Residential Loan Application For Reverse Mortgages Page 2
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4IV. Liens Against The Property
List the creditor’s name, address, and account number for all liens against the property.
NOTE: This section should not be used to list all personal liabilities, only liens against the property.
Name of Creditor
Address of Creditor
Unpaid Balance
$
Account Number
Name of Creditor
Address of Creditor
Unpaid Balance
$
Account Number
Name of Creditor
Address of Creditor
Unpaid Balance
$
Account Number
Total liens to be paid:
$
V. Total Non-Real Estate Debts
Total Amount of Non-Real Estate Debts: $
VI. Declarations
If you answer “Yes” to any questions a through h,
Please use continuation sheet for explanation.
Borrower
Co-Borrower
Yes
No
Yes
No
a. Are there any outstanding judgments against you?
b. Have you filed for any bankruptcy that has not been resolved?
c. Are you a party to a lawsuit?
d. Are you presently delinquent or in default on any Federal debt or any
other loan, mortgage, financial obligation, bond, or loan guarantee?
[If “Yes,” give details, including date, name and address of lender,
FHA or VA Case number (if applicable), and reason for
delinquency/default.]
e. Do you intend to occupy the property as your primary residence?
f. Are you a co-maker or endorser on a note? (Optional for HUD)
g. Are you a U.S. citizen? (Optional for HUD)
h. Are you a permanent resident alien? (Optional for HUD)
Fannie Mae Form 1009 05/2004
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