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Mortgage Proof of Claim Instructions

Official Form 410A

Instructions for Mortgage Proof of Claim Attachment

United States Bankruptcy Court                                                                                                                                                                                                                12/15




This form is used only in individual debtor cases.

When required to be filed, it must be attached to Proof of Claim (Official Form B410) with other documentation required under the Federal Rules of Bankruptcy Procedure.

Applicable Law and Rules

Rule 3001(c)(2)(A) of the Federal Rules of Bankruptcy Procedure requires for the bankruptcy case of an individual that any proof of claim be accompanied by a statement itemizing any interest, fees, expenses, and charges that are included in the claim. 

Rule 3001(c)(2)(B) requires that a statement of the amount necessary to cure any default be filed with the claim if a security interest is claimed in the debtor’s property. 

If a security interest is claimed in property that is the debtor’s principal residence, Rule 3001(c)(2)(C) requires this form to be filed with the proof of claim. The form implements the requirements of Rule 3001(c)(2)(A) and (B). 

If an escrow account has been established in connection with the claim, Rule 3001(c)(2)(C) also requires an escrow statement to be filed with the proof of claim. The statement must be prepared as of the date of the petition and in a form consistent with applicable nonbankruptcy law. 



This form must list all transactions on the claim from the first date of default to the petition date. The first date of default is the first date on which the borrower failed to make a payment in accordance with the terms of the note and mortgage, unless the note was subsequently brought current with no principal, interest, fees, escrow payments, or other charges immediately payable.

Information required in Part 1: Mortgage and Case Information

Insert on the appropriate lines:

  • the case number;
  • the names of Debtor 1 and Debtor 2;
  • the last 4 digits of the loan account number or any other number used to identify the account;
  • the creditor’s name; 
  • the servicer’s name, if applicable; and
  • the method used to calculate interest on the debt (i.e., fixed accrual, daily simple interest, or other method).




Information required in Part 2: Total Debt Calculation


  • the principal balance on the debt; 
  • the interest due and owing; 
  • any fees or costs owed under the note or mortgage and outstanding as of the date of the bankruptcy filing; and
  • any Escrow deficiency for funds advanced— that is, the amount of any prepetition payments for taxes and insurance that the servicer or mortgagee made out of its own funds and for which it has not been reimbursed.

Also disclose the Total amount of funds on hand. This amount is the total of the following, if applicable: 

  • a positive escrow balance, 
  • unapplied funds, and 
  • amounts held in suspense accounts.

Total the amounts owed—subtracting total funds on hand—to determine the total debt due. 

Insert this amount under Total debt. The amount should be the same as the claim amount that you report on line 7 of Official Form 410.


Information required in the Part 3: Arrearage as of the Date of Petition

Insert the amount of the principal and interest portion of all prepetition monthly installments that remain outstanding as of the petition date.  The escrow portion of prepetition monthly installment payments should not be included in this figure.

Insert the amount of fees and costs outstanding as of the petition date. This amount should equal the Fees/Charges balance as shown in the last entry in Part 5, Column P.

Insert any escrow deficiency for funds advanced. This amount should be the same as the amount of escrow deficiency stated in Part 2.

Insert the Projected escrow shortage as of the date the bankruptcy petition was filed. The projected escrow shortage is the amount the claimant asserts should exist in the escrow account as of the petition date, less the amount actually held. The amount actually held should equal the amount of a positive escrow account balance as shown in the last entry in Part 5, Column O.

This calculation should result in the amount necessary to cure any prepetition default on the note or mortgage that arises from the failure of the borrower to satisfy the amounts required under the Real Estate Settlement Practices Act (RESPA). The amount necessary to cure should include 1/6 of the anticipated annual charges against the escrow account or 2 months of the monthly pro rata installments due by the borrower as calculated under RESPA guidelines. The amount of the projected escrow shortage should be consistent with the escrow account statement attached to the Proof of Claim, as required by Rule 3001(c)(2)(C).  

Insert the amount of funds on hand that are unapplied or held in a suspense account as of the petition date.

Total the amounts due listed in Part 3, subtracting the funds on hand, and insert the calculated amount in Total prepetition arrearage. This should be the same amount as “Amount necessary to cure any default as of the date of the petition” that your report on line 9 of Official Form 410.




Information required in Part 4: Monthly Mortgage Payment



Insert the principal and interest amount of the first postpetition payment.

Insert the monthly escrow portion of the monthly payment. This amount should take into account the receipt of any amounts claimed in Part 3 as escrow deficiency and projected escrow shortage. Therefore, a claimant should assume that the escrow deficiency and shortage will be paid through a plan of reorganization and provide for a credit of a like amount when calculating postpetition escrow installment payments.  

Claimants should also add any monthly private mortgage insurance amount.

Insert the sum of these amounts in Total monthly payment

Information required in Part 5: Loan Payment History from the First Date of Default

Beginning with the First Date of Default, enter:

  • the date of the default in Column A;
  • amount incurred in Column D; 
  • description of the charge in Column E;
  • principal balance, escrow balance, and unapplied or suspense funds balance as of that date in Columns M, O, and Q, respectively.



For (1) all subsequently accruing installment payments; (2) any subsequent payment received; (3) any fee, charge, or amount incurred; and (4) any escrow charge satisfied since the date of first default, enter the information in date order, showing:



  • the amount paid, accrued, or incurred;
  • a description of the transaction; 
  • the contractual due date, if applicable; 
  • how the amount was applied or assessed; and
  • the resulting principal balance, accrued interest balance, escrow balance, outstanding fees or charges balance, and the total unapplied funds held or in suspense.

If more space is needed, fill out and attach as many copies of Mortgage Proof of Claim

Attachment: Additional Page as necessary.