MORTGAGE DEBT SERVICES, LLC.

Facing foreclosure is an unsettling, emotional event that plagues many families across the United States. Currently, there are more than 1.4 Million mortgagors facing either foreclosure or Bankruptcy. Our Company is one that extends an attentive ear to those in desperate financial need. Our goal is to assist homeowners with foreclosure prevention. We will assist in mediating a forbearance, a workout, a shortsale or a conventional refinance. Our job is not complete until you are satisfied. In fact, our contingency fee is only earned if we get the results you want.

1.	First Name	Last Name
2.	Address
3.	City	State	ZIP
4.	Phone Number	Cell Number
5.	E-Mail Address
6.	Days you are delinquent
7.	Have you been notified of an auction date? Yes No
8.	Are you interested in keeping your home? Yes, I want to keep it No, I want to sell it Need help deciding
9.	Can you meet with one of our representatives immediately? Yes No

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