Exhibit #2
MAINE MORTGAGE LOAN ORIGINATOR (MLO)
EMPLOYMENT VERFICATION FORM
Name of Applicant for Mortgage Loan Originator (MLO) License________________________
Address of Applicant:________________________________________________________________
Applicant’s NMLS Unique ID Number: ______________
I, ___________________________________ hereby certify, to the best of my
(Name of employer’s certifying officer)
knowledge, information and belief, that: ___________________________________
(Name of Applicant)
- Is a bona fide W-2 employee OR o Is an exclusive agent
(Only select one)
of: _________________________________________________________________________________
(Name of Company or Organization)
and is covered under surety bond number _________________________ (copy attached) on file with the Maine Bureau of Consumer Credit Protection.
Furthermore, I certify that the employer:
- Holds a Maine Supervised Lender or Loan Broker license number: ___________(Enter Maine license number)
- Has a pending application for a Maine supervised lender and or loan broker license.
o Other (explain)
___________________ ____________________ __________________ _____________
Print Name Print Title Signature Date
STATE OF: __________________
COUNTY OF: _____________________, to wit:
Sworn and subscribed before me this _________ day of __________, __________.
____________________________
Notary Public
My commission expires: ______________________
