City State ZIP Code

Contact phone (______) _____– _________ Email ________________________

Official Form 410S1 Notice of Mortgage Payment Change page 2

X

Willie E. Parker 17-11751-BFK

/s/ Michelle Ghidotti 07/06/2019

Michelle Ghidotti-Gonsalves AUTHORIZED AGENT

Ghidotti/Berger LLP.

1920 Old Tustin Ave.

Santa Ana, CA 92705

949 427 2010 MGhidotti@ghidottiberger.com

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Document Page 2 of 6
314 S. Franklin Street, 2nd Floor 

P.O. Box 517 

Titusville, PA 16354 

1-800-327-7861 

https://myloanweb.com/BSI 

Licensed as Servis One, Inc. dba BSI Financial Services. BSI Financial Services NMLS# 38078. Colorado Office Location: 13111 E. Briarwood Ave.,

Suite 340, Centennial, CO 80112 80112 (303) 309-3839. Licensed as a Debt Collection Agency by the New York City Department of Consumer Affairs, (#

2001485-DCA). North Carolina Collection Agency Permit (# 105608). 

PROPERTY ADDRESS

5785 ROCKLIFF LN

WOODBRIDGE, VA 22193

WILLIE E PARKER

REGINA M PARKER

5785 ROCKCLIFF LN

WOODBRIDGE, VA 22193

 101

DATE: 06/25/19

ACCOUNT NUMBER:

Annual Escrow Account

Disclosure Statement

PLEASE REVIEW THIS STATEMENT CLOSELY - YOUR MORTGAGE PAYMENT MAY BE AFFECTED. THIS STATEMENT TELLS

YOU OF ANY CHANGES IN YOUR MORTGAGE PAYMENT, ANY SURPLUS REFUNDS, OR ANY SHORTAGE YOU MUST PAY.

IT ALSO SHOWS YOU THE ANTICIPATED ESCROW ACTIVITY FOR YOUR ESCROW CYCLE BEGINNING 08/01/2019

THROUGH 07/31/2020.

 -------- ANTICIPATED PAYMENTS FROM ESCROW 08/01/2019 TO 07/31/2020 ---------

HOMEOWNERS INS $1,598.00

COUNTY TAX $3,803.61

TOTAL PAYMENTS FROM ESCROW $5,401.61

MONTHLY PAYMENT TO ESCROW $450.13

 ------ ANTICIPATED ESCROW ACTIVITY 08/01/2019 TO 07/31/2020 ---------

 ANTICIPATED PAYMENTS ESCROW BALANCE COMPARISON

MONTH TO ESCROW FROM ESCROW DESCRIPTION ANTICIPATED REQUIRED

 STARTING BALANCE --> $10,507.77 $900.31

AUG $450.13 $10,957.90 $1,350.44

SEP $450.13 $11,408.03 $1,800.57

OCT $450.13 $11,858.16 $2,250.70

NOV $450.13 $12,308.29 $2,700.83

DEC $450.13 $1,812.45 COUNTY TAX $10,945.97 $1,338.51

JAN $450.13 $11,396.10 $1,788.64

FEB $450.13 $11,846.23 $2,238.77

MAR $450.13 $12,296.36 $2,688.90

APR $450.13 $12,746.49 $3,139.03

MAY $450.13 $13,196.62 $3,589.16

JUN $450.13 $1,598.00 HOMEOWNERS INS $12,048.75 $2,441.29

JUL $450.13 $1,991.16 COUNTY TAX L1->$10,507.72 L2-> $900.26

 --------- DETERMINING THE SUFFICIENCY OF YOUR ESCROW BALANCE --------

IF THE ANTICIPATED LOW POINT BALANCE (L1) IS GREATER THAN THE REQUIRED BALANCE (L2), THEN YOU HAVE AN

ESCROW SURPLUS. YOUR ESCROW SURPLUS IS $9,607.46.

 CALCULATION OF YOUR NEW PAYMENT 

PRIN & INTEREST $1,259.25

ESCROW PAYMENT $450.13

NEW PAYMENT EFFECTIVE 08/01/2019 $1,709.38

YOUR ESCROW CUSHION FOR THIS CYCLE IS $900.26.

PAGE 1 OF 2 

********** Continued on reverse side ************

Our records indicate that you have filed for Bankruptcy protection. As a result of your

Bankruptcy filing, escrow account deficiencies prior to your filing date have been removed

from calculation of your analysis, and they are now reflected as amounts due within your

pre-petition arrearage. This Escrow Analysis Statement was prepared under the

assumption that all escrow payments have been made in the amount required each

month. The surplus funds indicated above are not an accurate reflection of your escrow

account because no surplus funds will exist until all amounts are received towards your

pre-petition arrearage. 

004 1461093319_ESCROWDISCS 

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 ACCOUNT HISTORY

THIS HISTORY STATEMENT COMPARES YOUR PRIOR ANALYSIS CYCLE PROJECTED ESCROW ACTIVITY TO THE ACTUAL

ESCROW ACTIVITY BEGINNING 08/01/2018 AND ENDING 07/31/2019. IF YOUR LOAN WAS PAID-OFF, ASSUMED OR

TRANSFERRED DURING THIS PRIOR CYCLE, OR THE COMPUTATION YEAR IS BEGING CHANGED, ACTUAL ACTIVITY STOPS AT

THAT POINT. THIS STATEMENT IS INFORMATION ONLY AND REQUIRES NO ACTION ON YOUR PART.

YOUR PAYMENT BREAKDOWN AS OF 08/01/2018 IS:

PRIN & INTEREST $1,259.25

ESCROW PAYMENT $473.24

BORROWER PAYMENT $1,732.49

 PAYMENTS TO ESCROW PAYMENTS FROM ESCROW ESCROW BALANCE

MONTH PRIOR PROJECTED ACTUAL PRIOR PROJECTED ACTUAL DESCRIPTION PRIOR PROJECTED ACTUAL

 STARTING BALANCE $0.00 $0.00

SEP $0.00 $7,434.58 * $0.00 $7,434.58-

OCT $0.00 $445.09 * $0.00 $6,989.49-

NOV $0.00 $439.66 * $1,812.45 * COUNTY TAX $0.00 $8,362.28-

DEC $0.00 $879.32 * $54.68 * UTILITY $0.00 $7,537.64-

JAN $0.00 $439.66 * $0.00 $7,097.98-

FEB $0.00 $439.66 * $0.00 $6,658.32-

MAR $0.00 $439.66 * $0.00 $6,218.66-

APR $0.00 $879.32 * $0.00 $5,339.34-

MAY $0.00 $439.66 * $1,598.00 * HOMEOWNERS INS $0.00 $6,497.68-

JUN $0.00 $0.00 $1,991.16 * COUNTY TAX $0.00 A-> $8,543.52-

JUN $54.68 IRRIGATION FEE __________ __________ __________ __________

 $0.00 $3,032.55 $0.00 $5,510.97

UNDER FEDERAL LAW, WHEN YOUR ACTUAL ESCROW BALANCE REACHED THE LOWEST POINT, THAT BALANCE WAS

TARGETED NOT TO EXCEED 1/6TH OF THE ANNUAL PROJECTED DISBURSEMENTS. YOUR LOAN DOCUMENTS OR STATE

LAW MAY SPECIFY THAT YOUR LOWEST BALANCE MUST BE A LOWER AMOUNT THAN THE FEDERAL LAW ALLOWS.

UNDER YOUR MORTGAGE CONTRACT OR STATE OR FEDERAL LAW, YOUR TARGETED LOW POINT BALANCE (T) WAS

$0.00. YOUR ACTUAL LOW POINT ESCROW BALANCE (A) WAS $8,543.52-.

BY COMPARING THE ANTICIPATED ESCROW TRANSACTIONS WITH THE ACTUAL TRANSACTIONS YOU CAN DETERMINE

WHERE A DIFFERENCE MAY HAVE OCCURRED. AN ASTERISK (*) INDICATES A DIFFERENCE IN EITHER THE AMOUNT OR

DATE OF THE PROJECTED ACTIVITY THAT HAS NOT YET OCCURRED DUE TO THE DATE OF THIS STATEMENT. 

IF THERE ARE NO PRIOR PAYMENTS TO OR FROM ESCROW SHOWN, THERE WAS NO PRIOR PROJECTION TO WHICH THE

ACTUAL ACTIVITY COULD BE COMPARED. 

Determining your Shortage or Surplus

Shortage:

Any shortage in your escrow account is usually caused by one the following items: An increase, if any, in what was paid for insurance and/or taxes from your escrow account.

A projected increase in taxes for the upcoming year.

The number of months elapsed from the time of these disbursements to the new payment effective date.

Shortages are divided evenly of the next twelve months. To reduce the increase in your monthly payment, the

shortage can be paid either partially or in full.

Surplus:

A surplus in your escrow account is usually caused by one the following items: The insurance/taxes paid during the past year were lower than projected.

A refund was received from the taxing authority or insurance carrier.

Additional funds were applied to your escrow account.

If your surplus is $50.00 or greater and your loan was contractually current at the time when the analysis was

run or calculated, a check will be sent to you. If your surplus is less than $50.00, the funds will be retained in

your escrow account. 

...

...

PAGE 2 OF 2 

********** Continued from front **********

If you have filed a bankruptcy petition and there is either an "automatic stay" in effect in your bankruptcy case or you have received a discharge of your personal liability for the obligation identified in this letter, we

may not and do not intend to pursue collection of that obligation from you personally. If these circumstances apply, this notice is not and should not be construed to be a demand for payment from you personally.

Unless the Bankruptcy Court has ordered otherwise, please also note that despite any such bankruptcy filing, whatever rights we hold in the property that secures the obligation remain unimpaired

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CERTIFICATE OF SERVICE

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Michelle R. Ghidotti-Gonsalves, Esq. (SBN 232837)

Kristin A. Zilberstein (SBN 200041)

GHIDOTTI BERGER LLP

1920 Old Tustin Ave.

Santa Ana, CA 92705

Ph: (949) 427-2010

Fax: (949) 427-2732

mghidotti@ghidottilaw.com

Attorney for Creditor

Chalet Properties III, LLC

UNITED STATES BANKRUPTCY COURT

EASTERN DISTRICT OF VIRGINIA (ALEXANDRIA)

In Re:

Willie E. Parker,

Debtors.

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CASE NO.: 17-11751-BFK

CHAPTER 13

CERTIFICATE OF SERVICE

CERTIFICATE OF SERVICE

I am employed in the County of Orange, State of California. I am over the age of 

eighteen and not a party to the within action. My business address is: 1920 Old Tustin Ave., 

Santa Ana, CA 92705.

I am readily familiar with the business’s practice for collection and processing of 

correspondence for mailing with the United States Postal Service; such correspondence would 

be deposited with the United States Postal Service the same day of deposit in the ordinary 

course of business.

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CERTIFICATE OF SERVICE

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On July 6, 2019 I served the following documents described as: 

 PAYMENT CHANGE NOTICE

on the interested parties in this action by placing a true and correct copy thereof in a sealed 

envelope addressed as follows:

(Via United States Mail)

Debtor

Willie E. Parker

5785 Rockcliff Lane 

Woodbridge, VA 22193

Debtor’s Counsel

Tommy Andrews, Jr.

Tommy Andrews, Jr. P.C. 

122 North Alfred St. 

Alexandria, VA 22314

Chapter 13 Trustee

Thomas P. Gorman

300 N. Washington St. Ste. 400 

Alexandria, VA 22314

U.S. Trustee

U.S. Trustee

Office of The United States Trustee

1725 Duke Street, Suite 650

Alexandria, VA 22314

_xx___(By First Class Mail) At my business address, I placed such envelope for deposit with 

the United States Postal Service by placing them for collection and mailing on that date 

following ordinary business practices.

______Via Electronic Mail pursuant to the requirements of the Local Bankruptcy Rules of the 

Eastern District of California 

__xx_(Federal) I declare under penalty of perjury under the laws of the United States of 

America that the foregoing is true and correct.

Executed on July 6, 2019 at Santa Ana, California

/s / Maben May

Maben May

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