Reverse Mortgage Quote Proposal Request

To pre-review your borrower’s credit and income situation please complete the following form. The requirement of pre-counseling approval is intended to prevent unnecessary counseling and appraisal expenses. Please note that pre-counseling approval is NOT loan approval nor a commitment to lend. Pre-counseling approval is based solely on the information provided and should be used as a tool to communicate with your borrower. Land Home Financial Services can not make a final decision until completing a full review of the complete file.

North Carolina is ineligible under the Wholesale Channel.

Broker Information

Broker Name

Loan Originator

First Name

Last Name

Loan Originator NMLS

Loan Originator Phone

Loan Originator Email

Loan Originator Company Name

Property Information

Street Address

City

State

ZIP Code

Estimated Market Value of Home

1st Mortgage Balance

2nd Mortgage Balance

Other Liens Requiring Payoff at Closing

Property Type

Power of Attorney?

Yes

HECM Type

Would you like to add an Origination Fee?

Yes

Borrower Information

Borrower First Name

Borrower Last Name

Borrower DOB

Borrower's Income

Source of Borrower's Income

Liquid Assets: Total in Checking and Savings

Liquid Assets: Retirement

Liquid Assets: Other

Is there a Co-Borrower?

Yes

Car Payments

Additional Car Payments?

Yes

Credit Card Minimum Payments

Additional Credit Card?

Yes

Other Installment Payments

Additional Installment Payments?

Yes

Cosigned Debts

Tax Payment Plan (Monthly)

Bankruptcy Payment Plan (Monthly)

Extenuating Circumstances for Credit Issues or Major Delinquencies

Compensating Factors for Satisfying Residual Income

Non-Borrowing Spouse Information

Is there a Non-Borrowing Spouse?

Yes

Is there a Non-Borrowing Household Member?

Yes

Payment History

Bankruptcy

Yes

Short Sale / Foreclosure

Short Sale

Foreclosure

Not Applicable

Extenuating Circumstances for BK, SS, and/or Foreclosure

Mortgage Lates in the Past 24 Months

Yes

Late Property Tax Payment in Past 24 Months?

Yes

Lapse of Homeowner's Insurance in Past 12 Months?

Yes

No/Not Applicable

Flood Insurance?

Yes

Homeowners Association?

Yes

Additional Information

If you are experiencing issues submitting the proposal request above, please complete the pdf Proposal Request Form and submit via email to ReverseProcessing@LHFS.com.