Official Form 410S1 Notice of Mortgage Payment Change Page 1 

Fill in this information to identify the case: 

Debtor 1 Tatyana Pauline Arboleda 

Debtor 2 

(Spouse, if filing) 

United States Bankruptcy Court for the: Southern District of Florida___

 (State) 

Case number 21-10636-LMI

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: U.S. BANK TRUST NATIONAL 

ASSOCIATION AS TRUSTEE OF THE TIKI SERIES III TRUST

Court claim no. (if known): ___7_____

Last four digits of any number you 

use to identify the debtor's account: 

4610 

Date of payment change: 

Must be at least 21 days 

after date 

of this notice 

_11/1/2023_____ 

New total payment: 

Principal, interest, and escrow, 

if any 

$_1,009.13___

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 non-bankruptcy law. Describe 

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

__________________________________________________________________________________________________ 

Current escrow payment: $_202.14____ New escrow payment: $_267.24____

 Part 2: Mortgage Payment Adjustment 

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

 debtor's variable-rate note? 

 No

 Yes Attach a copy of the rate change notice prepared in a form consistent with applicable non-bankruptcy 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: $___________ 

Case 21-10636-LMI Doc 163 Filed 09/28/23 Page 1 of 6
Debtor 1 Tatyana Pauline Arboleda Case Number (if known) 21-10636-LMI

 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. 

5 I am the creditor's authorized agent.

 

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

knowledge, information, and reasonable belief. 

2 /s/ Matthew B. Klein Date 09/28/2023 

Signature

Print: Matthew B. Klein 73529 Title Bankruptcy Attorney First name Middle Name Last name

Company HOWARD LAW 

Address 4755 Technology Way, Suite 104, 

 Number Street

 Boca Raton, FL 33431 

 City State Zip Code

Contact phone (954) 893-7874 Email: Matthew@howardlaw.com 

CERTIFICATE OF SERVICE 

I HEREBY CERTIFY that on September 28, 2023, I electronically filed the foregoing with the 

Clerk of Court by using the CM/ECF System, which will send a notice of electronic filing to all CM/ECF 

participants: 

Marilyn L Maloy, Esq., MALOY LAW GROUP, LLC, 540 NW 165 Street Road, Suite 210, Miami, FL 

33169 

Nancy K. Neidich, www.ch13miami.com, POB 279806, Miramar, FL 33027 

Office of the US Trustee, 51 S.W. 1st Ave., Suite 1204 Miami, FL 33130 

And a true and correct copy was mailed to: 

Tatyana Pauline Arboleda, 15067 SW 103 Terrace Apt 14112, Miami, FL 33196 

/s/ Matthew Klein 

MATTHEW KLEIN 

FLORIDA BAR#: 73529 

Case 21-10636-LMI Doc 163 Filed 09/28/23 Page 2 of 6
 ),)7+675((7

(85(.$&$ 

 

3DUD(VSDxRO([W   R 

 DP  SP 3DFLILF7LPH

0DLQ2IILFH10/6

%UDQFK2IILFH10/6

<866(),60$(/

 6: 5'7(5$37 

0,$0,)/ 

$QDO\VLV'DWH6HSWHPEHU )LQDO

3URSHUW\$GGUHVV  6287+:(67  7(55$&(81,7  0,$0,)/  /RDQ 

$QQXDO(VFURZ$FFRXQW'LVFORVXUH6WDWHPHQW

$FFRXQW+LVWRU\

7KLVLVDVWDWHPHQWRIDFWXDODFWLYLW\LQ\RXUHVFURZDFFRXQWIURP1RY  WR2FW  /DVW\HDU
VDQWLFLSDWHGDFWLYLW\

SD\PHQWVWRDQGIURP\RXUHVFURZDFFRXQW LVQH[WWRWKHDFWXDODFWLYLW\

-XO











 





3D\PHQW,QIRUPDWLRQ (VFURZ%DODQFH&DOFXODWLRQ

'XH'DWH

(VFURZ%DODQFH

$QWLFLSDWHG3PWVWR(VFURZ

$QWLFLSDWHG3PWVIURP(VFURZ 

$QWLFLSDWHG(VFURZ%DODQFH

3ULQFLSDO	,QWHUHVW3PW

(VFURZ3D\PHQW

2WKHU)XQGV3D\PHQW

$VVLVWDQFH3D\PHQW 

7RWDO3D\PHQW 









&XUUHQW 



(IIHFWLYH1RY  



 7KHWHUPVRI\RXUORDQPD\UHVXOWLQFKDQJHVWRWKHPRQWKO\SULQFLSDODQGLQWHUHVWSD\PHQWVGXULQJWKH\HDU

5HVHUYH$FFW3D\PHQW  

3D\PHQWVWR(VFURZ

'DWH $QWLFLSDWHG $FWXDO

3D\PHQWV)URP(VFURZ

$QWLFLSDWHG $FWXDO $FWXDO

(VFURZ%DODQFH

'HVFULSWLRQ 5HTXLUHG

6WDUWLQJ%DODQFH  

1RY    
 &RXQW\7D[  

'HF    


-DQ    


)HE    


0DU    


$SU    


0D\    


-XQ    


-XO    


$XJ     


6HS    


6HS    
 (VFURZ2QO\3D\PHQW

2FW    


$QWLFLSDWHG7UDQVDFWLRQV  

6HS  

2FW  

   

$QDVWHULVN 
 LQGLFDWHVDGLIIHUHQFHIURPDSUHYLRXVHVWLPDWHHLWKHULQWKHGDWHRUWKHDPRXQW ,I\RXZDQWDIXUWKHUH[SODQDWLRQSOHDVHFDOO

RXUWROOIUHHQXPEHU

3DJH 

Case 21-10636-LMI Doc 163 Filed 09/28/23 Page 3 of 6
/DVW\HDUZHDQWLFLSDWHGWKDWSD\PHQWVIURP\RXUDFFRXQWZRXOGEHPDGHGXULQJWKLVSHULRGHTXDOLQJ8QGHU

)HGHUDOODZ\RXUORZHVWPRQWKO\EDODQFHVKRXOGQRWKDYHH[FHHGHGRURIWKHDQWLFLSDWHGSD\PHQWIURPWKH

DFFRXQWXQOHVV\RXUPRUWJDJHFRQWUDFWRU6WDWHODZVSHFLILHVDORZHUDPRXQW<RXUPRUWJDJHFRQWUDFWDQG6WDWHODZDUH

VLOHQWRQWKLVLVVXH

3DJH 

Case 21-10636-LMI Doc 163 Filed 09/28/23 Page 4 of 6
$QDO\VLV'DWH6HSWHPEHU )LQDO

%RUURZHU <866(),60$(/ /RDQ

$QQXDO(VFURZ$FFRXQW'LVFORVXUH6WDWHPHQW

3URMHFWLRQVIRU&RPLQJ<HDU

7KLVLVDQHVWLPDWHRIDFWLYLW\LQ\RXUHVFURZDFFRXQWGXULQJWKHFRPLQJ\HDUEDVHGRQSD\PHQWVDQWLFLSDWHGWREHPDGHWRDQG

IURP\RXUDFFRXQW

'DWH $QWLFLSDWHG3D\PHQWV

7R(VFURZ )URP(VFURZ 'HVFULSWLRQ

(VFURZ%DODQFH

$QWLFLSDWHG 5HTXLUHG

6WDUWLQJ%DODQFH  

1RY     &RXQW\7D[

'HF   

-DQ   

)HE   

0DU   

$SU   

0D\   

-XQ   

-XO   

$XJ   

6HS   

2FW   

 

3OHDVHNHHSWKLVVWDWHPHQWIRUFRPSDULVRQZLWKWKHDFWXDODFWLYLW\LQ\RXUDFFRXQWDWWKHHQGRIWKHHVFURZDFFRXQWLQJFRPSXWDWLRQ\HDU

<RXUHVFURZEDODQFHFRQWDLQVDFXVKLRQRI$FXVKLRQLVDQDGGLWLRQDODPRXQWRIIXQGVKHOGLQ\RXUHVFURZ

)HGHUDOODZ\RXUORZHVWPRQWKO\EDODQFHVKRXOGQRWH[FHHGRURIWKHDQWLFLSDWHGSD\PHQWIURPWKHDFFRXQW

XQOHVV\RXUPRUWJDJHFRQWUDFWRU6WDWHODZVSHFLILHVDORZHUDPRXQW<RXUPRUWJDJHFRQWUDFWDQG6WDWHODZDUHVLOHQWRQ

WKLVLVVXH

EDODQFHWRSUHYHQWWKHEDODQFHIURPEHFRPLQJRYHUGUDZQZKHQDQLQFUHDVHLQWKHGLVEXUVHPHQWDPRXQWRFFXUV 8QGHU

<RXUHQGLQJEDODQFHIURPWKHODVWPRQWKRIWKHDFFRXQWKLVWRU\HVFURZEDODQFHDQWLFLSDWHGLV<RXUVWDUWLQJ

EDODQFHHVFURZEDODQFHUHTXLUHGDFFRUGLQJWRWKLVDQDO\VLVVKRXOGEH7KLVPHDQV\RXKDYHDVKRUWDJHRI

7KLVVKRUWDJHPD\EHFROOHFWHGIURP\RXRYHUDSHULRGRIPRQWKVRUPRUHXQOHVVWKHVKRUWDJHLVOHVVWKDQPRQWK
V

GHSRVLWLQZKLFKFDVHZHKDYHWKHDGGLWLRQDORSWLRQRIUHTXHVWLQJSD\PHQWZLWKLQ  GD\V :HKDYHGHFLGHGWRFROOHFWLWRYHU 

PRQWKV

:HDQWLFLSDWHWKHWRWDORI\RXUFRPLQJ\HDUELOOVWREH  :HGLYLGHWKDWDPRXQWE\WKHQXPEHURISD\PHQWVH[SHFWHGGXULQJ

WKHFRPLQJ\HDUWRREWDLQ\RXUHVFURZSD\PHQW

3DJH 

Case 21-10636-LMI Doc 163 Filed 09/28/23 Page 5 of 6
1HZ(VFURZ3D\PHQW&DOFXODWLRQ

8QDGMXVWHG(VFURZ3D\PHQW 

6XUSOXV$PRXQW

6KRUWDJH$PRXQW





5RXQGLQJ$GMXVWPHQW$PRXQW 

(VFURZ3D\PHQW 

3D\LQJWKHVKRUWDJH ,I\RXUVKRUWDJHLVSDLGLQIXOO\RXUQHZ

PRQWKO\SD\PHQWZLOOEH FDOFXODWHGE\VXEWUDFWLQJWKH

6KRUWDJH$PRXQWWRWKHOHIWDQGURXQGLQJLIDSSOLFDEOH 3D\LQJWKH

VKRUWDJHGRHVQRWJXDUDQWHHWKDW\RXUSD\PHQWZLOOUHPDLQWKHVDPHDV

\RXUWD[RULQVXUDQFHELOOVPD\KDYHFKDQJHG ,I\RXZRXOGOLNHWRSD\

WKHVKRUWDJHQRZSOHDVHSD\WKHHQWLUHDPRXQWRIWKHVKRUWDJHEHIRUH

WKHHIIHFWLYHGDWHRI\RXUQHZSD\PHQW 7RHQVXUHWKDWWKHIXQGVDUH

SRVWHGWR\RXUDFFRXQWFRUUHFWO\SOHDVHQRWLI\\RXUDVVHWPDQDJHUWKDW

\RXDUHSD\LQJWKHVKRUWDJH

127,&(2)5,*+772&$1&(/35,9$7(0257*$*(,1685$1&( ,I\RXFXUUHQWO\SD\SULYDWHPRUWJDJHLQVXUDQFH

SUHPLXPV\RXPD\KDYHWKHULJKWWRFDQFHOWKHLQVXUDQFH ,QPRVWFDVHV\RXKDYHWKHULJKWWRFDQFHOSULYDWHPRUWJDJHLQVXUDQFHLI

WKHSULQFLSDOEDODQFHRI\RXUORDQLV  SHUFHQWRUOHVVRIWKHRULJLQDODSSUDLVHGYDOXHRI\RXUKRPHDQG\RXKDYHDJRRGSD\PHQW 

KLVWRU\RQ\RXUORDQ ,I\RXZDQWWROHDUQZKHWKHU\RXDUHHOLJLEOHWRFDQFHOWKLVLQVXUDQFHSOHDVHFRQWDFWXVDW  )LIWK6WUHHW

(XUHND&D  RU 


 3OHDVHQRWHLI\RXKDYHDXWRSD\()7VHWXSRQ\RXUORDQLWLV\RXUUHVSRQVLELOLW\WRPDNHVXUH\RXUSD\PHQWDPRXQWLV

XSGDWHG (QFORVHGLVWKH()7IRUPWKDWQHHGVWREHFRPSOHWHG 2QFHFRPSOHWHGSOHDVHID[WRWKHQXPEHUOLVWHGRQWKH()7IRUP

RUUHWXUQLQWKHVHOIDGGUHVVHGHQYHORSH

%RUURZHU <866(),60$(/ /RDQ

$QDO\VLV'DWH6HSWHPEHU )LQDO

3DJH 

Case 21-10636-LMI Doc 163 Filed 09/28/23 Page 6 of 6