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WC MCA FORECLOSURE COUNSELING TRIAGE FORM Counselor: Robbie Counselor Max Number: Date: Want to stay: Yes No Talked to mortgage company: Modified: Yes Yes No No Date Modified/Type: Other steps taken

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Employees or team members in a job-related context may be required to fill out a form with this question to express their interest in continuing their employment or involvement with a project, team, or organization.

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