Reverse Mortgage Tampa Bay Florida

Type of Loan:

Address:

City:

State:

Zip:

Property Type:

Residence Type

Appraised Value:

First Name: *

Middle Name:

Last Name: *

Home Phone:

Cell Phone: *

Email: *

SSN: *

DOB: *

Rent or Own?: *

Monthly Rental $:

Current Address: *

City: *

State: *

Zip: *

# Yrs in Address: *

Dependents:

School # Yrs:

First Name:

Middle Name:

Last Name:

Home Phone:

Cell Phone:

Email:

SSN:

DOB:

Dependents:

School # Yrs:

How Do you get paid?:*

Employer*:

Address *:

City *:

State *:

Zip *:

Position *:

Phone *:

Years Job *:

Months Job *:

Years Field *:

How Do you get paid?:

Employer:

Address:

City:

State:

Zip:

Position:

Phone:

Years Job:

Months Job:

Years Field:

If employed in current position for less than 2 years or if current employed in more than one position, complete the following:

Employer:

Address:

City:

State:

Zip:

Position:

Phone:

Years Job:

Months Job:

Years Field:

Employer:

Address:

City:

State:

Zip:

Position:

Phone:

Years Job:

Months Job:

Years Field:

Monthly Base Income (Gross) *
Overtime
Bonuses
Commission
Dividend
Net Rent (property owned)
Other

Monthly Base Income (Gross)
Overtime
Bonuses
Commission
Dividend
Net Rent (property owned)
Other

Escrow:

Financial Institutions:

#	Bank Name *	Amount *	Account # *
1 *
2
3
4

Life Insurance

Insurance Name	Life Value

Stocks and Bonds:

#	Stocks Name	Amount
1
2
3

Automobile(s) Owned:

#	Type	Value
1
2
3

Other Assets:

#	Name	Value
1
2
3

Real Estate Owned:

Address	City/State/Zip	Value	Mortgage Balance	Mortgage Payment	Rent	HOI Taxes	Net Rent	S/PS/R	Type	REMARKS

#	Question	Yes/No
a	Are there any outstanding judgments against you? *
b	Have you been declared bankrupt within the past 7 years? *
c	Have you had property foreclosed upon or given title or deed in lieu thereof in the last 7 years? *
d	Are you a party to a lawsuit? *
e	Have you directly or indirectly been obligated on any loan which resulted in foreclosure, transfer of title in lieu of foreclosure or judgment? (This would include such loans as home mortgage loans. SBA loans. home improvement loans. educational loans. manufactured (mobile) home loans, any mortgage, financial obligation, bond, or loan guarantee. If "Yes," provide details, including date. name. and address of Lender. Fl IA or VA case number, if any. and reasons for the action.) *
f	Are you presently delinquent or in delimit on any Federal debt or any other loan, mortgage, financial obligation, bond or loan guarantee? *
g	Are you obligated to pay alimony, child support, or separate maintenance? *
h	Is any part of the down payment borrowed? *
i	Are you a co-maker or endorser on a note? *
j	Are you a U.S. citizen? *
k	Are you a permanent resident alien? *
l	Do you intend to occupy the property, as your primary residence? *
m	Have you had an ownership interest in a property in the last three years? *
	(1) What type of property did you own principal residence (PR), second home (SH) or investment property (IP)? *
	(2) How did you hold title to the home by yourself (S), jointly with your spouse (SP), or jointly with another person (O)? *

#	Question	Yes/No
a	Are there any outstanding judgments against you?
b	Have you been declared bankrupt within the past 7 years?
c	Have you had property foreclosed upon or given title or deed in lieu thereof in the last 7 years?
d	Are you a party to a lawsuit?
e	Have you directly or indirectly been obligated on any loan which resulted in foreclosure, transfer of title in lieu of foreclosure or judgment? (This would include such loans as home mortgage loans. SBA loans. home improvement loans. educational loans. manufactured (mobile) home loans, any mortgage, financial obligation, bond, or loan guarantee. If "Yes," provide details, including date. name. and address of Lender. Fl IA or VA case number, if any. and reasons for the action.)
f	Are you presently delinquent or in delimit on any Federal debt or any other loan, mortgage, financial obligation, bond or loan guarantee?
g	Are you obligated to pay alimony, child support, or separate maintenance?
h	Is any part of the down payment borrowed?
i	Are you a co-maker or endorser on a note?
j	Are you a U.S. citizen?
k	Are you a permanent resident alien?
l	Do you intend to occupy the property, as your primary residence?
m	Have you had an ownership interest in a property in the last three years?
	(1) What type of property did you own—principal residence (PR), second home (SH) or investment property (IP)?
	(2) How did you hold title to the home— by yourself (S), jointly with your spouse (SP), or jointly with another person (O)?

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Application

I.- TYPE OF MORTGAGE AND TERMS LOAN

II.-PROPERTY INFORMATION AND PURPOSE OF THE LOAN

III.-BORROWER INFORMATION

IV.-EMPLOYMENT

V.- MONTHLY INCOME AND HOUSING EXPENSES

VI.- ASSETS AND LIABILITIES

VIII.- DECLARATIONS

X.- INFORMATION FOR GOVERMENT FOR MONITORING PURPOSES