[Servicer Name]
Customer Service: [PHONE NUMBER] [WEBSITE]
[Borrower Name and Address]
 
Mortgage Statement
Statement Date: _______
Account Number  | 
____________  | 
Payment Due Date  | 
____________  | 
Amount Due  | 
____________  | 
If payment is received after [DATE], $____ late fee will be charged.
 
 
Account Information
Outstanding Principal  | 
$_______  | 
Interest Rate (Until [Date])  | 
______%  | 
Prepayment Penalty  | 
[Yes/No]  | 
 
Explanation of Amount Due
Principal  | 
$_______  | 
Interest  | 
$_______  | 
Escrow (for Taxes and Insurance)  | 
$_______  | 
Regular Monthly Payment  | 
$_______  | 
Total Fees Charged  | 
$_______  | 
Total Amount Due  | 
$_______  | 
 
 
Transaction Activity (_/_/_ [Date] to _/_/_ [Date])
Date  | 
Description  | 
Charges  | 
Payments  | 
[Date]  | 
Late Fee (charged because full payment not received by _/_/_  | 
$  | 
   | 
[Date]  | 
Payment Received – Thank you  | 
   | 
$  | 
[Date]  | 
Fee Description  | 
$  | 
   | 
Past Payments Breakdown
   | 
Paid  | 
Paid  | 
   | 
Last  | 
Year to  | 
   | 
Month  | 
Date  | 
Principal  | 
$  | 
$  | 
Interest  | 
$  | 
$  | 
Escrow (Taxes and Insurance)  | 
$  | 
$  | 
Fees  | 
$  | 
$  | 
Total  | 
$  | 
$  | 
-------------------------------------------------------------------------------------------------------------------------------------------------------------------------
[Servicer Name and Address]
Amount Due
Due By _/_/_ [Date]$
$___ late fee will be charged after [Date]
Additional Principal  | 
$  | 
Additional Escrow  | 
$  | 
Total Amount Enclosed  | 
$  | 
Make check payable to [Servicer Name]
 
 
[Additional tables to be translated]
Important Messages
*Partial Payments: Any partial payments that you make are not applied to your mortgage, but instead are held in a separate suspense account. If you pay the balance of a partial payment, the funds will then be applied to your mortgage.
**Delinquency Notice**
You are late on your mortgage payments. Failure to bring your loan current may result in fees and foreclosure – the loss of your home. As of [Date], you are __ days delinquent on your mortgage loan.
Recent Account History
·Payment due [Date]: Fully paid on time
·Payment due [Date]: Fully paid on [Date]
·Payment due [Date]: Unpaid balance of $________
·Current payment due [Date]: $_______
·Total: $_______ due. You must pay this amount to bring your loan current.
If you are Experiencing Financial Difficulty: See back for information about mortgage counseling or assistance.