The Reverse Mortgage Handbook


Request for additional information

If you would like additional information on reverse mortgages and/or the amount of funds for which you would be eligible for your specific situation, please complete the form below or email any question(s) you may have to Info@ReverseMortgageHandbook.com.

Borrower's Name:
Borrower's Date of Birth:
Co-Borrower's Name:
Co-Borrower's Date of Birth:
Property Address:
Property City:
Property County:
Property State:
Property Type: Single Family Townhouse Condominium Manufactured Home
Other
Contact Information:
Estimated Market Value:
Mortgage Balance:
Year Property Built:
How long have you
owned the property?
years.
Name(s) listed on title:
 (If applicable)
 (If applicable)
   
Please check if applicable: Property is in a living trust.
Person signing form is a Conservator, Guardian, or Power of Attorney.
Property is in a Planned Unit Development.
   
Can you provide:
Picture Identification? Yes   No
Copy of Social Security Card? Yes   No
Evidence of Insurance? Yes   No