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.

New York is ineligible across all LHFS Channels.

North Carolina is ineligible under the Wholesale Channel.

Broker Information

Loan Originator

Property Information

Borrower Information

Non-Borrowing Spouse Information

Payment History

Additional Information

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