Deed-for-Lease™ Program Referral Form
Instructions: This form should be used by servicers to refer a borrower eligible for a deed-in-lieu of foreclosure for a determination of eligibility for a Deed-for-Lease property rental. E-mail to: deedforlease_applications@fanniemae.com.
Part 1 – Servicer Information Today’s Date: Servicer Loan Number: Fannie Mae loan Number: Part II – Pre-screen Check Loan Types (Yes - not eligible; No –eligible) HECM loan USDA Rural Loan FHA Loan VA Loan Loan with Recourse Second Lien Y/N Candidate Requirements (“No” answers will render borrower ineligible for lease back) Is property occupied as the occupant’s primary residence? Has borrower made more than 3 payments since origination? Has borrower made more than 3 payments since modification? Is borrower fewer than 12 payments delinquent? Does borrower have a verifiable source of income? Can borrower convey marketable title? Y/N Servicer Contact Name: Servicer Name: Servicer E-mail Address: Servicer Contact Telephone Number: Servicer ID: Other:
Is borrower in bankruptcy or litigation regarding the property or loan? (“Yes” answer will render borrower ineligible for lease back) Date borrower consented to servicer providing his/her contact information and property address to a property manager: Part III – Property Information Property Address: Property Type: [ ] Single Family [ ] Condo [ ] Duplex [ ] Triplex [ ] 4 Units Property Occupied by: [ ] Borrower [ ] Tenant [ ] Both Estimated Property Value (If available, and note basis for estimate): City/State/Zip Code:
Part IV – Borrower/Co-Borrower Information Borrower Name: Home Phone Number: Office Number: Cell Number: E-mail Address: Special Notes: Co-Borrower Name: Home Phone Number: Office Number: Cell Number:: E-mail Address:
Form 187
Fannie Mae November 2009