Mortgage Occupancy Verification Form

Mortgage Occupancy Verification Form
Use this form to verify how a mortgaged property is occupied and to record supporting occupancy details.
Borrower and Property Details
Borrower Full Name
First NameMiddle NameLast Name
Property Address
Street Address
Street Address Line 2
CityState / ProvincePostal / Zip Code
Street Address Line 2
Loan or Mortgage Reference Number
Property State/Province
Occupancy Verification
Occupancy Status
Other
Move-In / Occupancy Start Date
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Do you currently occupy the property as stated?
Declaration and Submission Details
Date of Verification
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Name and Title of Person Completing Form
Additional Occupancy Notes or Clarification
Should be Empty: