Lender Contact Information I request approval to participate in the following NCHFA program(s) NC Home Advantage Mortgage™ Mortgage Credit Certificate (MCC) Corporate Name Name Title Email Address Address Street Address City State - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces (Canada, Europe, Africa, or Middle East)Armed Forces AmericasArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederated States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyomingAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNova ScotiaNorthwest TerritoriesNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Zip Phone Fax mortgage_info_1 Number of mortgage origination branches in NC (Only loan officers/offices located in NC are eligible to originate our programs) Number of NC based mortgage origination branches that will participate in originating NCHFA Mortgages If different than number of mortgage origination branches in NC, why are all of your NC mortgage origination branches not planning on originating NCHFA mortgages? Please provide the exact date (month/year) and address of first retail (residential) mortgage origination office to open in North Carolina, under current company name Month/Year Opened Address Company Name Will your staff originate, process, underwrite and close the Loan in the name of your company? Brokers are not eligible. List the company name and NMLS# that will be used to close and fund the loan If different than the Company Name listed above, provide an explanation Please enter in the IDs for the designations that apply to your company *FHA Direct Endorsement Lender ID *VA Automatic Lender ID Freddie Mac or Fannie Mae Seller/Servicer Lender ID USDA Guarantee Program Approved Lender ID *Provide name and email of the primary contacts for HFA programs employed by your company. Underwriter Option 1 Name Email Underwriter Option 2* Name Email Underwriter Option 3 Name Email Mortgage Info 2 Indicate membership in the following FHLB FDIC Is institution state or federally chartered? State Federal What is the net asset worth of your company? (Once your application is received, you will be asked to provide the latest audited financial statement) Has your company participated in NCHFA Home Ownership Programs in the past? Yes No If yes, which programs and when? Has your company ever been suspended or terminated by FHA/VA, USDA, Fannie Mae or Freddie Mac, a private mortgage insurer, or other investors? Yes No If yes, for what reason and when? Are you and all your affiliates currently in compliance with applicable minimum capital requirements imposed by federal banking laws and regulations? Yes No Are you or any affiliate under supervisory control of, or subject to, enforcement proceedings by federal banking regulations with respect to any violations or alleged violations of federal banking laws or regulators? Yes No Do you have any MARI (fraud) reports in the last 5 years? Yes No (If Yes, once your application is received, you will be asked to provide copies) CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
