[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.