CFPB v CFLA Claims Worksheet

CFPB v. CFLA

Claims Administrator

P.O. Box 6909

Portland, OR 97228-6909

<<Mail ID>>

<<Name 1>>

<<Name 2>>

<<Address 1>>

<<Address 2>>

<<Address 3>>

<<Address 4>>

<<Address 5>>

<<City>><<State>><<Zip>>

<<Country>>

Tracking Number: <Tracking Number>>

<<DATE>>

To receive a payment, you must fill out and return a claim form by

<<Claims Due Date>>.

_{CLAIM WORKSHEET}

Consumer Financial Protection Bureau v. Certified Forensic Loan Auditors, LLC

Case No. CV 19-07722-ODW (JEMx)

We are the Consumer Financial Protection Bureau (CFPB), a federal government agency that enforces laws that protect consumers. The CFPB sued Certified Forensic Loan Auditors, LLC, and its owner, for charging illegal advance fees for mortgage-assistance relief and financial advisory services and deceptive and abusive practices. The CFPB prevailed in its lawsuit, and the company’s records indicate that Certified Forensic Loan Auditors, LLC collected fees from you in violation of the law.

If you paid fees to Certified Forensic Loan Auditors, LLC you may be eligible for a refund. If you have already received a check, and if any of the fees you paid to Certified Forensic Loan Auditors, LLC were not included in the check you received, you may claim the additional fees you paid.

Here’s what to do before <<deadline>>:

• Gather all the information about fees you paid to Consumer Forensic Loan Auditors, LLC.

• For each payment you made, you’ll need:

• Amount, date of payment, and if you know it, the description of the fee

• Proof of payment, such as credit card or bank statements or copies of cancelled checks

File your claim online	OR	File your claim by mail
Fill in your information online at www.cfpb-cfla.org		Use the worksheet to organize each payment Sign and date the form Email the form to [email protected] or mail it to P.O. Box 6909, Portland, OR 97228-6909

COMPLETE THIS SECTION ONLY IF YOUR NAME AND ADDRESS PRINTED ABOVE NEED TO BE CORRECTED.

First Name* MI* Last Name*

Business Name (if applicable)

*Please provide copies of supporting documentation for any name changes.

Mailing Address

City State ZIP Code

You must answer the following questions before submitting your claim:

Have you already received a refund for any of the fees you paid to Certified Forensic Loan Auditors, LLC?

_{Yes No}

How much did you receive as a refund for fees you paid to Certified Forensic Loan Auditors, LLC?

●

Please fill in the total dollar amount of the fees you paid and sign below. Attach copies of all payments and receipts.

●

The information I have provided on this form is true to the best of my knowledge.

Signature:

MM DD YY

HOW MUCH DID YOU PAY?

You need to send proof of the amount(s) of fees you paid to Certified Forensic Loan Auditors, LLC so we can confirm your payments and process your refund claim. Make copies of the proofs of payment and any receipts. Here are some ways you can provide proof of payment:

√ Canceled check image(s);

√ Canceled money order image(s);

√ eCheck receipt(s);

√ Credit card, debit card, or bank statement showing payment was sent to Certified Forensic Loan Auditors, LLC; and/or

√ Email confirmation from Certified Forensic Loan Auditors, LLC or someone acting on its behalf that a specific payment was received.

How much did you pay Certified Forensic Loan Auditors, LLC from July 1, 2014, through July 20, 2020? Fill out one section for each payment you made.

Date of Payment (MM/DD/YY) Amount Payment made to:

/ / _●

Is proof of payment attached? Proof of payment is required for eligibility.

YES NO

Was any portion of this payment refunded already?

_{YES NO}

What was the amount refunded for this payment?

_.

Date of Payment (MM/DD/YY) Amount Payment made to:

/ / _●

Is proof of payment attached? Proof of payment is required for eligibility.

YES NO

Was any portion of this payment refunded already?

_{YES NO}

What was the amount refunded for this payment?

_.

Date of Payment (MM/DD/YY) Amount Payment made to:

/ / _●

Is proof of payment attached? Proof of payment is required for eligibility.

YES NO

Was any portion of this payment refunded already?

_{YES NO}

What was the amount refunded for this payment?

_.

HOW MUCH DID YOU PAY?

You need to send proof of the amount(s) of fees you paid to Certified Forensic Loan Auditors, LLC so we can confirm your payments and process your refund claim. Make copies of the proofs of payment and any receipts. Here are some ways you can provide proof of payment:

√ Canceled check image(s);

√ Canceled money order image(s);

√ eCheck receipt(s);

√ Credit card, debit card, or bank statement showing payment was sent to Certified Forensic Loan Auditors, LLC; and/or

√ Email confirmation from Certified Forensic Loan Auditors, LLC or someone acting on its behalf that a specific payment was received.

How much did you pay Certified Forensic Loan Auditors, LLC from July 1, 2014, through July 20, 2020? Fill out one section for each payment you made.

Date of Payment (MM/DD/YY) Amount Payment made to:

/ / _●

Is proof of payment attached? Proof of payment is required for eligibility.

YES NO

Was any portion of this payment refunded already?

_{YES NO}

What was the amount refunded for this payment?

_.

Date of Payment (MM/DD/YY) Amount Payment made to:

/ / _●

Is proof of payment attached? Proof of payment is required for eligibility.

YES NO

Was any portion of this payment refunded already?

_{YES NO}

What was the amount refunded for this payment?

_.

Date of Payment (MM/DD/YY) Amount Payment made to:

/ / _●

Is proof of payment attached? Proof of payment is required for eligibility.

YES NO

Was any portion of this payment refunded already?

_{YES NO}

What was the amount refunded for this payment?

_.

Frequently Asked Questions and Privacy Act Notice

Please keep for your records.

Why did you send me a claim worksheet?

We sent you a claim worksheet because we obtained information indicating that you may have been a client of Certified Forensic Loan Auditors, LLC or because you requested a claim worksheet. We’re providing an opportunity for you to send us more information about payments you made to Certified Forensic Loan Auditors, LLC that may be eligible for a refund. We will review all receipts to determine eligibility for refunds.

Why do I need to provide the requested information?

Your name, contact information, and payment information are used to verify that you are eligible for refunds of payments you made. Please submit your receipts by the deadline printed at the top of the claim worksheet. Please note that all information submitted is treated in accordance with the Privacy Act, described below.

What is my claim amount?

Your claim amount is the total amount of money you paid to Certified Forensic Loan Auditors, LLC in up-front fees.

Who is Epiq?

The CFPB has contracted with Epiq to administer claims and payments to consumers on our behalf.

How do I verify that this claims process is legitimate?

The CFPB never requires you to pay money up front or provide any banking information, credit card information, or other payment information before you can cash refund checks that the CFPB has issued. If anyone claims that they can get you a refund but asks you for money, it could be a scam. You can verify with the CFPB that this is a legitimate claims process by calling the CFPB directly at (855) 411-2372 or by visiting our website at www.cfpb-cfla.org.

Can I still ask questions?

To find out more about the case or the payment, please contact the Claims Administrator:

• Email: [email protected]

• Call: (855) 675-2859

• Write: P.O. Box 6909, Portland, OR 97228-6909

• Visit: www.cfpb-cfla.org

Notice of Privacy Act Statement:

The information we are requesting is being collected to determine your eligibility for a redress payment to compensate you for harm suffered from a violation of a Federal consumer financial law that was the subject of a Bureau enforcement action. Information collected will be treated in accordance with CFPB’s published System of Records Notice (SORN), CFPB.025 – Civil Penalty and Bureau-Administered Redress Program Records.

This information may be used by and disclosed to employees, contractors, agents, and others authorized by the CFPB to receive this information to assist in providing your redress. It may also be disclosed:

• to a court, magistrate, or administrative tribunal in the course of a proceeding;

• for enforcement, statutory, and regulatory purposes;

• to another federal or state agency or regulatory authority;

• to a member of Congress, to the Department of Justice, a court, an adjudicative body or administrative tribunal, or a party in litigation; and

• pursuant to the Routine Uses described in the SORN.

The collection of this information is authorized by Pub. L. 111-203, Title X, Sections 1017(d) (Civil Penalty Fund) and/or 1055(a) (Redress), codified at 12 U.S.C. §§ 5497(d), 5565(a). You are not required to submit or provide any identifying information; however, not doing so may delay processing or be a basis for rejection of your claim.

According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a valid OMB control number. The OMB control number for this collection is ____-____. It expires on __/__/202__. The time required to complete this information collection is estimated to average approximately 30 minutes per response. Responding to this collection of information is voluntary. Comments regarding this collection of information, including the estimated response time, suggestions for improving the usefulness of the information, or suggestions for reducing the burden to respond to this collection should be submitted to Bureau of Consumer Financial Protection (Attention: PRA Office), 1700 G Street NW, Washington, DC 20552, or by email to [email protected].

Questions?

Email [email protected] or call (855) 675-2859