Reverse Mtg. Form

Name

Name *

Email

Email *

Phone

Phone

Comment

Comment

Is this a refinance of an existing reverse mortgage?

Is this a refinance of an existing reverse mortgage?

Is this loan being transferred from another reverse lender?

Is this loan being transferred from another reverse lender?

Credit Evaluaiton

Credit Evaluaiton

Great Credit

Great Credit

A few collections and late's

A few collections and late's

Bankruptcy or NOD within 2 years

Bankruptcy or NOD within 2 years

Poor Credit

Poor Credit

Little to no credit

Little to no credit

Unsure at this time

Unsure at this time

Full Address of Subject Property with Zip Code

Full Address of Subject Property with Zip Code

County of Subject Property

County of Subject Property

Balance due on Mortgages 1st and 2nd

Balance due on Mortgages 1st and 2nd

Market Value of Home

Market Value of Home

Type of Home :

Type of Home :

Single Family Residence

Single Family Residence

Condo (FHA approved condos only)

Condo (FHA approved condos only)

2-4 Units

2-4 Units

Modular

Modular

Planned Unit Development

Planned Unit Development

Manufactured

Manufactured

Transaction: is this a purchase?

Transaction: is this a purchase?

Do you plan to use Power of Attorney?

Do you plan to use Power of Attorney?

Is this loan Vested in a trust?

Is this loan Vested in a trust?

Borrower Married?

Borrower Married?

Borrower Full Name

Borrower Full Name

Borrower Date of Birth

Borrower Date of Birth

Co-Borrower Full Name

Co-Borrower Full Name

Co-Borrower Date of Birth

Co-Borrower Date of Birth

Total Monthly Household Income

Total Monthly Household Income

Total Monthly Household Assets

Total Monthly Household Assets

Total Monthly Housing Expenses

Total Monthly Housing Expenses

Number of Household Members Living in Subject Property

Number of Household Members Living in Subject Property

Monthly Credit Debt

Monthly Credit Debt