1Step 12Step 23Step 34Step 45Step 5Program I'm Applying ForCurrently UndecidedFor My Present HomeFor a Home I'm PurchasingJumbo Reverse MortgageHave you closed on any mortgages in the last 12 months?NoYes(Refinance, private mortgage, equity line etc.)Did the refinance result in any cash amount to you in excess of $500?NoYesYour FundsI want all funds available (Full Draw)Undecided on amount of funds.I want a specific amount upfront(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.)Amount*Do you intend to buy a financial product with your funds?NoYesName and cost of the financial product*Secondary BorrowerWill there be a secondary/co-borrower?NoYesIs secondary borrower your spouse?*NoYes1. General InformationIn 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.First Name*Middle NameLast Name*Date of Birth*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Sex*MaleFemaleMarital Status(Single, Divorced or Widowed)MarriedImmigration Status*US CitizenLawful Perm. Resident AlienOtherSocial Security Number*RaceSelectAmerican Indian / Alaska NativeAsianBlack / African AmericanHispanic / LatinoNative Hawaiian / Pacific IslanderWhiteI Will Not Disclose My RaceOtherNot ApplicableHome Phone*Mobile Phone (not required)Email Address*Spouse InformationFirst Name*Middle Name*Last Name*Social Security Number*Date of Birth*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Secondary Borrower InformationFirst Name*Middle Name*Last Name*Date of Birth*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Sex*MaleFemaleImmigration Status*US CitizenLawful Perm. Resident AlienOtherSocial Security Number*Race*SelectAmerican Indian / Alaska NativeAsianBlack / African AmericanHispanic / LatinoNative Hawaiian / Pacific IslanderWhiteI Will Not Disclose My RaceOtherNot Applicable2. Financial InformationIn this section, we need to input your financial information. Please separate the monthly income, real estate assets and available assets for all applicants.Sources of Income Pension/Retirement Self Employed Social Security Employment Overtime Bonuses Rental Home Social Security Disability Benefits VA Disability Benefits Private Disability Benefits Annuities Military Income Other Public Assistance Automobile Allowance Subject Property Rental Investment Income Capital Gains and Losses Expected Income Trust Accounts Alimony /Child Support/ Maintenance Notes Receivable Government Non Cash Primary Borrower, Please input Your each Source of Monthly income which applies to you:Pension/Retirement*Self Employed*Social Security*Employment*Overtime*Bonuses*Rental Home*Social Security Disability Benefits*VA Disability Benefits*Private Disability Benefits*Annuities*Military Income*Other Public Assistance*Automobile Allowance*Subject Property Rental*Investment Income*Capital Gains and Losses*Expected Income*Trust Accounts*Alimony /Child Support/ Maintenance*Notes Receivable*Government Non Cash*Required to bring money to closingNoYesDid you borrow the moneyNoYesAvailable Assets*How many homes do you own?1 home (my primary residence)2 homes3 homes4 homes5 homesTotal estimated value of all homes owned*Monthly property tax*Monthly homeowners insurance*Number of years you have lived at your current address*Total number of people (including yourself) who live at your current address*Second HomeStreet Address*City*Zip Code*Monthly Property Tax*Monthly Insurance*Monthly MortgageThird HomeStreet Address*City*Zip CodeMonthly Property TaxMonthly Insurance*Monthly MortgageFourth HomeStreet Address*City*Zip Code*Monthly Property TaxMonthly Insurance*Monthly MortgageFifth HomeStreet Address*City*Zip Code*Monthly Property TaxMonthly Insurance*Monthly Mortgage3. Credit InformationHere 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?YesNoPlease list each time you were late and and for how long below:Is your mortgage now current?YesNoHave you been late on any consumer debt in the last 24 months?YesNoPlease list each item and how long you were late below:Are all bills now current?NoYesHave you been late on your property tax payments in the last 24 months?YesNoPlease list each time you were late and for how long below:Is your property tax now current?YesNoDo you have any other delinquent credit that will be reported in the last 24 months?YesNoPlease list each instance below:Do you have any deferred student loans or taxes that may not show up on credit?YesNoPlease list each instance below:Have you maintained homeowners insurance on your home consecutively for the past 24 months?YesNoPlease list each instance below:Is your home located in an Homeowner's Association(HOA)?YesNoHow much are the monthly dues?Have you been late on paying them in the last 24 months?YesNoPlease list each time you were late and for how long below:Are your HOA dues now current?NoYesWhat is your total combined minimum credit card payments per monthWhat is the total combined amount paid to auto loans or other personal loans per month:4. Legal InformationIn 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.Party to a LawsuitYesNoBorrower is incompetentYesNoDefault on Federal DebtYesNoUnresolved BankruptcyYesNoBorrower cannot sign, is incapacitatedYesNoAre there outstanding judgmentsYesNoCo-maker or Endorser on a NoteYesNo5. Property InformationHere 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*StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificZip Code*Estimated Purchase PriceEstimated Property Value*Will this be your primary residence?YesNoDoes the property you are purchasing have an HOA – Homeowners Association?NoYesIs this home a new construction?NoYesas the Certificate of Occupancy or local equivalent been issued to the builder?NoYesExisting Mortgage AmountTitle is currently heldIn My NameIn the Name of My Family TrustIs the property in foreclosure?YesNoSale date if given by lenderIs this property your primary residence?YesNoWill you continue to occupy this property as your primary residence?YesNoProperty Type2 to 4 familyCondominiumCooperativeFarmManufactured HomeMulti-Family 4+Single FamilyTownhouseCondo association nameLiving Units234Guest house or "In Law" quarters?NoYesAre they rented?YesNoProperty Has a WellNoYesIs it private?YesNoProperty Has a Septic TankNoYesProperty Has Solar PanelsNoYesAre the solar panels owned by you or are they leased from a 3rd party company?Owned By MeLeased From 3rd Party CompanyPlease tell us the name of the companyAbout Your Current Home (Primary Residence)Street AddressCityStateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificZip6. Contact InformationWe need contact information for all parties. The Reverse Mortgage program also requires that we have an alternate contact for every applicant as well.Alternate ContactThis 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 mortgageFirst NameMiddle NameLast NameRelationshipHome PhoneStreet AddressCityStateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificZip7. Counseling InformationReverse 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?NoYesWas there a Fee?NoYesHow Much?Was this fee paid upfront or will it be financed through this loan?UpfrontFinancedWould 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)NoYesNameThis field is for validation purposes and should be left unchanged.
