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H.I.S. COTA Report
Intake Form

Please complete this multi-step intake form to order your comprehensive H.I.S. COTA Report. Ensure all required fields marked with an asterisk (*) are filled out accurately.

Purpose: This intake form helps Home Information Support (“H.I.S.”) gather the information and documents needed to prepare a COTA Report™ concerning the recorded chain of title, mortgage/deed of trust history, assignments, servicing claims, foreclosure-related records, and other potentially relevant document issues.


Important: H.I.S. provides educational research and document-analysis services only. H.I.S. is not a law firm, does not provide legal advice, and does not guarantee a particular outcome, cancellation, modification, settlement, litigation result, or foreclosure defense result.

Birthday
Month
Day
Year
Preferred Contact
Is Your Mailing Address the same as the property subject of the COTA Report?
Yes
No
Complete if mailing address is different than the property subject of the COTA Report research
Are You Presently Facing Foreclosure?
Yes
No
Have You Faced Past Foreclosure Threats / Attempts for Your Current Mortgage?
Yes
No
Have You Filed Bankruptcy In the Since You Owned Your Home?
Yes
No
Your Primary Reason for Ordering a COTA Report™ (Select all that apply).

AUTHORIZATION, REPRESENTATIONS, AND ACKNOWLEDGMENTS


By signing the box below, I acknowledge and agree that:

  • I have provided information that is accurate to the best of my knowledge.

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H.I.S. COTA Report (Digital Copy, w/ Rush Delivery Option).
H.I.S. COTA Report (Digital and Paper Copy, w/ Rush Delivery Option).
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