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                    "text": "(This document must be submitted to the Program Administrator at least 10 calendar days before the first mediation management conference or mediation session.)",
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                    "text": "Please list a contact person for this case. The Program Administrator will contact this person to deal with any issues. The contact person may be an attorney representing the plaintiff.",
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                    "text": "E-mail address:",
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                            "text": "Does the plaintiff have a second lien on the home?",
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                    "text": "(If yes, please answer A and B below.)",
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                            "text": "Does the plaintiff or the loan servicer have another program addressing a second lien?",
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                    "text": "(If yes, please attach a description of the program to this checklist.)",
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                            "text": "Please indicate the owner of the loan and any other boxes that apply:",
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                            "text": "Fannie Mae □ Ginnie Mae □ FHA Loan □ RHS Loan □ Freddie Mac □ Private Investor Owned",
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                            "text": "VA Loan □ Other: _____",
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                                        "l": 144.0005,
                                        "t": 308.5417,
                                        "r": 270.6009,
                                        "b": 295.0417
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                                    "text": "",
                                    "attrs": {
                                        "field_kind": "text",
                                        "label": "□ Other",
                                        "source": "blank_line",
                                        "label_source": "parent_text",
                                        "label_ref": "p1.17.3",
                                        "text_offset": 7,
                                        "text_span": 0
                                    },
                                    "reading_order": 0
                                },
                                {
                                    "id": "p1.17.3.2",
                                    "order": 49,
                                    "type": "form_field",
                                    "bbox": {
                                        "l": 72.00058,
                                        "t": 308.5079,
                                        "r": 84.00058,
                                        "b": 296.5679
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                                    "text": "",
                                    "attrs": {
                                        "field_kind": "checkbox",
                                        "label": "VA Loan",
                                        "source": "glyph",
                                        "label_source": "parent_text",
                                        "label_ref": "p1.17.3",
                                        "text_offset": 8,
                                        "text_span": 1
                                    },
                                    "reading_order": 1
                                }
                            ],
                            "reading_order": 2
                        }
                    ],
                    "reading_order": 16
                },
                {
                    "id": "p1.18",
                    "order": 50,
                    "type": "heading",
                    "bbox": {
                        "l": 268.08,
                        "t": 276.48,
                        "r": 352.32,
                        "b": 263.76
                    },
                    "text": "Loss Mitigation",
                    "attrs": {
                        "block_label": "paragraph_title"
                    },
                    "level": 3,
                    "reading_order": 17
                },
                {
                    "id": "p1.19",
                    "order": 51,
                    "type": "list",
                    "bbox": {
                        "l": 51.6,
                        "t": 261.6,
                        "r": 499.92,
                        "b": 231.12
                    },
                    "text": "",
                    "attrs": {
                        "item_count": 2
                    },
                    "children": [
                        {
                            "id": "p1.19.1",
                            "order": 52,
                            "type": "list_item",
                            "bbox": {
                                "l": 51.6,
                                "t": 261.6,
                                "r": 499.92,
                                "b": 247.68
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                            "text": "Has the lender received a complete packet and all required documents necessary for review?",
                            "marker": "3.",
                            "reading_order": 0
                        },
                        {
                            "id": "p1.19.2",
                            "order": 53,
                            "type": "list_item",
                            "bbox": {
                                "l": 70.8,
                                "t": 244.56,
                                "r": 176.4,
                                "b": 231.12
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                            "text": "Yes □ No",
                            "marker": "□",
                            "children": [
                                {
                                    "id": "p1.19.2.1",
                                    "order": 54,
                                    "type": "form_field",
                                    "bbox": {
                                        "l": 72.00138,
                                        "t": 244.06799999999998,
                                        "r": 84.00138,
                                        "b": 232.12800000000004
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                                    "text": "",
                                    "attrs": {
                                        "field_kind": "checkbox",
                                        "label": "Yes",
                                        "source": "glyph",
                                        "label_source": "parent_text",
                                        "label_ref": "p1.19.2",
                                        "text_offset": 4,
                                        "text_span": 1
                                    },
                                    "reading_order": 0
                                },
                                {
                                    "id": "p1.19.2.2",
                                    "order": 55,
                                    "type": "form_field",
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                                        "field_kind": "checkbox",
                                        "label": "No",
                                        "source": "glyph",
                                        "label_source": "parent_text",
                                        "label_ref": "p1.19.2",
                                        "text_offset": 6,
                                        "text_span": 0
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                                    "reading_order": 1
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                            ],
                            "reading_order": 1
                        }
                    ],
                    "reading_order": 18
                },
                {
                    "id": "p1.20",
                    "order": 56,
                    "type": "text",
                    "bbox": {
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                    "text": "(If no, please attach an itemized list of the missing documents to this checklist.)",
                    "reading_order": 19
                },
                {
                    "id": "p1.21",
                    "order": 57,
                    "type": "list",
                    "bbox": {
                        "l": 51.6,
                        "t": 196.8,
                        "r": 562.32,
                        "b": 69.36
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                    "text": "",
                    "attrs": {
                        "item_count": 3
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                    "children": [
                        {
                            "id": "p1.21.1",
                            "order": 58,
                            "type": "list_item",
                            "bbox": {
                                "l": 51.6,
                                "t": 196.8,
                                "r": 556.56,
                                "b": 167.76
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                            "text": "Lender/servicer-specific loss mitigation application materials were due to the Mediation Program within 10 calendar days of the Notice of Entry. Please select the appropriate option below:",
                            "marker": "4.",
                            "reading_order": 0
                        },
                        {
                            "id": "p1.21.2",
                            "order": 59,
                            "type": "list_item",
                            "bbox": {
                                "l": 70.08,
                                "t": 163.92,
                                "r": 545.04,
                                "b": 134.4
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                            "text": "Lender/servicer-specific application materials were sent to FM@17thCircuit.IllinoisCourts.gov on _____(date).",
                            "marker": "□",
                            "children": [
                                {
                                    "id": "p1.21.2.1",
                                    "order": 60,
                                    "type": "form_field",
                                    "bbox": {
                                        "l": 72,
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                                        "r": 194.025,
                                        "b": 134.4818
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                                    "text": "",
                                    "attrs": {
                                        "field_kind": "text",
                                        "label": "(date)",
                                        "source": "blank_line",
                                        "label_source": "parent_text",
                                        "label_ref": "p1.21.2"
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                                    "reading_order": 0
                                },
                                {
                                    "id": "p1.21.2.2",
                                    "order": 61,
                                    "type": "form_field",
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                                        "l": 72.002,
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                                        "r": 84.002,
                                        "b": 152.08770000000004
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                                    "text": "",
                                    "attrs": {
                                        "field_kind": "checkbox",
                                        "label": "Lender/servicer-specific application materials were sent to FM@17thCircuit.IllinoisCourts.gov on _____(date).",
                                        "source": "glyph",
                                        "label_source": "parent_text",
                                        "label_ref": "p1.21.2",
                                        "text_offset": 0,
                                        "text_span": 0
                                    },
                                    "reading_order": 1
                                },
                                {
                                    "id": "p1.21.2.3",
                                    "order": 62,
                                    "type": "link",
                                    "bbox": {
                                        "l": 359.074,
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                                    "text": "FM@17thCircuit.IllinoisCourts.gov",
                                    "attrs": {
                                        "uri": "mailto:FM@17thCircuit.IllinoisCourts.gov",
                                        "action_type": "/URI"
                                    },
                                    "reading_order": 2
                                }
                            ],
                            "reading_order": 1
                        },
                        {
                            "id": "p1.21.3",
                            "order": 63,
                            "type": "list_item",
                            "bbox": {
                                "l": 69.6,
                                "t": 130.8,
                                "r": 562.32,
                                "b": 69.36
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                            "text": "The forms provided by the Mediation Program include: Request for Mortgage Assistance (RMA), Mortgage Assistance Application (Form 710), Dodd-Frank Certification, IRS Forms 4506C & 4506T, the Financial Worksheet, and the Hardship Letter. Lender/servicer-specific materials were not sent to the Mediation Program as the above-listed forms are accepted by the lender/servicer.",
                            "marker": "□",
                            "children": [
                                {
                                    "id": "p1.21.3.1",
                                    "order": 64,
                                    "type": "form_field",
                                    "bbox": {
                                        "l": 72,
                                        "t": 130.66830000000004,
                                        "r": 84,
                                        "b": 118.72829999999999
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                                    "text": "",
                                    "attrs": {
                                        "field_kind": "checkbox",
                                        "label": "The forms provided by the Mediation Program include: Request for Mortgage Assistance (RMA), Mortgage Assistance Application (Form 710), Dodd-Frank Certification, IRS Forms 4506C & 4506T, the Financial Worksheet, and the Hardship Letter. Lender/servicer-specific materials were not sent to the Mediation Program as the above-listed forms are accepted by the lender/servicer.",
                                        "source": "glyph",
                                        "label_source": "parent_text",
                                        "label_ref": "p1.21.3",
                                        "text_offset": 0,
                                        "text_span": 0
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                                    "reading_order": 0
                                }
                            ],
                            "reading_order": 2
                        }
                    ],
                    "reading_order": 20
                },
                {
                    "id": "p1.22",
                    "order": 65,
                    "type": "footer",
                    "bbox": {
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                    "text": "EXHIBIT FM-5",
                    "attrs": {
                        "block_label": "footer"
                    },
                    "reading_order": 21
                },
                {
                    "id": "p1.23",
                    "order": 66,
                    "type": "footer",
                    "bbox": {
                        "l": 158.16,
                        "t": 48,
                        "r": 452.4,
                        "b": 36
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                    "text": "This document is not confidential and may be shared with the court.",
                    "attrs": {
                        "block_label": "footer"
                    },
                    "reading_order": 22
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            ]
        },
        {
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            "page": 2,
            "width": 612,
            "height": 792,
            "rotation": 0,
            "pipeline_version": "paddleocr-vl-1.6+paul-48",
            "width_pt": 612,
            "height_pt": 792,
            "engine": "paddleocr_vl",
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            "item_count": 61,
            "counts_by_type": {
                "footer": 1,
                "form_field": 26,
                "heading": 3,
                "list": 6,
                "list_item": 23,
                "text": 2
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            "build_ms": 5,
            "items": [
                {
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                    "order": 1,
                    "type": "list",
                    "bbox": {
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                        "t": 740.88,
                        "r": 566.4,
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                    "text": "",
                    "attrs": {
                        "item_count": 4
                    },
                    "children": [
                        {
                            "id": "p2.1.1",
                            "order": 2,
                            "type": "list_item",
                            "bbox": {
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                                "t": 740.88,
                                "r": 566.4,
                                "b": 725.09
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                            "text": "Has the plaintiff or loan servicer completed review for all applicable Loss Mitigation options?",
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                            "attrs": {
                                "bbox_estimated": true
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                            "reading_order": 0
                        },
                        {
                            "id": "p2.1.2",
                            "order": 3,
                            "type": "list_item",
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                                "r": 174.3601,
                                "b": 709.7159
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                            "text": "Yes □ No",
                            "marker": "□",
                            "children": [
                                {
                                    "id": "p2.1.2.1",
                                    "order": 4,
                                    "type": "form_field",
                                    "bbox": {
                                        "l": 144.0001,
                                        "t": 723.1079,
                                        "r": 156.0001,
                                        "b": 711.1679
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                                    "text": "",
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                                        "field_kind": "checkbox",
                                        "label": "No",
                                        "source": "glyph",
                                        "label_source": "parent_text",
                                        "label_ref": "p2.1.2",
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                                        "text_span": 1
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                                    "reading_order": 0
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                            ],
                            "reading_order": 1
                        },
                        {
                            "id": "p2.1.3",
                            "order": 5,
                            "type": "list_item",
                            "bbox": {
                                "l": 72.0003,
                                "t": 705.0717999999999,
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                                "b": 693.6358
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                            "text": "If yes, the documents in the lender's possession will not expire in the next 35 calendar days except for:",
                            "marker": "A.",
                            "reading_order": 2
                        },
                        {
                            "id": "p2.1.4",
                            "order": 6,
                            "type": "list_item",
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                                "l": 58.32,
                                "t": 693.5,
                                "r": 566.4,
                                "b": 677.71
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                            "text": "_____ which must be updated. (Please attach an itemized list, if necessary.)",
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                                "bbox_estimated": true
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                            "children": [
                                {
                                    "id": "p2.1.4.1",
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                                        "l": 90.0003,
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                                        "label": "_____ which must be updated. (Please attach an itemized list, if necessary.)",
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                            ],
                            "reading_order": 3
                        },
                        {
                            "id": "p2.1.5",
                            "order": 8,
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                            "text": "",
                            "attrs": {
                                "field_kind": "checkbox",
                                "label": "Yes",
                                "source": "glyph"
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                            "reading_order": 4
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                    ],
                    "reading_order": 0
                },
                {
                    "id": "p2.2",
                    "order": 9,
                    "type": "list_item",
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                    "text": "If no, please attach a written explanation and an itemized list of any missing documents.",
                    "marker": "B.",
                    "reading_order": 1
                },
                {
                    "id": "p2.3",
                    "order": 10,
                    "type": "heading",
                    "bbox": {
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                    "text": "Reinstatement/Redemption:",
                    "attrs": {
                        "block_label": "paragraph_title"
                    },
                    "level": 3,
                    "reading_order": 2
                },
                {
                    "id": "p2.4",
                    "order": 11,
                    "type": "list",
                    "bbox": {
                        "l": 54,
                        "t": 607.512,
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                        "b": 564.9959
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                    "text": "",
                    "attrs": {
                        "item_count": 4
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                    "children": [
                        {
                            "id": "p2.4.1",
                            "order": 12,
                            "type": "list_item",
                            "bbox": {
                                "l": 54.00002,
                                "t": 607.512,
                                "r": 370.439406,
                                "b": 596.076
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                            "text": "As of ___ (date) Reinstatement Amount is: $___",
                            "marker": "6.",
                            "children": [
                                {
                                    "id": "p2.4.1.1",
                                    "order": 13,
                                    "type": "form_field",
                                    "bbox": {
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                                        "t": 609.5018,
                                        "r": 370.4393,
                                        "b": 596.0018
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                                    "text": "",
                                    "attrs": {
                                        "field_kind": "text",
                                        "label": "As of ___ (date) Reinstatement Amount is: $___",
                                        "source": "blank_line",
                                        "label_source": "parent_text",
                                        "label_ref": "p2.4.1"
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                                    "reading_order": 0
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                            ],
                            "reading_order": 0
                        },
                        {
                            "id": "p2.4.2",
                            "order": 14,
                            "type": "list_item",
                            "bbox": {
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                                "t": 591.912,
                                "r": 385.678863,
                                "b": 580.476
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                            "text": "The Acceptance Due Date is: ___",
                            "children": [
                                {
                                    "id": "p2.4.2.1",
                                    "order": 15,
                                    "type": "form_field",
                                    "bbox": {
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                                        "r": 385.6788,
                                        "b": 580.4018
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                                    "text": "",
                                    "attrs": {
                                        "field_kind": "text",
                                        "label": "date",
                                        "source": "blank_line",
                                        "label_source": "parent_text",
                                        "label_ref": "p2.4.2"
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                                    "reading_order": 0
                                },
                                {
                                    "id": "p2.4.2.2",
                                    "order": 16,
                                    "type": "form_field",
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                                        "b": 549.3217
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                                    "text": "",
                                    "attrs": {
                                        "field_kind": "text",
                                        "label": "date",
                                        "source": "blank_line",
                                        "label_source": "parent_text",
                                        "label_ref": "p2.4.2"
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                                    "reading_order": 1
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                            ],
                            "reading_order": 1
                        },
                        {
                            "id": "p2.4.3",
                            "order": 17,
                            "type": "list_item",
                            "bbox": {
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                                "t": 576.4319,
                                "r": 382.319471,
                                "b": 564.9959
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                            "text": "As of ___ (date) Redemption Amount is: $___",
                            "marker": "7.",
                            "children": [
                                {
                                    "id": "p2.4.3.1",
                                    "order": 18,
                                    "type": "form_field",
                                    "bbox": {
                                        "l": 54,
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                                        "r": 382.3195,
                                        "b": 564.9217
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                                    "text": "",
                                    "attrs": {
                                        "field_kind": "text",
                                        "label": "As of ___ (date) Redemption Amount is: $___",
                                        "source": "blank_line",
                                        "label_source": "parent_text",
                                        "label_ref": "p2.4.3"
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                                    "reading_order": 0
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                            ],
                            "reading_order": 2
                        },
                        {
                            "id": "p2.4.4",
                            "order": 19,
                            "type": "list_item",
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                            "text": "The Acceptance Due Date is: ___",
                            "reading_order": 3
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                    ],
                    "reading_order": 3
                },
                {
                    "id": "p2.5",
                    "order": 20,
                    "type": "heading",
                    "bbox": {
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                    "text": "Relinquishment:",
                    "attrs": {
                        "block_label": "paragraph_title"
                    },
                    "level": 3,
                    "reading_order": 4
                },
                {
                    "id": "p2.6",
                    "order": 21,
                    "type": "list",
                    "bbox": {
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                        "b": 448.488
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                    "text": "",
                    "attrs": {
                        "item_count": 3
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                    "children": [
                        {
                            "id": "p2.6.1",
                            "order": 22,
                            "type": "list_item",
                            "bbox": {
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                                "t": 493.3921,
                                "r": 426.540182,
                                "b": 481.9561
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                            "text": "Has the plaintiff or loan servicer issued a denial of a relinquishment request?",
                            "marker": "8.",
                            "reading_order": 0
                        },
                        {
                            "id": "p2.6.2",
                            "order": 23,
                            "type": "list_item",
                            "bbox": {
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                                "t": 478.068,
                                "r": 174.36,
                                "b": 464.676
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                            "text": "Yes □ No",
                            "marker": "□",
                            "children": [
                                {
                                    "id": "p2.6.2.1",
                                    "order": 24,
                                    "type": "form_field",
                                    "bbox": {
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                                        "r": 156,
                                        "b": 466.128
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                                    "text": "",
                                    "attrs": {
                                        "field_kind": "checkbox",
                                        "label": "No",
                                        "source": "glyph",
                                        "label_source": "parent_text",
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                                        "text_span": 1
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                                    "reading_order": 0
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                            ],
                            "reading_order": 1
                        },
                        {
                            "id": "p2.6.3",
                            "order": 25,
                            "type": "list_item",
                            "bbox": {
                                "l": 72.0002,
                                "t": 459.432,
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                                "b": 448.488
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                            "text": "(If yes, please attach copies of all denials.)",
                            "reading_order": 2
                        },
                        {
                            "id": "p2.6.4",
                            "order": 26,
                            "type": "form_field",
                            "bbox": {
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                                "r": 84,
                                "b": 466.128
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                            "text": "",
                            "attrs": {
                                "field_kind": "checkbox",
                                "label": "Yes",
                                "source": "glyph"
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                            "reading_order": 3
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                    ],
                    "reading_order": 5
                },
                {
                    "id": "p2.7",
                    "order": 27,
                    "type": "list",
                    "bbox": {
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                        "r": 427.92,
                        "b": 381.6
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                    "text": "",
                    "attrs": {
                        "item_count": 3
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                    "children": [
                        {
                            "id": "p2.7.1",
                            "order": 28,
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                            "bbox": {
                                "l": 51.84,
                                "t": 431.04,
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                                "b": 417.84
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                            "text": "Check all the relinquishment options available in this case:",
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                            "reading_order": 0
                        },
                        {
                            "id": "p2.7.2",
                            "order": 29,
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                                "b": 399.36
                            },
                            "text": "Short Sale □ Deed-in-lieu □ Cash for Keys □ Consent Judgment",
                            "marker": "□",
                            "children": [
                                {
                                    "id": "p2.7.2.1",
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                                    "reading_order": 1
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                                {
                                    "id": "p2.7.2.3",
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                                        "label": "Cash for Keys",
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                                        "text_span": 1
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                                    "reading_order": 2
                                },
                                {
                                    "id": "p2.7.2.4",
                                    "order": 33,
                                    "type": "form_field",
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                                        "l": 324.0001,
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                                        "label": "Consent Judgment",
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                                    "reading_order": 3
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                            ],
                            "reading_order": 1
                        },
                        {
                            "id": "p2.7.3",
                            "order": 34,
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                                "l": 70.8,
                                "t": 395.52,
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                                "b": 381.6
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                            "text": "Other (please specify): ___",
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                                {
                                    "id": "p2.7.3.1",
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                                    "type": "form_field",
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                                        "l": 72.0001,
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                                        "field_kind": "text",
                                        "label": "Other (please specify): ___",
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                            ],
                            "reading_order": 2
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                    ],
                    "reading_order": 6
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                {
                    "id": "p2.8",
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                    "type": "heading",
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                    "text": "Loan Modification:",
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                    "level": 3,
                    "reading_order": 7
                },
                {
                    "id": "p2.9",
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                    "text": "",
                    "attrs": {
                        "item_count": 6
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                        {
                            "id": "p2.9.1",
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                            "text": "For FHA loans, is there any reason that the FHA Home Affordable Modification Program would not apply?",
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                        },
                        {
                            "id": "p2.9.2",
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                            "type": "list_item",
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                            "text": "Yes □ No □ N/A (not FHA)",
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                                {
                                    "id": "p2.9.2.1",
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                                        "label": "No",
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                                    "reading_order": 0
                                },
                                {
                                    "id": "p2.9.2.2",
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                                    "reading_order": 1
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                            "reading_order": 1
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                        {
                            "id": "p2.9.3",
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                            "text": "For Fannie Mae & Freddie Mac loans, is there any reason that the Flex Modification Program would not apply?",
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                            "reading_order": 2
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                        {
                            "id": "p2.9.4",
                            "order": 43,
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                            "text": "Yes □ No □ N/A (not Fannie Mae/Freddie Mac)",
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                                {
                                    "id": "p2.9.4.1",
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                                        "l": 93,
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                                {
                                    "id": "p2.9.4.3",
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                            "id": "p2.9.5",
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                            "text": "Has the plaintiff or loan servicer issued an offer for a loan modification including any streamlined modification?",
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                        {
                            "id": "p2.9.6",
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                            "type": "list_item",
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                            "text": "Yes □ No",
                            "marker": "□",
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                                    "id": "p2.9.6.2",
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                            "reading_order": 5
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                            "id": "p2.9.7",
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                        {
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                            "text": "",
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                                "label": "No",
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                    ],
                    "reading_order": 8
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                    "type": "text",
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                    "text": "(If yes, please attach copies of all offers of modification, along with NPV analysis only if applicable and used.)",
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                },
                {
                    "id": "p2.11",
                    "order": 55,
                    "type": "list",
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                    "children": [
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                            "id": "p2.11.1",
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                            "text": "Has the plaintiff or loan servicer issued a denial of a loan modification?",
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                            "text": "Yes □ No",
                            "marker": "□",
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                    "reading_order": 10
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                {
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                    "text": "(If yes, please attach copies of all denials, along with NPV analysis only if applicable and used.)",
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                },
                {
                    "id": "p2.13",
                    "order": 61,
                    "type": "footer",
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                    "text": "EXHIBIT FM-5\nThis document is not confidential and may be shared with the court.",
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        },
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                    "text": "Misc. Retention:",
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                {
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                            "bbox": {
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                            "text": "Are there any additional home-retention programs offered by the owner of the loan that are not included in the above sections?",
                            "marker": "14.",
                            "reading_order": 0
                        },
                        {
                            "id": "p3.2.2",
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                            "text": "Yes □ No",
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                            "reading_order": 1
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                    "reading_order": 1
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                    "text": "(If yes, please attach a detailed list of these programs with information about how to apply.)",
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                },
                {
                    "id": "p3.4",
                    "order": 8,
                    "type": "list",
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                    "text": "",
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                    "children": [
                        {
                            "id": "p3.4.1",
                            "order": 9,
                            "type": "list_item",
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                            "text": "Has the plaintiff or loan servicer issued an offer for any retention options that are not included in the above sections?",
                            "marker": "15.",
                            "reading_order": 0
                        },
                        {
                            "id": "p3.4.2",
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                            "type": "list_item",
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                            "text": "Yes □ No",
                            "marker": "□",
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                                        "label_ref": "p3.4.2",
                                        "text_offset": 4,
                                        "text_span": 1
                                    },
                                    "reading_order": 0
                                },
                                {
                                    "id": "p3.4.2.2",
                                    "order": 12,
                                    "type": "form_field",
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                                        "l": 144.00054,
                                        "t": 617.6277,
                                        "r": 156.00054,
                                        "b": 605.6877
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                                    "text": "",
                                    "attrs": {
                                        "field_kind": "checkbox",
                                        "label": "No",
                                        "source": "glyph",
                                        "label_source": "parent_text",
                                        "label_ref": "p3.4.2",
                                        "text_offset": 6,
                                        "text_span": 0
                                    },
                                    "reading_order": 1
                                }
                            ],
                            "reading_order": 1
                        }
                    ],
                    "reading_order": 3
                },
                {
                    "id": "p3.5",
                    "order": 13,
                    "type": "text",
                    "bbox": {
                        "l": 70.32,
                        "t": 601.2,
                        "r": 447.12,
                        "b": 586.08
                    },
                    "text": "(If yes, please attach copies of all offers, along with NPV analysis only if applicable and used.)",
                    "reading_order": 4
                },
                {
                    "id": "p3.6",
                    "order": 14,
                    "type": "list",
                    "bbox": {
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                        "b": 557.0759
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                    "text": "",
                    "attrs": {
                        "item_count": 2
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                    "children": [
                        {
                            "id": "p3.6.1",
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                            "type": "list_item",
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                                "l": 54.00074,
                                "t": 568.5119,
                                "r": 570.686134,
                                "b": 557.0759
                            },
                            "text": "Has the plaintiff or loan servicer issued a denial for any retention options that are not included in the above sections?",
                            "marker": "16.",
                            "reading_order": 0
                        },
                        {
                            "id": "p3.6.2",
                            "order": 16,
                            "type": "list_item",
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                                "l": 87.00054,
                                "t": 617.6277,
                                "r": 174.36054,
                                "b": 604.2357
                            },
                            "text": "Yes □ No",
                            "marker": "□",
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                                {
                                    "id": "p3.6.2.1",
                                    "order": 17,
                                    "type": "form_field",
                                    "bbox": {
                                        "l": 87,
                                        "t": 617.63,
                                        "r": 99,
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                                    "text": "",
                                    "attrs": {
                                        "field_kind": "checkbox",
                                        "label": "Yes",
                                        "source": "glyph_estimate",
                                        "bbox_estimated": true,
                                        "label_source": "parent_text",
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                                    "reading_order": 0
                                }
                            ],
                            "reading_order": 1
                        }
                    ],
                    "reading_order": 5
                },
                {
                    "id": "p3.7",
                    "order": 18,
                    "type": "text",
                    "bbox": {
                        "l": 72.00074,
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                        "b": 588.1676
                    },
                    "text": "(If yes, please attach copies of all denials.)",
                    "reading_order": 6
                },
                {
                    "id": "p3.8",
                    "order": 19,
                    "type": "form_field",
                    "bbox": {
                        "l": 72.00052,
                        "t": 537.5878,
                        "r": 84.00052,
                        "b": 525.6478
                    },
                    "text": "",
                    "attrs": {
                        "field_kind": "checkbox",
                        "label": "Yes",
                        "source": "glyph"
                    },
                    "reading_order": 7
                },
                {
                    "id": "p3.9",
                    "order": 20,
                    "type": "form_field",
                    "bbox": {
                        "l": 144.00052,
                        "t": 537.5878,
                        "r": 156.00052,
                        "b": 525.6478
                    },
                    "text": "",
                    "attrs": {
                        "field_kind": "checkbox",
                        "label": "No",
                        "source": "glyph"
                    },
                    "reading_order": 8
                },
                {
                    "id": "p3.10",
                    "order": 21,
                    "type": "text",
                    "bbox": {
                        "l": 51.12,
                        "t": 470.16,
                        "r": 472.56,
                        "b": 456.48
                    },
                    "text": "Date: ___ Prepared by: ___",
                    "children": [
                        {
                            "id": "p3.10.1",
                            "order": 22,
                            "type": "form_field",
                            "bbox": {
                                "l": 54.0007,
                                "t": 470.4216,
                                "r": 470.7608,
                                "b": 456.9216
                            },
                            "text": "",
                            "attrs": {
                                "field_kind": "text",
                                "label": "Date: ___ Prepared by: ___",
                                "source": "blank_line",
                                "label_source": "parent_text",
                                "label_ref": "p3.10"
                            },
                            "reading_order": 0
                        }
                    ],
                    "reading_order": 9
                },
                {
                    "id": "p3.11",
                    "order": 23,
                    "type": "text",
                    "bbox": {
                        "l": 51.36,
                        "t": 444.96,
                        "r": 470.16,
                        "b": 430.8
                    },
                    "text": "Title: _____ Phone Number: _____",
                    "children": [
                        {
                            "id": "p3.11.1",
                            "order": 24,
                            "type": "form_field",
                            "bbox": {
                                "l": 54.0008,
                                "t": 444.8614,
                                "r": 468.2407,
                                "b": 431.3614
                            },
                            "text": "",
                            "attrs": {
                                "field_kind": "text",
                                "label": "Title: _____ Phone Number: _____",
                                "source": "blank_line",
                                "label_source": "parent_text",
                                "label_ref": "p3.11"
                            },
                            "reading_order": 0
                        }
                    ],
                    "reading_order": 10
                },
                {
                    "id": "p3.12",
                    "order": 25,
                    "type": "text",
                    "bbox": {
                        "l": 50.88,
                        "t": 418.32,
                        "r": 380.88,
                        "b": 404.88
                    },
                    "text": "Signature: _____",
                    "children": [
                        {
                            "id": "p3.12.1",
                            "order": 26,
                            "type": "form_field",
                            "bbox": {
                                "l": 54.0008,
                                "t": 419.3016,
                                "r": 378.8411,
                                "b": 405.8016
                            },
                            "text": "",
                            "attrs": {
                                "field_kind": "text",
                                "label": "Signature: _____",
                                "source": "blank_line",
                                "label_source": "parent_text",
                                "label_ref": "p3.12"
                            },
                            "reading_order": 0
                        }
                    ],
                    "reading_order": 11
                },
                {
                    "id": "p3.13",
                    "order": 27,
                    "type": "footer",
                    "bbox": {
                        "l": 269.04,
                        "t": 60.72,
                        "r": 343.44,
                        "b": 48.96
                    },
                    "text": "EXHIBIT FM-5",
                    "attrs": {
                        "block_label": "footer"
                    },
                    "reading_order": 12
                },
                {
                    "id": "p3.14",
                    "order": 28,
                    "type": "footer",
                    "bbox": {
                        "l": 157.92,
                        "t": 48,
                        "r": 452.4,
                        "b": 36
                    },
                    "text": "This document is not confidential and may be shared with the court.",
                    "attrs": {
                        "block_label": "footer"
                    },
                    "reading_order": 13
                }
            ]
        }
    ]
}