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If you need immediate assistance, please call 2-1-1 now. Otherwise, complete the form below.  Once you complete the form, 2-1-1 NH will contact you to complete the intake process.  You will then be referred to a free homeownership counselor and/or no or low-cost legal services.

Required fields noted with *

Your Name*

Property Address

Street*

City*

State*

Zip*

Primary Phone*

Secondary Phone

Your Email*

Best time to contact you  Morning Afternoon Evening

Is this your primary residence?*  Yes No

Is there a foreclosure date/ sale date scheduled for your home?*  Yes No

If yes, when is the foreclosure sale date?

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