Reverse Mortgage Servicing Department Annual Occupancy

Annual Occupancy Certificate

Reverse Mortgage Servicing Department P.O. Box 40087

Lansing, MI 48901 Phone (866) 654-0020

Fax (866) 429-6529

Instructions

On an annual basis, we are required to confirm that the property which secures your mortgage is still your primary residence. You may e-sign your Occupancy form at or sign below and return this form to us within 30 days via email, fax or mail as indicated below. If the property is not your primary residence, please provide a written explanation and return it to us as soon as possible.

By computer Scan to an image or PDF file and upload to or email to occupancy.dept@

By fax (866)-429-6529

By mail Reverse Mortgage Servicing Department P.O. Box 40087 Lansing, MI 48901

***IMPORTANT*** If you do not e-Sign the Occupancy Certification form online, a form will be mailed to you within 30 days of the anniversary of your loan closing date each year. This form is only intended to be a replacement for the one mailed to you in case it is misplaced. Please do not complete and submit this form in advance of your loan's anniversary date. Doing so will not satisfy the annual requirement.

As a reminder, it is your responsibility to advise us in writing of any absences from your property that exceed two (2) months, and provide a temporary mailing address, to avoid a determination that your principal residence has changed. If you have entered into a tax deferral program, or have any questions, please call us at (866) 654-0020.

Annual Occupancy Certificate

All fields are required, except where noted.

Date ___________ Printed Name ______________________________ Account Number: ________________ I (we) hereby certify that I (we) occupy the property noted below as my (our) principal residence.

Property Address:

The following message is applicable to you if your loan is insured by HUD:

Warning: Section 1001 of Title 18 of the United States Code makes it a criminal offense to make a willfully false statement or misrepresentation to any department or agency of the United States government as to any matter within its jurisdiction.

Borrower 1 Signature

Date

Borrower 2 Signature (f applicable)

Date

If you would like to give permission to us to discuss your account and share copies or your loan documents with anyone other than yourself (son, daughter, etc...), please complete the section below. Please note that completing this section is optional.

Name ___________________________________________ Phone Number ________________________________

Address __________________________________________________________________________________________

Relationship to Borrower ____________________________________________________________________________

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Annual Occupancy Certificate

Reverse Mortgage Servicing Department P.O. Box 40087

Lansing, MI 48901 Phone (866) 654-0020

Fax (866) 429-6529

Cell Phone & Email Consent

By providing my/our telephone phone number(s) and/or email address(es) below, I/we consent to be contacted via email, text message, voice call, or through an automated dialing system, or pre-recorded voice message by the Servicer or its authorized third party for informational and account service calls related to my/our account, but not for telemarketing or sales calls, at any telephone number, including my/our mobile telephone number, or email addresses(es) that I/we have provided. Message and data rates may apply. I/we understand that we may contact the Servicer at any time to change these preferences.

Reverse Mortgage Loan #:

Borrower Name(s):

Borrower Cell Phone:

Borrower Email Address:

Co-Borrower Cell Phone:

Co-Borrower Email Address:

Borrower 1 Signature Borrower 2 Signature (f applicable)

Date Date

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