Month Day, Year s3

Genworth Mortgage Insurance File Submission Form Exhibit 02-457

SONYMA - CONVENTIONAL PLUS PROGRAM

Genworth Mortgage Insurance 8325 Six Forks Rd. Raleigh, N.C. 27615 Ph: 800-548-0884 Fax: 800-346-7961

Genworth Master Policy Number B22222 ______

Borrowers Name:______

Lender Name:______

Lender Contact Person:______

Phone Number:______

Fax Number:______

E-Mail address:______

M.I. Coverage: 18% ______; 16%______;12%______6%______

Homebuyer Education Center: FX # 800-716-4066 Homebuyer Education Center: Web https://homebuyereducation.genworth.com/register Questions on Homebuyer Education, Call 800-477-2040 Genworth Action Center 800-444-5664