Mortgage Payment Assistance Contact Form Please scroll to view all form fields and submit. Question Title * 1. General Information First, MI, Last Name * Property Address * City * State * ZIP/Postal Code * Email Address Phone Number * Question Title * 2. Mortgage Loan Number Question Title * 3. Occupancy Status of Property Borrower Occupied Tenant Occupied Second Home Question Title * 4. How have your finances been affected? Loss or reduction of employment Illness Other, please describe Question Title * 5. My mortgage is with: Merchants Bank First National Bank of Northfield A Merchants Bank representative will be in contact with you within two business days. SUBMIT