All Reverse Mortgage / Reverse Mortgage Application

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Welcome to our Secure Reverse Mortgage Application. All data that you input through this form is encrypted using SSL technology (Green bar at the top of your browser indicates secure SSL connection).
Once your application is transmitted we will call to confirm receipt and begin preparing your documents overnight UPS delivery.
Program I'm Applying For
Have you closed on any mortgages in the last 12 months?
(Refinance, private mortgage, equity line etc.)
Your Funds
(If you choose an adjustable rate program you can choose to take only a portion of your available funds and leave the rest as a credit line etc.)
Do you intend to buy a financial product (annuity, etc) with your funds?
Secondary Borrower
Will there be a secondary/co-borrower?
1. General Information
In this section we must have your complete legal name (as stated on your photo ID documentation). We also need your exact date of birth and sex as these are requirements for the application. We must have your Social Security Number to complete your loan application as HUD defines that in order for an application to be complete under guidelines it must contain the SSN of all borrowers.

Your Information

First Name
Middle Name
Last Name
Date of Birth
Sex
Immigration Status
Social Security Number
Marital Status
Race

Spouse Information

First Name
Middle Name
Last Name
Date of Birth
Social Security Number

Secondary Borrower Information

First Name
Middle Name
Last Name
Sex
Date of birth
Immigration Status
Social Security Number
Race
2. Financial Information
In this section, we need to input your financial information. Please separate the monthly income, real estate assets and available assets for all applicants.

Your Information

x
Primary Borrower, please check each source of income which applies to you:
Monthly Income
Monthly Income
Monthly Income
Monthly Income
Monthly Income
Monthly Income
Monthly Income
Monthly Income
Monthly Income
Monthly Income
Monthly Income
Monthly Income
Monthly Income
Monthly Income
Monthly Income
Monthly Income
Monthly Income
Monthly Income
Monthly Income
Monthly Income
Monthly Income
Monthly Income
Done
Sources of Income
Available Assets
Required to bring money to closing
Do you own any homes?
How many homes do you own?
Total estimated value of all homes owned
Primary Residence
Monthly property tax
Monthly homeowners insurance
Second Home
Street Address
City
Zip Code
Monthly Property Tax
Monthly Insurance
Monthly Mortgage
Third Home
Street Address
City
Zip Code
Monthly Property Tax
Monthly Insurance
Monthly Mortgage
Fourth Home
Street Address
City
Zip Code
Monthly Property Tax
Monthly Insurance
Monthly Mortgage
Fifth Home
Street Address
City
Zip Code
Monthly Property Tax
Monthly Insurance
Monthly Mortgage
Will primary residence be sold prior to new home close?
What type of funds are you using for the down down payment on your new home?
Number of years you have lived at your current address
Total number of people (including yourself) who live at your current address

Spouse Information

x
For Spouse, please check each source of income which applies to you:
Monthly Income
Monthly Income
Monthly Income
Monthly Income
Monthly Income
Monthly Income
Monthly Income
Monthly Income
Monthly Income
Monthly Income
Monthly Income
Monthly Income
Monthly Income
Monthly Income
Monthly Income
Monthly Income
Monthly Income
Monthly Income
Monthly Income
Monthly Income
Monthly Income
Monthly Income
Done
Sources of Income

Secondary Borrower Information

x
Secondary Borrower, please check each source of income which applies to you:
Monthly Income
Monthly Income
Monthly Income
Monthly Income
Monthly Income
Monthly Income
Monthly Income
Monthly Income
Monthly Income
Monthly Income
Monthly Income
Monthly Income
Monthly Income
Monthly Income
Monthly Income
Monthly Income
Monthly Income
Monthly Income
Monthly Income
Monthly Income
Monthly Income
Monthly Income
Done
Sources of Income
3. Credit Information
Here we need to get a general idea of your credit history. Including any late payments on credit, mortgage, and other obligations.
Have you been late on your mortgage in the last 24 months?
Have you been late on any consumer debt in the last 24 months? this includes (Car loans, Credit cards, etc.)
Have you been late on your property tax payments in the last 24 months?
Do you have any other delinquent credit that will be reported in the last 24 months? (i.e. Judgment, Tax Lien, Collections, Bankruptcy or Foreclosure)
Do you have any deferred student loans or taxes that may not show up on credit?
Have you maintained homeowners insurance on your home consecutively for the past 24 months?
Is your home located in an Homeowner's Association(HOA)?
Total Monthly Obligations
What is your total combined minimum credit card payments per month:
What is the total combined amount paid to auto loans or other personal loans per month:
Rental Information
Do you currently rent or live with a relative/friend rent free?
5. Property Information
Here we need you to fill in all the information about your home. If you have a separate mailing address such as a PO Box because you live in an area where the Post Office does not deliver, please indicate so in the notes section. We need your estimate of your home's value along with any mortgages that need to be paid off belonging to the property.

Info About Your Home (Primary Residence)

Year Built
Square Footage
Street Address
City
State
Zip Code
Estimated Property Value
Existing Mortgage Amount
Property Type
Title is currently held
Is the property in foreclosure?
Sale date if given by lender
Property Has a Well
Property Has a Septic Tank
Is this property your primary residence?
Will you continue to occupy this property as your primary residence?

About The Home You Are Purchasing

Property Type
Street Address
 
City
State
Zip Code
Square Footage
Final agreed purchase price
Property Has a Well
Property Has a Septic Tank
Will this be your primary residence?
Is this home a new construction?

About Your Current Home (Primary Residence)

Street Address
City
State
Zip
6. Contact Information
We need contact information for all parties. The Reverse Mortgage program also requires that we have an alternate contact for every applicant as well.

Your Information

Home Phone
Mobile Phone (not required)
Email Address

Spouse Information

Email Address (not required)

Secondary Borrower Information

Home Phone (not required)
Mobile Phone (not required)
Email Address

Alternate Contact

This should not be a spouse or co-borrower but rather a close friend or family member. This alternate contact will only be contacted in situations in which we can not get in touch with you regarding important matters relating to your reverse mortgage
First Name
Middle Name
Last Name
Relationship
Home Phone
Street Address
City
State
Zip
7. Counseling Information
Reverse mortgage counseling is required in order to complete the loan process. If you have not yet completed the counseling we will provide you with a list of qualified 3rd parties which can help you with counseling after you submit this application.
Have you received your HUD Required Counseling?
Would you like a copy of this application sent to the primary borrower's email address? (Please Note That Social Security Data Will Not Be Sent)
Add Notes for this Application
Save Application for Later
Questions?
If you have any questions about any part of this application please don't hesitate to call us toll free 1.800.565.1722
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