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Program HR 3648 Scam Prevention Complaint Submission Form

This form was created by Program HR 3648 to provide foreclosure scam victims with a simple, straightforward way to report individuals or companies that may be operating fraudulent or illegal foreclosure prevention scams.

Please fill out the form below to submit your complaint to the Program HR 3648 Scam Prevention Task Force. This task force was established by Program HR 3648 to educate homeowners, investigate foreclosure prevention scams, and submit cases to local authorities for further investigation and action.

This form is designed to provide scam victims with a way to submit complaints regarding companies or individuals that may be operating fraudulent or illegal foreclosure prevention scams. With your permission, the complaint will be forwarded to law enforcement agencies for further investigation and action they deem appropriate. While you may receive a follow-up call or information from Program HR 3648, Program HR 3648 does not provide direct legal representation to complainants. You may also receive a follow-up call or information from local law enforcement agencies in connection with your complaint.


• Were you asked to pay a fee?
  redirect mortgage payments?
  sign over the title to your property?
  stop making loan payments?
  none of the above

• If you paid a fee, check here:

• How much did you pay?  $

• Did you pay before any services were provided? Yes  / No

• What services did the company or individual offer? (check all that apply) Loan Modification assistance/consulting
  Foreclosure relief/consulting
  Legal Representation
  Offer to purchase homeowner´s property
  Refinancing
  Bankruptcy
  Other:

• If you signed a contract, did the person perform the services agreed to in the contract? Yes  / No

• When was your last contact with the person who offered to help? (MM / YYYY)   /  

• Contact Information for Person Who Offered Help
Company / Individual Name:  
Main Contact Name:  
Street Address 1:  
Street Address 2:  
City:  
State:  
Zip Code:  
Phone Number:  
Email Address:  
Website:  

• Homeowner Information
First Name:  
Last Name:  
Email Address:  
Phone Number:  
Street Address 1:  
Street Address 2:  
City:  
State:  
Zip Code:  

• Please use this space to include any other relevant information. (For example, how you were contacted, how you paid, etc.)

• The best way to contact you is


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ProgramHR3648 Scam Prevention Task Force - A privately sponsored nation-wide initiative - Mortgage Foregiveness Debt Relief for homeowners