Section a Applicant Information s1

Martin O’Malley Mark Kaufman Governor Commissioner

Anthony G. Brown Anne B. Norton Lt. Governor Deputy Commissioner

Alexander M. Sanchez Secretary

State of Maryland Department of Labor, Licensing and Regulation Commissioner of Financial Regulation

MortgageMortgage LendersLenders –– SoleSole Proprietors/LicensedProprietors/Licensed InsuranceInsurance ProducersProducers ApplicationApplication PackagePackage

Rev 11/18/2010 Commissioner of Financial Date Stamp Regulation Office Use Only

License Application

A decision on a completed application package will be made within sixty (60) days. To ensure that your application is complete, please review each question and use the check box when all items or questions are satisfied. Failure to file a completed application may result in the denial of your application. Your responses to the questions on this application are continuing in nature. You must promptly notify the Commissioner of any circumstance that would cause your answers to change. Please note that “You” refers to any person included as part of this application, including any owners, officers, directors or business entity. Please type or print clearly in dark ink.

Section A – Applicant Information

A1. Name under which applicant will conduct business:

A2. Business address where applicant will conduct business (This business address must be the same on bond):

A3. Tax ID or social security # of applicant: Telephone #: Fax #: Address: Email:

A4. Name, telephone number and email address of principal contact for consumer complaints:

A5. Name, telephone number and email address of principal contact for licensing and compliance matters:

A6. Address where records pertaining to Maryland transactions will be maintained:

A7. If you or the financial institution described under Section B of this application uses a trade name, provide a copy of the trade name registration(s) from the Maryland Department of Assessments and Taxation.

A8. Provide a current (within the last 12 months) personal financial statement. The financial statement must be notarized and include assets, liabilities, and net worth. Please see the attached advisory regarding minimum net worth requirements for Maryland mortgage lenders.

A9. Provide a current credit report (within the last 12 months).

A10. Is the applicant an employer required to comply with the Maryland Workers’ Compensation Law? Yes No If yes, complete the following: Policy/Binder Number Insurance Company

A11. Have you ever been issued another license by this office? Yes No If yes, list the type of license and date(s) held.

A12. Will applicant be or is the applicant now directly or indirectly paying or providing any form of compensation to any person other than a bona fide employee for referrals of applications related to the licensed business? If yes, provide details on a separate sheet of paper. Yes No

Rev 11/18/2010 A13. Have you ever been denied a license issued by the Department of Labor, Licensing and Regulation or any other governmental unit of this State or any other state? If yes, provide a detailed explanation with the appropriate documentation. Yes No

A14. Have there been any criminal, civil or administrative actions initiated against you by any state, governmental unit or any individual in the past 12 months? If yes, provide details with appropriate documentation. Yes No

A15. Have you ever had a license (except a driver’s license), permit, or registration denied, suspended, revoked or restricted by any state or federal agency, or FNMA, GNMA, FMAC, VA, or HUD/FHA? If yes, provide details on a separate sheet of paper with appropriate documentation. Yes No

A16. Have you ever been the subject of any order, judgment, decree, reprimand or other sanction by a court of law or a regulatory agency? If yes, provide details on a separate sheet of paper. Yes No

A17. Have you ever been convicted of any criminal offense? If yes, provide details on a separate sheet of paper. Yes No

A18. Complete the enclosed Application for Criminal History Record Check. (Note: fee and application for the criminal record check must be forwarded to the address indicated on the record check application).

Section B – Financial Institution To Which Mortgages will be Brokered – (The following information is to be completed as to the financial institution lender)

B1. Provide the name, address, telephone number and email address of the financial institution to which the applicant will be brokering mortgages.

B2. Attach a copy of the financial institution’s Certificate of Good Standing or Certificate of Status from the state of origination.

B3. Provide verification that the financial institution controls, is controlled by or is under common control with the insurer identified in section C2.

Section C – Licensed Insurance Producer (The following information is to be completed as to the insurer for which applicant is an insurance producer)

C1. Provide verification that the applicant is a licensed insurance producer in good standing under §10-103 of the Insurance Article of the Md. Annotated Code.

C2. Provide name, address, email address and telephone number of the insurer for which the applicant is a producer.

C3. Provide verification that the applicant holds an appointment as an insurance producer for the insurer identified in C2.

Section D – Sworn Activity Structure

D1. Has the applicant brokered any Maryland mortgage loans at the business address listed on this application? If yes, state Yes No the number of loan transactions and the total dollar amount $

Rev 11/18/2010 D2. If the applicant has conducted mortgage lending business at any time during the 36 months prior to the filing of this application, complete the Sworn Activity Statement below for any mortgage activity conducted during the 12 months preceding the month this application is filed.

Sworn Activity Statement

Maryland Mortgage Loan Activity Only Mortgage Loan Activity Outside of Maryland

Number Dollar Amount Number Dollar Amount Loans brokered Loans brokered Loans made Loans made Loans serviced Loans serviced Aggregate Maryland Aggregate Maryland mortgage transactions transactions

D2. If applicant has not conducted mortgage lending business at any time during the 36 months prior to the filing of this Section A: All applicantsapplication, must swear complete to that fact this by signing section and dating this statement. Signature: Date:

A1. Check the license category for which you are applying and complete a separate application for each license request. If you have ٱ previously Section filedE – Suretyan original Bond application and License with the Commissioner Fee Structure and are( To applying be completed for a branchby applicant) office license, complete A1 through A8, Section D and Section F only: All Maryland Mortgage Lender licenses issued will expire two (2) years after the issuance date. The fee for the license will be as Original license ڤ follows: Money Transmission - MD. F. I. Code Ann., Title 12, Subtitle 4 ڤ  All applications for licenses require a license fee of $1,000.00.  All initial applicants will also require a nonrefundable $100.00 investigation fee. Limited Liability Company ڤ Unincorporated Association ڤ Corporation ڤ :(A2. Applicant is a(n ڤ Each applicant must file a surety bond. The bond amount varies in accordance with the mortgage lending activity of the applicant. aggregate amount Individual/Sole of loans in the Proprietorship Sworn Activity ڤ Limitedbond of: Liability (1) $50,000.00, Partnership if the ڤ with Partnership the application a surety ڤApplicants must file Statement was $3 million or less; (2) $100,000.00, if the aggregate amount of loans in the Sworn Activity Statement was over $3 A3. Namemillion under but lesswhich than applicant $10 million; will conduct and (3) business: $150,000.00, ______if the aggregate amount of loans in the Sworn Activity Statement was more ڤ than $10 million. An applicant filing five or more applications at the same time may provide a blanket surety bond of $750,000.00 for :(A4. Businessall licensed address offices. where (Please applicant refer towill the conduct Quick-reference business (Thistable businessbelow) address must be the same on bond if required ڤ ______

______:# A5. Tax ID or social security # of applicant: ______Quick Reference Table Telephone – Surety #: ______Bond Fax ڤ A6. Name, telephoneMortgage number Lending and email Business address of principalActivity contact Level for licensing and compliance matters. ______Bond Amount ڤ $3 million or less $50,000.00 ______Over $3 million to $10 million $100,000.00 Over $10 million $150,000.00 ______.A7. Name, telephone number and email address of principal contact for consumer complaints ڤ Five (5) or more applications at once $750,000.00 ______

______.A8. Name, telephone number and email address of the operation/general manager ڤ Section F – Education Requirements ______F1. The applicant has successfully completed during the 2 years immediately preceding the date of the A9. Address where licenserecords pertaining application to atMaryland least 20 transactions hours of classroomwill be maintained: instruction ______in residential mortgage lending ڤ education in approved courses and achieved passing grade on a written exam developed and ______administered by the person that conducts the classroom education course. Yes No Date Stamp ڤ No ڤ A10. Is applicantF2. an Theemployer required required 20 hours to comply of professional with the Maryland education Workers’ includes Compensation at least the Law?following If yes, subjects in Yesthe ڤ Office Use Only A decision Commissioner complete on a completed the following:number application of Policy/Binder hours package ofindicated: Financialwill No. be ______made within sixty Regulation(60) days. To ensure that your License application is complete Yes please No when all items or questions are satisfied. Failure to file a completed application may result in ٱ review each Insurance question Company and use the______check box theApplication denial of your application. Your responses to the questions on this application are continuing in nature. You must promptly notify the Commissioner of any circumstance that would cause your answers to changePage. 3Please note that “You” refers to any person included as partRev 11/18/2010 of this application, including any owners, officers, directors or business Page entity. 1 Please type or print clearly in dark ink.

a) Ethics – 2 hours b) Federal Real Estate Settlement Procedures Act (RESPA) compliance – 2 hours c) Federal Truth in Lending compliance – 2 hours d) Federal Equal Credit Opportunity Act/Fair Lending compliance – 2 hours e) Maryland law update – 2 hours f) Federal law update – 2 hours g) Electives – 8 hours

F3. Submit with your application, the following information for each professional education course completed: i) Name of provider ii) Name of course iii) Number of hours iv) Date(s) attended v) Brief description of course subject(s) vi) Written certification by the course provider that the sole proprietor has achieved a passing grade on a written examination developed and administered by the course provider.

To obtain additional professional educational information, see our website at www.dllr.state.md.us.

*Note: Licensing Requirement Check List (The below listed items must be submitted with your application package. Please check the , if included.)

1. Trade Name Registration (if applicable) 2 Financial Statement . 3 Credit Report (dated within 12 months of application filing date) . 4 Applicable Section A explanations . 5 Application for Criminal History Record Check (Fee and application must be forwarded . to the address indicated on the record check application) 6 Financial Institution’s Certificate of Good Standing . 7 Verification of Financial Institution’s control by/with Insurer identified in Section C . 8 Verification of applicant’s appointment as an insurance producer . 9 Verification of applicant’s good standing as an insurance producer . 1 Verification of required mortgage lending courses 0 . 1 Surety Bond 1 . 1 License fee 2 .

Rev 11/18/2010 Section G (Must be completed by applicant)

THE UNDERSIGNED APPLICANT HEREBY CERTIFIES AND AGREES TO THE FOLLOWING:

 That the information as submitted in the application and supplements hereto is correct, complete and accurate.

 That the Commissioner of Financial Regulation may conduct any investigation in accordance with State law, into the background of the applicant for the purpose of issuing the subject license.

 To promptly submit any information which may be required for consideration of this application.

 To promptly notify the Commissioner of Financial Regulation of any change in the information contained in this application.

 That the undersigned applicant will limit its mortgage lending activities to brokering mortgage loans to the single financial institution identified under section B1 of this application. Affidavit

I, ______, STATE UNDER PENALTY OF PERJURY THAT THE FOREGOING INFORMATION SET FORTH IN THIS APPLICATION, INCLUDING INFORMATION PROVIDED IN THE REQUIRED ATTACHMENTS HERETO, IS TRUE, CORRECT AND COMPLETE.

STATE OF ______(SIGNATURE OF APPLICANT) CITY / COUNTY ______

Personally appeared before me, ______, (Name of applicant) who being duly sworn according to law, deposes and says that the statements contained in this application are true and correct.

Sworn and subscribed before me this ______day of ______, 20 ______.

______NOTARY PUBLIC

Rev 11/18/2010 Section H - Agreement of Financial Institution (Must be completed by the financial institution identified in section B1)

THE UNDERSIGNED FINANCIAL INSTITUTION, BY ITS AUTHORIZED OFFICER, AGREES TO THE FOLLOWING:

 The financial institution will supervise the mortgage activities of the applicant, including providing direction through written instructions or electronic means and by periodically examining the applicant’s books, records, and other aspects of the business; and

 The financial institution is jointly and severally liable with the applicant for claims arising out of the applicant’s mortgage brokering activities.

 The financial institution is in good standing with its primary state or federal regulator.

 The financial institution is in material compliance with applicable state or federal law.

ATTEST ______(PRINT NAME OF FINANCIAL INSTITUTION)

by: ______(SIGNATURE OF AUTHORIZED OFFICER)

______(PRINT NAME AND TITLE)

STATE OF ______

CITY / COUNTY ______

Personally appeared before me, ______, who acknowledges him/herself to be the ______of ______, (Title) (Name of Financial Institution) and that as such, being authorized so to do, executed the foregoing agreement for the purposes therein contained, by signing the name of the financial institution by him/herself as ______. (Title) in witness where of I here unto set my hand and official seal this ______day of ______, 20 _____.

______NOTARY PUBLIC

Rev 11/18/2010 Licensee Surety Bond Surety Bond Number ______

(Check applicable license) Mortgage Lender Consumer/Installment Loan Collection Agency Money Transmission

THE UNDERSIGNED, ______of ______, as PRINCIPAL and ______of ______, as SURETY, are firmly bound unto the State of Maryland in the penal sum of $ ______for payment of which we jointly and severally bind ourselves and our heirs, personal representatives, successors and assigns, this ______day of ______, 20 ____.

WHEREAS, The principal has applied to the Commissioner of Financial Regulation or the Collection Agency Licensing Board of the State of Maryland for the license indicated above, as provided by applicable provisions of the Annotated Code of Maryland (“Md. Code”); and is required to file a surety bond in order to obtain such license.

NOW, THEREFORE, The conditions of the obligation are as follows:

1. The specific bonding characteristics and requirements set forth in the Md. Code and the Code of Maryland Regulations (“COMAR”) for the indicated license shall apply as follows:  Mortgage Lender License– Financial Institutions Article (“FI”), § 11-508, Md. Code. COMAR 09.04.06.15.  Consumer/Installment Loan License– FI, § 11-206(c) MD Code.  Collection Agency License– Business Regulation Article, § 7-304, Md. Code.  Money Transmission License– FI, § 12-412, MD Code.

The provisions of each of these laws and regulations are fully incorporated herein by reference.

2. This bond may be canceled at any time by the Surety, but such cancellation shall be effective 60 days (or, as to Money Transmission Licensees, 90 days) after written notice of such cancellation has been given by the Surety to the Commissioner of Financial Regulation (or the Collection Agency Licensing Board if the Principal is a collection agency licensee) by certified mail.

3. a) As to Mortgage Lender, Consumer/Installment Loan and Collection Agency licensees, any claim under this bond must be made with the Surety within the first to occur of:  One (1) year after the Principal ceases, for any reason, to be licensed; or  One (1) year after the cancellation or expiration of this license. b) As to Money Transmission licensees, any claim under this bond must be made with the Surety within five years after the Principal ceases, for any reason, to be licensed.

Rev 10/2007 Licensee Surety Bond

4. This bond covers any breach of the above stated obligations occurring during the bonding period, prior to the effective date of cancellation or termination of the bond.

5. If the Principal faithfully conforms to and abides by each and every provision of applicable laws and regulations while engaging in the business to which this bond applies; then this obligation is to be void. Otherwise, it shall remain in full force and effect for the period beginning ______, 20____, and continuing until cancelled by the surety in accordance with paragraph 2 herein.

WITNESS: (SIGNATURES OF INDIVIDUAL OR PARTNERSHIP PRINCIPALS)

______(SEAL)

ATTEST: ______Corporate or Limited Liability Company Principal

______By: ______(SEAL) Secretary or Assistant Secretary President, Vice President or Authorized Member

(Affix Seal of Corporation)

ATTEST: ______Surety

______By:______(SEAL) Secretary or Assistant Secretary Authorized Signature

Rev 10/2007 Licensee Surety Bond