Mediation Intake Form

Homeowner #1 Information


Homeowner #2 Information


Household Expense


Homeowner #1

Homeowner #1 Demographic Information


Homeowner #2

Homeowner #2 Demographic Information


Homeowner Mortgage Property Information

We are to provide ethnicity/race data to US Department of Housing and Urban Development as part of their standards. If you decline to provide the data, staff will be required to provide the missing information by observer identification.

Contact Us

Office Phone

217-423-0352

Housing Counselor

217-423-4901

Mail To

P.O. Box 228, Decatur, IL 62525

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