Broker Info
Email
*
Confirm Email
*
First Name
*
Last Name
*
Company
*
Phone Number/Toll Free
Phone Number
*
Service Provider
- Select -
AllTel
ATT
Cingular
Cricket
H20
Metro PCS
Boost Mobile
Nextel
Sprint PCS
Straight Talk
T-Mobile
Tracfone
US Cellular
Virgin Mobile
Verizon
Fax
Address
Suite #
City
State
- Select -
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Time Zone
HST (UTC-10)
AKST (UTC-9)
PST (UTC-8)
MST (UTC-7)
CST (UTC-6)
EST (UTC-5)
Zip Code
Broker/Partner Type
- Select -
Principal Mortgage Broker
Licensed Loan Officer
Principal Real Estate Broker
Independent Contractor
Referral Partner
Approved Referral Fee
- Select -
1.00%
0.75%
0.50%
0.25%
License #
EIN#
Preferred Communication
Phone
E-mail
Text
Web Portal
Website
Avatar
(The file types allowed are JPEG,PNG,GIF.)
License Information
Do you have Company NMLS #?
Yes
No
Company NMLS #
Do you have Company State License #?
Yes
No
Company State License #
State
- Select -
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State License #
Do you have Personal NMLS #?
Yes
No
Personal NMLS #
Do you have Personal State License #?
Yes
No
Personal State License #
State
- Select -
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State License #
States Authorized to Originate
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
DRE#
Social Security Number
LinkedIn URL
Type Of Loans Offered
Agency Mortgage
Private Lending
CRE Lending
Business Lending
Years of experience with Agency Mortgage Lending?
0-1 Years
1-2 Years
2-3 Years
3+ Years
of units funded in last 12 months for Agency Mortgage Lending
Loan Volume Funded in last 12 months for Agency Mortgage Lending
Detailed experience & background with Agency Mortgage Lending
Years of experience with Private Lending?
0-1 Years
1-2 Years
2-3 Years
3+ Years
of units funded in last 12 months for Private Lending
Loan Volume Funded in last 12 months for Private Lending
Detailed experience & background with Private Lending
Years of experience with CRE Lending?
0-1 Years
1-2 Years
2-3 Years
3+ Years
of units funded in last 12 months for CRE Lending
Loan Volume Funded in last 12 months CRE Lending
Detailed experience & background with CRE lending
Years of experience with Business Lending?
0-1 Years
1-2 Years
2-3 Years
3+ Years
of units funded in last 12 months for Business Lending
Loan Volume Funded in last 12 months Business Lending
Detailed experience & background with Business Lending
# of employees
States that you broker loans in?
Select All
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Please write a few sentences about your relevant experience and why you want to broker loans with us? (min 25 words)
Logo
(The file types allowed are JPEG, PNG, GIF.)
Primary Contact
Use same contact info as above
Primary contact First Name
Primary contact Last Name
Primary contact Phone
Primary contact Email
Password
*
Confirm Password
*
Upload Applicable Files
W9
Sales Representative Agreement
Driver License
Passport / Green Card
SSN
Terms And Conditions
Terms And Conditions
Lender is in the business of originating, processing, funding, closing, and servicing loans secured by residential real estate. Broker is a mortgage loan broker and desires to submit loans to Lender from time to time for consideration by Lender for funding. Lender and Broker ("Party or Parties") wish to establish a nonexclusive relationship whereby Broker submits loan packages ("Loan" or "Loans") to Lender on behalf of Broker's clients ("Borrower" or "Borrowers") for possible funding. In consideration of the mutual covenants and conditions contained herein and for other good and valuable consideration, the Parties agree as follows: 1. Loan Submission and Approval - Subject to the terms, conditions and limitations contained in this Agreement, Broker agrees to submit, and Lender agrees to review Loans. Broker acknowledges and agrees that the decision to make or not make any Loan is made exclusively by Lender in its sole and absolute discretion. Broker shall not represent that Lender has approved or will approve any Loan until Broker is so informed by Lender in writing. All Loans shall close in Lender's name. Lender is under no obligation to accept any minimum number of percentage of loans, or any loans at all. Lender reserves the right to decline any loan application or credit request that Lender deems, in its sole and absolute discretion, as "predatory" or as not having any reasonable benefit to the Borrower. 2. Status of Broker - Nothing in this Agreement shall be construed as making Broker an agent, employee, representative, joint venture, or partner of Lender. Broker will not hold itself out as such, nor will it use Lender's name in any advertising or solicitation without Lender’s prior written consent. Broker shall be deemed to be acting as an independent contractor, agent, and representative of the loan applicant, and not that of the Lender. During the term of this Agreement, Broker is responsible for, and shall pay in full, all costs and expenses directly or indirectly incurred by Broker in performing under this Agreement. Broker will not in any way represent or imply to any Borrower that Broker is in any way affiliated with or connected to Lender, including any representation that Broker’s office is an office or branch of Lender, or that Broker has any power or authority to bind Lender in any manner whatsoever. No statement or representation of Broker shall be published by an authorized employee of Lender. 3. Compensation to Broker - No fee shall be owed to Broker on any proposed loan that is not funded and closed. Broker waives and relinquishes any and all claims against Lender for professional services rendered by the Broker to the Borrower. Broker agrees that such compensation shall represent the market value for actual, non-duplicative services, including, but not limited to, interviewing and counseling the Borrower, as well as procuring and submitting to Lender the loan application, credit reports, property appraisal, and other information required to close the loan. It is agreed and understood that Lender is relying on the accuracy of the information submitted by Broker and contained in the Loan Estimate. Should Lender determine the information used to populate the Loan Estimate is not correct, or was not submitted in good faith, per RESPA guidelines, Lender reserves the right to not accept any and all files submitted incorrectly or that are otherwise not in compliance with applicable laws and regulations.
By checking this box I agree to the terms and conditions.
*