Forms Adopted By Rule
The following six forms will be published with the Temporary program rules. In most cases, these forms should be completed with the assistance of the mediation service provider or a housing counselor using the web-based computer program available at www.ForeclosureMediationOR.org.
- Notice of Mediation, Form 410
- Mediation Scheduling Notice, Form 420
- Homeowner’s Affidavit for Counseling Waiver, Form 430
- Universal Intake Form, Form 610
- Certificate of Compliance, Form 670
- Determination of Grantor Ineligibility for Foreclosure Avoidance Measure, Form 20
Other Forms
Beneficiary Exemption Affidavit, Form 2:2:d - This is a sample of a form of affidavit that a beneficiary may use for claiming the exemption from mediation found in Oregon Laws 2012 ch 112 Section 2 (i.e. Beneficiaries who did not commence more than 250 actions to foreclosure a residential trust deed during the preceding calendar year). Once completed, the form may be provided to the Attorney General by emailing a copy to foreclosuremediation@doj.state.or.us or by mailing to: Foreclosure Avoidance Mediation, Oregon Department of Justice, 1162 Court Street NE, Salem, OR 97301-4096. (SB 1552 requires this affidavit to be filed within 30 days after the operative date of the legislation (July 11) or when filing a notice of default under ORS 86.735. For this reason, the Beneficiary Exemption Affidavit will not be accepted prior to July 11, 2012.)
Homeowner Foreclosure Assistance Resources, Form 400 - This form is intended to accompany the Mediation Scheduling Notice. The contents of this form will be updated as the contact information for housing counseling and legal aide resources change.
Agreement to Mediate - This agreement is developed by the mediation service provider and executed early in the mediation process to clarify the details of mediation and the extent to which the mediation communications are confidential.
Mediation Report, Form 640(7) - This is a form used by mediators to report, in general terms, the outcome of the mediation.
Mediation Agreement, Form 660(2) - This template is used by the parties to the mediation and the mediator to write up any agreement resulting from the mediation.
Affidavit of Compliance, Form 4a - A form of Affidavit for Beneficiary compliance with Oregon Laws Chapter 112 Section 4a.