Reverse Mortgage Counseling Division
Get Started Now!

If you would like to speak to one of our Independently-Certified Credit Counselors, please complete the form below and you will be contacted as soon as possible.

You can also call our Reverse Mortgage Counseling Division at 1-888-764-7460 Monday through Thursday, 8am to 10pm; Friday, 8am to 5pm; or Saturday, 9am to 5pm.

We look forward to helping you.

Borrower 1

First Name: *

Last Name: *

Borrower Date of Birth:

Borrower 2

First Name:

Last Name:

Borrower Date of Birth:

Borrower 3

First Name:

Last Name:

Borrower Date of Birth:

Home Information

Street Address:

City:

State:

Zip Code:

Home Value:

Liens Against the Home
(include outstanding mortgage):



Borrower Phone Number: *

Language Spoken

English                    Spanish                Polish                  Other  

Best Time to Reach You

Mon                Tue                Wed                Thu                Fri                Sat

8am-12pm         12pm-5pm         after 5pm         anytime         Specify a time: 

Reverse Mortgage Loan Broker Information

If you would like us to send a copy of your certificate to your reverse mortgage loan broker upon completion of the counseling, please provide the following information:

Loan Broker Name:

Telephone Number:

Fax Number:

Company:

Email:

Special Instructions

Please include any special instructions for your counselor below.