Foreclosure Mediation Request Form
Formally request court-supervised foreclosure mediation — a mandatory step in many states before a foreclosure judgment can be entered.
The Foreclosure Mediation Request Form is the official document that invokes your right to participate in court-supervised foreclosure mediation or a mandatory settlement conference. Mediation brings the homeowner and lender to the table with a neutral third-party mediator to explore alternatives to foreclosure: loan modification, forbearance, short sale, deed-in-lieu, or other resolutions. In states with mandatory mediation (e.g., New York's CPLR 3408 settlement conferences, New Jersey's Foreclosure Mediation Program, Florida's managed mediation), the lender cannot obtain a foreclosure judgment without participating in mediation. The request form is your entry ticket — it must be filed within the program's specific deadline (often 15-30 days after being served) and typically includes financial disclosures.
Purpose of This Form
- 1Invoke your right to a foreclosure settlement conference or mediation
- 2Bring the lender to the negotiating table supervised by a neutral mediator
- 3Explore all loss mitigation alternatives before foreclosure proceeds
- 4Document servicer bad faith or dual tracking in a supervised forum
- 5Delay foreclosure while good-faith negotiations take place
Form Sections & How to Complete
Property and Case Information
Property address, case number, court, plaintiff (lender), and defendant (homeowner) information. This must match the foreclosure complaint exactly.
Owner-Occupancy Certification
Certify that the property is (or was) your primary residence. Most mediation programs are limited to owner-occupied residential properties — investment properties and vacant properties typically do not qualify.
Financial Disclosure
Provide income, expenses, assets, and hardship information. This is the core of the mediation request — the mediator and lender use this to determine whether modification or other alternatives are feasible. Be accurate and honest — falsifying financial information can result in sanctions.
Hardship Statement
Briefly explain the circumstances that caused the default: job loss, medical emergency, divorce, reduction in income, etc. This humanizes your application and provides context for the financial numbers.
Good Faith Certification
Certify that you are participating in mediation in good faith and have the willingness and ability to pay a modified mortgage amount if approved.
Filing Requirements
Where to File
The court where the foreclosure is pending (in mandatory mediation states) or the designated mediation program administrator. Follow your state's specific mediation program procedures.
Filing Fees
Typically no filing fee for the mediation request. Mediator fees (if any): often split between parties or subsidized by the court program.
Copies Required
Original to court/mediation program + copy to lender's attorney + keep a copy with proof of service.
Timing / Deadlines
Deadline varies by state: typically 15-30 days after service of the complaint, or by a date certain stated in the summons. NY: file a Request for Judicial Intervention (RJI) with RJI Addendum. NJ: mediation is automatic for owner-occupied properties. Check your state's program.
Other Mediation Forms
Related Forms
Mediation Financial Worksheet
Mediation
loss-mitigation-package-request
Coming soon
Answer to Foreclosure Complaint (State Court)
State Court
Frequently Asked Questions
Is foreclosure mediation mandatory in my state?▼
It depends on your state. States with mandatory mediation for residential foreclosures: New York (CPLR 3408 settlement conferences), New Jersey (statewide mediation program), Florida (for homestead properties), Illinois, Connecticut, Maryland, Indiana, Ohio (some counties), Nevada (mandatory mediation program), and several others. Many other states have voluntary programs. Check your state's specific foreclosure mediation laws.
What should I bring to the mediation session?▼
Come prepared: (1) complete loss mitigation package (already submitted to the servicer), (2) evidence of the servicer's failure to properly review (dual tracking evidence, dates), (3) documentation of RESPA violations (unanswered QWRs, NOEs sent without response), (4) proof of current income (pay stubs, tax returns), (5) a realistic proposal — what you can actually afford monthly, (6) a list of questions/issues to raise with the mediator. The more prepared you are, the more likely mediation succeeds.
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