Illinois Mortgage Bankers Association

* First

* Last

Title

* Company

* Business Address

* City

* State

* Zip

* Phone

* Email

Fax

* Company's Legal Structure

* How long has the company/institution been in business?

* Is company a subsidiary or division of another company?

If yes to the question above, please indicate the company's name/address

* Please indicate the focus of your business:

* Please indicate the appropriate category

Mortgage Banker
Mortgage Broker
Commercial Bank
Commercial Lender
S&L/Savings Bank
Life Insurance Co.
MI Company
Title Insurance Company

* Channels/Products

Please indicate below agency your company/institution is licensed by (if applicable)

* Has your license ever been revoked or suspended? (If yes, please explain in accompanying letter)

* Are you an FHA-approved mortgagee?

If answered yes to the question above, have you ever been suspended by FHA or VA? (If yes, please explain in accompanying letter.)

Yes
No

* Are you a FANNIE MAE / FREDDIE MAC-approved seller/servicer?

* Please list your company's origination volume (Illinois Loans only) $__Million (most recent fiscal year end)

* Please list your company's servicing volume (Illinois Loans Only) $__Million (most recent fiscal year end)

Please list the principal institutional investors you represent (if applicable)

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