A proposed monthly mortgage statement  that clearly spells out all charges and late fees and gives information on where to go for help  if a consumer has financial difficulty has been unveiled by the Consumer Financial Protection Bureau.

The form is required by the Dodd-Frank Act, which created the bureau.

The law required that during every billing cycle, creditors, assignees and servicers have to send a form to everyone who has a mortgage with them. The only exception would be people who are given annual payment booklets. The law also required a simplified disclosure form that is given to people at the time they are closing on a house.

Once the CFPB receives comments on the form, it plans to issue a proposed rule this summer. The bureau says that financial institutions and other mortgage issuers will “have some flexibility to tailor the model form to work for their needs and the needs of their customers.’’

A sample of the proposed form is online.