Reverse Mortgage Application

Let's get your real numbers

About ten minutes. No Social Security number, no credit pull, nothing binding. I use this to price your file with our lenders and put an actual quote in writing before we talk. You can stop at any step and I will still call you.

PurposePropertyWhat you oweBorrowersIncomeTaxes & insuranceGoalsReview

What would you like to do?

This decides which program I price for you.

The property

For a purchase, tell me about the home you plan to buy, or your best guess.

Street address

City

State

Zip code

Estimated value today

Type of home

How is it used?

How is title held?

Year you bought it (optional)

If the home is in a trust, do you have the complete trust document with all amendments?

HOA or condo association?

Monthly dues (if yes)

What is owed on the home

Everything here gets paid off first, from the reverse mortgage proceeds. Enter 0 if the home is paid off.

Mortgage balance

Current monthly payment (principal & interest)

Who is the mortgage with? (optional)

Home equity line or second mortgage balance

Any other liens? Solar panel loan, PACE, tax lien, judgment. If none, leave blank.

Was any mortgage, HELOC, or lien placed on the home in the last 12 months?

FHA only lets reverse mortgage proceeds pay off liens that are more than 12 months old (or that gave you less than $500 cash). Newer liens usually need a different plan, so it helps to know now.

Solar and PACE liens matter. They can take priority over a reverse mortgage and usually have to be paid or subordinated before closing. Telling me now saves weeks later.

Who is on the loan

Your date of birth sets the loan amount, so it needs to be exact. A younger spouse who is not a borrower can still be protected. Tell me about them too.

First name

Last name

Date of birth

Marital status

Phone

Is your name on the title (deed)?

Spouse or co-borrower (leave blank if none)

Full name

Date of birth

Are they on the title?

Are they under 62?

Income and savings

A reverse mortgage has no monthly payment, but HUD requires me to confirm you can keep paying taxes and insurance. Round numbers are fine.

Social Security (monthly, all borrowers)

Pension or annuity (monthly)

Employment or self-employment (monthly)

Rental, investment, or other (monthly)

Work status

Savings and investments you could access

Taxes and insurance

With a reverse mortgage you stay responsible for these. This is the heart of HUD's financial assessment, and honesty here helps you, not hurts you.

Property taxes per year

Homeowners insurance per year

Are you current on both?

Any late payments on taxes, insurance, or the mortgage in the last 24 months?

Bankruptcy or foreclosure in the last 3 years?

Any past-due federal debt (IRS, federal student loans)?

What you want the money to do

This shapes the structure I recommend, and whether I recommend one at all.

Main goal (a sentence is plenty)

How would you prefer to receive funds?

HUD counseling

Timeline

How did you hear about us? (optional)

Anything else I should know? (optional)

Review and send

Here is what I will receive. You can go back and change anything.

Something went wrong sending your application. Please try again, or call (703) 255-5810 and I will take it by phone.

✓ No Social Security number✓ No credit pull✓ Nothing binding✓ Your info stays private

Your answers are saved in this browser until you send them.

Application received

Thank you

Your application is in my inbox. Here is what happens next:

1I review it the same business day
and price your file with our lenders using your real numbers.

2You get your quote in writing
every rate, every cost, and what you can actually receive.

3We talk it through
including the reasons a reverse mortgage might not be right for you. If you have not scheduled HUD counseling, I will point you to an agency.

Want to pick the time now?

Book My Call With Chris

or call (703) 255-5810

The Mortgage Exchange Service LLC, NMLS ID 205178, Virginia License MC2538, Maryland License MB11493. Equal Housing Lender. This is not a commitment to lend. Reverse mortgages are loans that must be repaid, typically when the last borrower leaves the home; they are not government benefits. Borrowers must complete HUD-approved counseling. This material is not from HUD or FHA and was not approved by HUD or any government agency.