Broker Questionnaire

Broker Questionnaire 2.0

(1 of 3)

1. Contact person name*

2. Contact person phone number*

3. Contact person title*

4. Contact person email*

5. What is the official company name as reflected on its license?*

6. NMLS ID number*

7. Corporate office address*

7. Corporate office address

City

State/Province

Zip/Postal

8. Corporate website address *

9. Logo

Maximum file size: 5MB

10. Number of company employees*

11. Number of compliance staff employees*

12. Number of loan originator employees*

13. Estimated number of annual closed loans*

14. Current loan origination software (LOS)*

15. In which states does the company close the majority of its loan transactions?*

16. Any affiliated businesses? *

YesYes

17. Intend to become a lender in the future? *

Yes