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Reverse Mortgage Assessment
Click " Start " below to begin your Free No-Obligation Reverse Mortgage Assessment. A Certified Reverse Mortgage Specialist will review your information and contact you within 24 business hours to discuss your assessment.
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1
What property type is the home you're considering a reverse mortgage for?
*
This field is required.
Please click the choice that most closely resembles the property type
House (Detached)
House (Semi-Detached)
Townhouse
Condo
Duplex/Triplex/Quadplex
More Than 1 Property
Manufactured Home
Other
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2
Referrer
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3
What is the estimated value of your home (in $)?
eg. $200,000, $500,000, $1m. Please put 'do not know' if you are not sure. Click next when you're done.
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4
What is your planned use for the reverse mortgage funds?
*
This field is required.
Choose as many as you like - but at least one - then click on 'Next' in the bottom right
Major Purchase
Unexpected Major Expense
Travel
Health Care
Monthly Income
Home Renovation
Pay Debt
Estate Planning
Family Gifts
Investments
Other
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5
Are you a member of CARP (Canadian Association of Retired Persons)?
Please select one - if you're not sure, please select that
Yes
No
Not Sure
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6
Do you have an existing mortgage or line of credit?
*
This field is required.
Not including small balances or things that are paid off every month
Yes
No
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7
What is the balance you owe on your mortgage (roughly)?
No need to be exact - just an approximate amount will do. Leave this blank if there is none. Press next in the bottom right when done.
Just a rough estimate in $
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8
What is the balance you owe on your line of credit (roughly)?
No need to be exact - just an approximate amount will do. Leave this blank if there is none. Press next in the bottom right when done.
Rough estimate in $ format - eg. $20,000
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9
Do you have any major credit card or other debts?
*
This field is required.
For example, credit cards, car loans, overdue tax or other amounts due. Not including small balances paid off every month.
Yes
No
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10
What is the balance you owe across all your other debts (roughly)?
No need to be exact - just an approximate amount will do. Leave this blank if there is none. Press next in the bottom right when done.
Rough estimate in $ format - eg. $20,000
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11
What is your approximate household annual income?
*
This field is required.
Household income = the total income of you and your spouse (if applicable). Annual income is less important in assessing a reverse mortgage, but it will help us determine if there are other, better mortgage options available.
$0 to $30,000
$30,000 to $60,000
$60,000 to $90,000
$100,000+
Not Sure
Other
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12
And can you give us an estimate of your credit score?
*
This field is required.
Similarly to income, credit score is not as important for a reverse mortgage - but this will help us determine if there are other, better mortgage options available. Just an estimate - choose 'not sure' if you're not sure. If there is more than 1 person on title, choose the lowest of the applicant.
Good (eg. 680+)
Average (eg. 600-680)
Bad (eg. under 600)
Don't Know/Not Sure
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13
What is the property address?
*
This field is required.
Your property address and the location are vital to seeing how much reverse mortgage you qualify for. If you're looking for a reverse mortgage on more than one property, please use your principal residence - where you live for this address. Press next in the bottom right when done.
Street Address
Street Address Line 2
City / Town
Province
Postal Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
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14
First Name Parsed
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15
What is your marital status?
*
This field is required.
Married
Widowed
Divorced
Single
Separated
Other
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16
Is there a living second applicant - someone else who is also the homeowner or on title to the home?
*
This field is required.
eg. A relative or someone else who is on title or also listed as the homeowner
Yes
No
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17
Main applicant information
*
This field is required.
Please complete for the person filling out this application. Press next in the bottom right when done.
Title
Mr
Mrs
Ms.
Miss.
Other
Title
Title
Mr
Mrs
Ms.
Miss.
Other
Title
First Name
Last Name / Surname
Phone Number
Please enter your email
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18
Main applicant date of birth - please enter as day-month-year (eg. 25-12-1950)?
*
This field is required.
This is necessary, as your date of birth drastically impacts how much reverse mortgage is available. Press next in the bottom right when done.
Format should be DD-MM-YYYY
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19
Second applicant information
Please complete for your spouse or anyone else on title to the home. If you're married, we'll need this information even if they're not on the title. If there is no-one then leave this blank. Press next in the bottom right when done.
Title
Mr
Mrs
Ms.
Miss.
Other
Title
Title
Mr
Mrs
Ms.
Miss.
Other
Title
First Name
Last Name / Surname
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20
Second applicant date of birth - please enter as 'day-month-year' (eg. 25-06-1950)?
This is necessary, as their date of birth will also drastically impact how much reverse mortgage is available. Press submit in the bottom right when done.
Format should be DD-MM-YYYY
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21
original
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22
lastpage
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23
Reverse Mortgage Form Pixel
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Should be Empty:
Reverse Mortgage Assessment
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