StopMyForeclosure Agreement

 I  *  pay mortgage to * for my residence

 located at  *  City  * State * Zip *  

Phone numbers where I can be reached are:  Home , Work , Cell

 *required fields

Credit/Debit Card or Money Gram Authorization

I also agree that StopMyForeclosure.net is authorized to charge my credit/debit card or accept Money Gram payments for the amounts and dates specified herein.  Final payment must be scheduled no later than 2 weeks after the 1st payment is accepted.

1st Payment Date *

1st Payment Amount  *      

2nd Payment Date *   

2nd Payment Amount .*       

3rd Payment Date *

3rd Payment Amount  *      

Final Payment Date *   

Final Payment Amount .*

* Required field    

Payment Type 

 Billing Address*City* State* Zip*.

Card Number   

Name on card 

Expiration Date (mm/yy)

Security Code  (3 digit code on the back of the card)

For your privacy and security this is a secured site.  Your personal information will not be seen by 3rd parties.  This site is not a processing site and will not charge your credit card.  This information will be entered into our accounts receivable database for processing on the agreed upon date.  if you have any questions please contact accounts receivable management at 877-243-1597.

Money Gram/Account Now Instructions are listed below in the agreement

Signature * Date *(mm/dd/yyyy)

If you would like a copy of this agreement please print now or ask your foreclosure specialist for a copy

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