Reverse Mortgage Application | Secure Application by All Reverse Mortgage

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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

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?

4. Legal Information

In this section you are acknowledging if any of these following items apply to you. For example, if you were involved in bankruptcy currently, here is where you would check the box acknowledging you were in BK and then your Loan Officer would need to go over that with you.

Your Information

Borrower cannot sign, is incapacitated

Borrower is incompetent

Are there outstanding judgements

Unresolved Bankruptcy

Party to a Lawsuit

Default on Federal Debt

Co-maker or Endorser on a Note

Secondary Borrower Information

Borrower cannot sign, is incapacitated

Borrower is incompetent

Are there outstanding judgements

Unresolved Bankruptcy

Party to a Lawsuit

Default on Federal Debt

Co-maker or Endorser on a Note

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

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. This is not someone that we would need to contact during the processing of your file, but merely someone to have on file for down the line when your loan was being serviced in the event you were unreachable. This can be anyone you like that you trust (family member, friend, business associate, etc.)

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 is the person that we can contact should we not be able to reach you after your loan has closed.

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?

Add Notes for this Application

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