(Please be very thorough in completing this information)* Required BORROWER Name: * SSN: * DOB: * MARRIEDUNMARRIEDDIVORCEDWIDOWED CO-BORROWER Name: SSN: DOB: MARRIEDUNMARRIEDDIVORCEDWIDOWEDNot Selected HOME Home Phone: Cell: Email address: * HOME ADDRESS: * Please list any repairs that need to be done to your home: Have you been declined for a Reverse Mortgage transaction? YesNo If so, why? How many years have you lived in your home? Do you have an unpermitted addition or a garage conversion? YesNo Do you have Solar Panels on your home? YesNo Is your property in a Family Trust? YesNo Have your property taxes and home insurance been on time over the last 24 months? YesNo Do you own other properties? YesNo If so, please list the addresses: Do you pay any Home-Owners Association Dues? YesNo If yes, provide HOA name: and Phone #: If yes, how much are your monthly HOA dues? ($) If yes, have you been late on your HOA dues in the last 24 months? YesNo Mortgage or Reverse Mortgage Company Mortgage or Reverse Mortgage Company: Loan #: Phone #: Home Insurance Company Home Insurance Company: Agent Name: Policy #: Phone #: Approximately how much are your annual home insurance dues? Updated Emergency Contact Information (someone who doesn’t live with you) Name: Phone #: Relationship: Address: Misc Have you had any late payments that would show on your credit report in the last 2 years? YesNo Do you have credit card debt? YesNo If so, approximately how much? Do you have any outstanding auto loans? YesNo If so, how much are the payments? Do you give permission for the lender to check your credit? YesNo Do you currently have credit freezes on Equifax, Experian, Transunion? YesNo Are you currently employed full time or part time? Full timePart timeNot employed Are you self-employed? YesNo Household Income & Assets Please list the sources and amounts of all household income including but not limited to Social Security, Disability, Pension, Retirement, IRA distributions, Employment, Self- Employment, Annuity, … etc: How much are your total estimated liquid assets in the form of Checking, Savings, Retirement Accounts, Annuity…etc…? This will only be referred to as a Compensating Factor in the rate case that your income is not enough to qualify.
