SENIOR SOLUTIONS FINANCIAL ASSESSMENT

Borrower name
First Name: Last Name:
NBS name/co-Borrower
First Name: Last Name:
Property Address: City: State: Zip:
FHA Case # (If available):
Data Collection
Credit History - Installment Accounts (Required)
Total Family Size (ie: 1, 2, 3, if 4 or more type"4")
How many 30 Day Lates (if none, enter zero "0")
Age of youngest borrower (Minimum 62 years old)
How many 60 Day Lates (if none, enter zero "0")
Subject Property State Abreviation
How many 90 Day Lates (if none, enter zero "0")
Real EstateTaxes Current?
Credit History - Revolving Accounts (Required)
Property Taxes Delinquent In Last 24 Months?
How many 30 Day Lates (if none, enter zero "0")
Other Assessments Delinquent in last 24 months?
How many 60 Day Lates (if none, enter zero "0")
HOA/PUD/Condo Fees delinquent in last 24 months?
How many 90 Day Lates (if none, enter zero "0")
Flood insurance in place for the last 12 months?
 
Monthly Effective Income
Annual Amount
Monthly Amount
Monthly Property Charges Annual Amount Monthly Amount
Social Security
0
Home owner's insurance
0
Pension/Retirement
0
Real Estate Taxes
0
Employment
0
Flood insurance
0
Disability Benefits (Private, VA, etc)
0
HOA fees
0
Other
0
PUD fees
0
Other
0
Ground rents
0
Other
0
Other
0
Total Income :
Other
0
Total Monthly Property Charges:
Monthly Property Taxes as % of Monthly Income:
 
Monthly Maintenance & Utility Expenses (Required) Living Area Sq.Ft. Expense Amount
Square footage of gross living area above grade
0
 
Other Monthly Expenses (Required) Outstanding Balance Monthly Payment Calculation of imputed income from Assets subject to federal taxes (Optional) Net Value Discounted value
Installment accounts
Checking
Income Taxes
Savings
Alimony & child support
Certificate of Deposits
Bankruptcy payments
Roth IRA
Revolving accounts
Other
FICA
Other
Judgement payments
Total assets NOT subject to federal taxes:
Other
 
Other
Calculation of imputed income from Assets NOT subject to federal taxes (Optional) Net Value Before Federal taxes Discounted Value after Federal taxes
Other
Other
Taxed retirement account
Monthly Maintenance Expenses:
Real Estate
Total other monthly expenses:
Annuities based on remaining term
Notes: Stocks & Bonds
Other
Other
Total assets subject to federal taxes:
Total combined discounted assets
Total monthly income from all asset sources:
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Income & Expense Analysis Result
Sources Amount Extenuating circumstances (If applicable):
Total monthly effective income from all sources:
$0.00
minus Total monthly property charges:
$0.00
minus Total other monthly expenses:
$0.00
equals Total Monthly Residual Income:
$0.00
Compensating Factors (If applicable):
Required Monthly Residual Income: (,)
True
Income & Expense Analysis Results:
Residual Income Short Fall