HUD-92911 Home Equity Conversion Mortgage Counseling Session Evalu

Home Equity Conversion

U.S. Department of Housing and Urban Development

OMB Approval No. 2502-0585 (Exp. )

Mortgage Counseling

Session Evaluation

Office of Housing

Federal Housing Commissioner

Counseling Agency Name and Address (completed by HUD office)

A “Reverse Mortgage” pays a homeowner loan proceeds drawn from accumulated home equity and that requires no repayment until a future time. A HUD approved reverse mortgage is called a Home Equity Conversion Mortgage (HECM). The following questions below relate to your HECM counseling experience.

1. How did you hear about the HECM program?

7. Where did the counseling take place?

AARP website, handout

Lender

In your home

Counselor’s office

or referral

In private setting

On the telephone

HUD Staff or HUD website

Television/radio ad

Other:

Newspaper or other

Family member

publication

8. Was the setting in which the counseling was conducted private so that no one could hear your conversation to insure confidentiality?

Senior fair or local program

Estate planning firm

Other:

Yes

No

2. How did you hear about the counseling agency you

utilized?

9. How many times did you meet with your counselor?

HUD Staff or HUD website

Lender referral

(number of meetings, not counting initial intake call) and for how long?

Local community action program

AARP

15 to 30 minutes

30 minutes to 1 hour

State and/or local office on aging

Estate planning firm

1 hour or more

Other:

Random selection provided by

Automated online

Lender

referral system

10. a. Did the agency charge you a fee for the counseling?

Other:

Yes

No

3. Who interviewed you when you first contacted the counseling agency?

b. If “Yes,” how much was the charge for the counseling service?

$

A receptionist

A counselor

c. Did the counselor explain the basis for the charges?

4. Were you provided with a basic information package

Yes

No

directly related to your specific situation in advance of your counseling session?

d. If “Yes,” did you find the fees reasonable?

Yes

No

Yes

No

5. If you answered “Yes” to question 4, did the information

package contain information on the various HECM options available, the payment options and the amortization sheets?

11. Did the counselor disclose to you, at any time, any relationship it may have with a specific lender or bank?

Yes

No

Yes

No

6. Was the counselor knowledgeable of the HECM program?

12. Did the counselor provide you with information about other reverse mortgage programs or alternatives to reverse mortgages?

Yes

No

Yes

No

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( )

form HUD-92911

and no assurance of confidentiality is provided.

information is required to obtain funding under Section 106 of the Housing and Community Development Act of 1974. The information is not considered sensitive

the requirements of the Notice of Funding Availability (NOFA) and to assign points for awarding grant funds on a competitive and equitable basis. The

Public reporting burden for this collection of information is estimated to average 15 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. This agency may not conduct or sponsor, and a person is not required to respond to, a collection information unless that collection displays a valid OMB control number. This information is collected in connection with HUD’s Housing Counseling Program, and will be used by HUD to determine that the grant applicant meets

Please use the remaining space to provide any other comments you may have regarding your counseling experience.

Social security

Other retirement programs

Applied for an alternative program (specify which)

Medicaid

Property tax and insurance

Undecided

Medicare

Inheritance of property

Decided not to apply

16. Did the counselor advise you of the potential impact a HECM loan may have on the following?

Applied for a HECM/reverse mortgage

21. As of today, have you:

No

Yes

No

Yes

15. Did the counselor make any specific recommendations about what mortgage product you should obtain?

20. Did the counselor discuss your current financial situation and complete a budget or financial analysis with you?

No

Yes

14. Did the counselor make any specific recommendations regarding which lender to utilize?

Go to another agency (briefly describe why)

Go to the same counselor/counseling agency

Other:

19. If further counseling were necessary, would you:

Reverse mortgage program

Health/Social Services

No

Yes

Family support

Home repair loan/grant

Property tax/deferral

Selling/moving

18. Did the counselor make a specific recommendation as to whether you should or should not obtain a HECM?

Prescription drug program

Home equity/refinance

No

Yes

Medicaid

Credit counseling

17. Did the counselor discuss the pros and cons and potential pitfalls of purchasing an annuity with your HECM proceeds?

13. Which alternatives to a HECM were discussed? (check all that apply)

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