Reverse Mortgage Enquiry Form

1

What province are you located in?* This field is required.Select your province from the drop-down

2

What is your name?* This field is required.

First Name

Last Name

3

Email Address

example@example.com

4

Phone number* This field is required.

Area Code

Phone Number

5

Most of our clients like to communicate via Text and WhatsApp for quick confirmation and updates, what's your preference?💬* This field is required.Check all that apply

Yes - Text Messages

Yes - WhatsApp

No - Text Messages

No - WhatsApp

6

Retirement Status* This field is required.

I am currently retired

I am not retired

I plan on retiring within 5 years

7

What type of Reverse Mortgage Solution are you looking for?* This field is required.

Reverse Mortgage

Equity Mortgage

Second Mortgage

USA Mortgage

Mortgage Literacy Education & Coaching

Retire Abroad Planning

8

Are you aged 55+?* This field is required.

YESNO

9

Mortgage amount required?* This field is required.

10

How familiar are you with reverse mortgages?* This field is required.

I'm not familiar with reverse mortgages at all

I'm somewhat familiar with reverse mortgages

I'm very familiar with reverse mortgages

11

Would you like additional resources or education about mortgages and home equity options?* This field is required.

YESNO

12

Do you currently have a mortgage on the property?* This field is required.

YESNO

13

What is the current mortgage amount/Line of credit amount owing on your property?Include all mortgages and HELOCs

14

Are you looking to receive:* This field is required.Select all that applies

A lump sum

Monthly payments

Not sure yet

15

When are the funds required?* This field is required.

Less than 30 days

30-45 days

45-120 days

Unsure

17

When are the funds required?* This field is required.

Less than 30 days

30-45 days

45-120 days

Unsure

18

Describe your private mortgage needs?* This field is required.

I want to get a second mortgage on top of a reverse mortgage

I want to get a second mortgage on top an existing mortgage/HELOC

I want to refinance an existing second mortgage

19

Mortgage amount required?* This field is required.

20

When are the funds required?* This field is required.

Less than 30 days

30-45 days

45-120 days

Unsure

21

Mortgage amount required?* This field is required.

22

What is the primary goal of getting an equity mortgage* This field is required.Select all that apply

Renovations

Debt consolidation

Pay off CRA

Divorce/separation

Investment

I want to buy another property

I want to access my equity for other reasons

23

When are the funds required?* This field is required.

Less than 30 days

30-45 days

45-120 days

Unsure

24

Are you looking to:

Buy a vacation home

Buy an investment property

Refinance an existing U.S. property

25

Which U.S. state is the property located in (or intended)?* This field is required.

26

What is your estimated budget or property value?* This field is required.

27

Do you already own property in the U.S.?* This field is required.

YESNO

28

Are you a Canadian citizen or dual citizen?* This field is required.

YESNO

29

What areas would you like more clarity on? (Select all that apply)

Reverse Mortgage 101

Understanding documents

General Mortgages 101

Credit repair guidance

30

Are you planning to purchase or refinance in the next 12 months?

YESNO

31

Tell us more about the type of support your looking for

32

Would you prefer:Select all that apply

One-on-one coaching

Online resources

A group workshop

33

Which country are you considering retiring to?* This field is required.Select which country you are most likely considering retiring to

34

Do you plan to own or rent in your place of retirement* This field is required.

Rent

I'm unsure

Own

35

Will you need to finance a property purchase abroad? * This field is required.

YESNO

36

Are you also exploring residency or citizenship options? * This field is required.

YESNO

37

Do you plan to keep your Canadian property?* This field is required.

YESNO

38

Property status* This field is required.

Primary residence

Second home/cottage

Rental property

40

What is the estimated property value?* This field is required.

41

Do you have an existing mortgage or home equity line of credit (HELOC) on your property?

YESNO

42

What is your remaining mortgage balance?* This field is required.

43

Who is your current mortgage lender?* This field is required.

44

What is your current employment situation* This field is required.

Employed - Full-Time

Self-Employed

Employed - Part-Time

Unemployed

Retired

45

What is your credit score?* This field is required.

300 - 559 (Poor)

725 - 759 (Very Good)

560 - 659 (Fair)

760+ - Excellent

660 - 724 (Good)

I'm unsure what my credit score is

46

When is the best time for a call?🤙* This field is required.We'll send you a confirmation and reminder📆

47

When is the best time for a call?🤙* This field is required.We'll send you a confirmation and reminder🗓️

48

Let's Go!* This field is required.We look forward to speaking with you about your mortgage needs!

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