Reverse Mortgage Questionnaire
Is The Borrower Married?:
*
Yes
No
Borrower First Name:
*
Borrower Last Name:
*
Borrower Birth Date
(MM/DD/YYYY)
:
*
Co-Borrower First Name:
Co-Borrower Last Name:
Co-Borrower Birth Date
(MM/DD/YYYY)
:
Total Household Monthly Income:
Total Household Assets
(checking, saving, CD's, brokerage, retirement accounts, etc.)
:
Total Monthly Housing expenses
(Taxes,Insurance, HOA, etc.)
:
Number of Household Members Living in Subject Property:
Estimated Property Square Footage:
Monthly Credit Debt
(Minimum payments from credit & installment)
:
Credit Evaluation (Pick all that apply):
*
Please select atleast one option
Great credit
A few collections and lates
Bankruptcy and Notice of Default within two years
Poor credit
Little to no credit
Unsure at this time
Address of Subject Property:
*
City of Subject Property:
*
State of Subject Property:
*
Zip Code of Subject Property:
*
County of Subject Property:
*
Market Value of Home:
Balance Due on 1st Mtg:
Balance Due on 2nd Mtg:
Other Liens secured by the subject property, if so how much?:
Type of Home:
*
Single Family Residence
Condo (FHA approved condos only)
Condo (Not FHA approved. Requesting Single Unit Approval)
2-4 Units
Modular
Pud
Manufactured
Transaction: Is this for a purchase?:
*
Yes
No
Do you plan to use a Power of Attorney (POA) in this transaction?:
*
Yes
No
Is this loan vested in a Trust?:
*
Yes
No
Is this a refinance of an existing reverse mortgage?:
*
Yes
No
Is this loan being transferred from another reverse lender?:
*
Yes
No
What was the appraised value of the property when you closed this reverse mortgage loan in the past?:
*
What was the closing date of the existing reverse mortgage?(MM/DD/YYYY):
*
Please upload a copy of the existing monthly reverse mortgage statement (max file size : 28 MB):
*
Any additional comments:
Thank you for completing the Reverse Mortgage Questionnaire.
It will help us have a more productive conversation. I am looking forward to visiting with you about this. Please keep in mind we are looking to help more families this year and would love to be able to count on you to pass out name along should the opportunity present itself. Thanks again!
