Please complete the registration form below and review the Certified Lender requirements.

• All Certified Lenders have proper operating authority from the NRMLA.
• All Certified Lenders have appropriate amount of insurance coverage as verified using the NRMLA guidelines.
• All Certified Lenders have been operating for a minimum of five years.
• All Certified Lenders currently have a satisfactory rating with the Better Business Bureau.
• All Certified Lenders specifically agree not to resale or redistribute users' information to any third-party without their express consent.

Company's Legal Name (or DBA) Contact Name Phone Email License Name License Number City State Zip I have read the certified reverse mortgage lenders requirements and agree to adhere to them and provide any necessary documentation to become certified.