This document is limited to current Hometown Equity Mortgage, LLC, DBA theLender and practice and should not be construed as legal advice, legal opinion, or
any other advice on specific facts or circumstances. Such policy and practice is subject to change. The recipient should contact its legal counsel for legal advice. For
business and professional use only. Not for consumer distribution. All loans subject to approval and not all products are available in every state. Certain conditions
and fees apply. Hometown Equity Mortgage, LLC, DBA theLender NMLS #133519. Equal Housing Opportunity – All Rights Reserved. 01.2021 Revised 01.2022
BUSINESS PURPOSE
BROKER PACKAGE
COMMERCIAL/BUSINESS PURPOSE MORTGAGE BROKER
Account Executive: ______________________________________________________________
Welcome to theLenders Commercial/Business Purpose Property Mortgage Broker application process,
also known as the “theStart” Program! Upon meeting our reasonable approval standards, theLender will
provide your organization with log-ins and system access so that you can start to deliver commercial and
business purpose property loans to us once approved!
Please provide each of the following documents:
1) Completed and signed Commercial/Business Purpose Property Mortgage Broker Application
2) Executed Commercial/Business Purpose Property Mortgage Broker Agreement
3) Completed W-9 Form*
4) Signed theLender Zero Tolerance Fraud Certification*
5) E&O Insurance, if applicable or required by state*
6) Signed Certifications and Authorization Form, which includes:
• Broker Origination Compensation Agreement Certification
• Background Check Certification
• AML/BSA Policy Certification
• Loan Fraud Zero Tolerance Policy Certification
• Broker Aliation Disclosure with Authorization
7) Corporate Resolution or Principal/Partner Authorization evidencing signature authority*
8) Articles of Incorporation, or other legal documents detailing ownership as applicable*
9) Completed Broker Contact List with names, numbers and e-mail addresses*
10) Completed Business Purpose Loan Sign Up form
*Do not need to provide if already approved for Consumer Loans
- 1 -
This document is limited to current Hometown Equity Mortgage, LLC, DBA theLender and practice and should not be construed as legal advice, legal opinion, or
any other advice on specific facts or circumstances. Such policy and practice is subject to change. The recipient should contact its legal counsel for legal advice. For
business and professional use only. Not for consumer distribution. All loans subject to approval and not all products are available in every state. Certain conditions and
fees apply. Hometown Equity Mortgage, LLC, DBA theLender NMLS #133519. Equal Housing Opportunity – All Rights Reserved. 01.2021
theAPPLICATION
FOR BUSINESS PURPOSE LOANS
COMMERCIAL/BUSINESS PURPOSE MORTGAGE BROKER
Account Executive: ______________________________________________________________
Business Channel: Commercial/Business Purpose Property Mortgage Loans
Company Information
Company Owners and Principals
- 2 -
Broker Corporate Entity Name: ____________________________________________________________
DBA Names (if applicable): _______________________________________________________________
State of Incorporation: _____________________ Date of Incorporation: _________________________
List of State Licenses Held (include) Licensing Numbers: _______________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Address of Main Oce: __________________________________________________________________
List of Branch Oces and Locations: _______________________________________________________
________________________________________________________
________________________________________________________
________________________________________________________
________________________________________________________
Volume Year Units Dollar Amount
Current Year: _______________ ________________ ______________________
Prior Year: _______________ ________________ ______________________
Name Title % of Ownership Email Phone
____________________ ______________ ________ ___________________ __________________
____________________ ______________ ________ ___________________ __________________
____________________ ______________ ________ ___________________ __________________
____________________ ______________ ________ ___________________ __________________
____________________ ______________ ________ ___________________ __________________
This document is limited to current Hometown Equity Mortgage, LLC, DBA theLender and practice and should not be construed as legal advice, legal opinion, or
any other advice on specific facts or circumstances. Such policy and practice is subject to change. The recipient should contact its legal counsel for legal advice. For
business and professional use only. Not for consumer distribution. All loans subject to approval and not all products are available in every state. Certain conditions and
fees apply. Hometown Equity Mortgage, LLC, DBA theLender NMLS #133519. Equal Housing Opportunity – All Rights Reserved. 01.2021
Key Contacts
Certifications
- 3 -
Name Title Email Phone Number
____________________ __________________ ________________________ ___________________
____________________ __________________ ________________________ ___________________
____________________ __________________ ________________________ ___________________
____________________ __________________ ________________________ ___________________
Has your company, or any of its Owners or Principals, been named as defendant in a lawsuit,
or been involved in any litigation during the past ten (10) years?
Has any Owner or Principal with your company ever been convicted of a crime?
Has your company, or any of its Owners or Principals, ever filed for protection from creditors
under any provision of United States Bankruptcy laws within the past ten (10) years?
Has your company, or any of its Owners, Principals or Loan Ocers, ever had a company or
individual mortgage lender/banker, mortgage broker, real estate or other professional license
suspended, revoked or received any other disciplinary action from a federal or state
regulatory agency?
Does your company have hiring policies and procedures that include a check for all
employees, including management, who are involved in the origination of mortgage loans
against the U.S. General Services Administration (GSA) excluded Parties List, the HUD
Limited Denial of Participation List (LDP List), and the Federal Housing Finance Agency
(FHFA) Suspended Counterparty Program (SCP) List?
Has your company, or any of its Owners, Principals or Loan Ocers (i) had any formal
complaints filed against them by a federal or state mortgage banking/broker regulatory
authority; (ii) been found in violation of any mortgage banking/broker federal or state
regulatory authority’s statutes or regulations; or (iii) had an order entered against them by a
federal or state mortgage banking/broker regulatory authority?
Has your company ever had unfavorable findings with regard to mortgage operations
included in any audit, examination or report by FHA, VA, Fannie Mae, Freddie Mac or any
regulatory, supervisory or investigative agency?
Have you been required to repurchase a loan(s) from a lender during the last twenty-four
(24) months??
1.
2.
3.
4.
5.
6.
7.
8.
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
theAPPLICATION
FOR BUSINESS PURPOSE LOANS
This document is limited to current Hometown Equity Mortgage, LLC, DBA theLender and practice and should not be construed as legal advice, legal opinion, or
any other advice on specific facts or circumstances. Such policy and practice is subject to change. The recipient should contact its legal counsel for legal advice. For
business and professional use only. Not for consumer distribution. All loans subject to approval and not all products are available in every state. Certain conditions and
fees apply. Hometown Equity Mortgage, LLC, DBA theLender NMLS #133519. Equal Housing Opportunity – All Rights Reserved. 01.2021
BUSINESS PURPOSE BROKER AGREEMENT
This BUSINESS PURPOSE BROKER AGREEMENT (the “Agreement”) is entered into as of this ______
day of __________, 20___ (the “Effective Date”), by and between Hometown Equity Mortgage, LLC dba
theLender, a Missouri limited liability company with an address at 25531 Commercentre Drive, Suite 25
0,
Lake Forest, CA 92630 ( “Company” ) and ______________________________, a __________________ ,
with an address at ________________________________________________ (“Broker”).
WHEREAS, Broker is in the business of marketing, soliciting, and processing business purpose, and com-
mercial purpose mortgage loans;
WHEREAS, Company is in the business of funding business purpose, and commercial purpose mortgage
loans;
WHEREAS, Company desires to partner with Broker to receive applications and loan documents from
Broker for the purpose of funding such loans for borrowers who qualify for one or more loan programs
oered by Company;
NOW THEREFORE, in consideration of the mutual promises contained herein, and other good and su-
cient consideration, the receipt and adequacy of which is hereby acknowledged, the parties hereto agree
as follows:
1. DUTIES OF BROKER
- 4 -
theAGREEMENT
FOR BUSINESS PURPOSE LOANS
Broker will solicit complete loan applications (the “Application”) from potential borrowers (each, an
Applicant”) from prospective Applicants for applicable business purpose and commercial
purpose loan programs (the “Programs”). Each Application shall be (i) executed by each Applicant,
(ii) signed by an authorized representative of Broker, and (iii) submitted by Broker to Company.
Broker will communicate to potential Applicants information about the available Programs oered
by Company, including the Programs’ terms and conditions.
Broker will submit Applications for Programs limited to loans that are (i) secured by real property
that is of a commercial and business purpose nature, and which is not at any point in time a
residence of a borrower who is, either directly or indirectly, obligated for such loan, or the family of
such borrower, (ii) an “exempt transaction”, as intended and described in 12 CFR 1026.3(a), Reg, Z
226.3(a), and related appendices and ocial sta interpretations, (iii) not considered a consumer
or consumer purpose (e.g., personal, family or household) loan under Applicable Law (as defined
below), (iv) complies with the Program requirements; (v) funded by Company, and (vi) Originated
(as defined below) by Broker (the “Loans”).
i.
ii.
A.
B.
C.
The term “Applicable Laws” means all federal, state and local laws, regulations, opinions,
guidelines, and sta interpretations (including but not limited to the SAFE Act, the
Federal Fair Housing Act, RESPA, the Truth in Lending Act, Regulation Z, the Equal
Credit Opportunity Act, including, but not limited to, applicable notices of adverse
action pursuant to Regulation B, the Consumer Credit Protection Act, the Flood Disaster
Protection Act, the Depository Institution Deregulation Monetary Act, the Financial
Institutions Reform Recovery and Enforcement Act, and the Federal Credit Union Act,
all as amended from time to time), along with standard industry practice, that pertain to
loan brokering, lending and servicing in the states or jurisdictions where the real
property proposed on the Application to secure the Loan (the “Subject Property”) may
be located.
The term “Originated” means a representative of Broker signed an Application for the
Loan.
This document is limited to current Hometown Equity Mortgage, LLC, DBA theLender and practice and should not be construed as legal advice, legal opinion, or
any other advice on specific facts or circumstances. Such policy and practice is subject to change. The recipient should contact its legal counsel for legal advice. For
business and professional use only. Not for consumer distribution. All loans subject to approval and not all products are available in every state. Certain conditions and
fees apply. Hometown Equity Mortgage, LLC, DBA theLender NMLS #133519. Equal Housing Opportunity – All Rights Reserved. 01.2021
- 5 -
theAGREEMENT
FOR BUSINESS PURPOSE LOANS
Broker shall not solicit or submit to Company Applications for loans that do not meet the definition
of “Loan” above (loans other than those that fall under the “Loans” definition are herein referred to
as “Consumer Purpose Loans”).
Broker shall, at all times with respect to the Application and the Loan, comply with all Applicable
Laws and act in good faith and fair dealing with the Applicants.
Broker will submit Applications to Company through Company’s online portal and will obtain an
acknowledgement of such submission through the portal.
Broker will, in accordance with the Programs and Applicable Law, including but not limited to ability
to repay standards, obtain documentation and information regarding Applicant’s creditworthiness,
and will submit such documentation and information to Company through the online portal.
As applicable, Broker will communicate Applicants’ desire to lock-in an interest rate to Company,
and Broker will deliver Interest Rate Lock Agreements issued by Company to Applicants.
Broker will keep Applicants apprised of the status of their Applications at all times.
Broker will, at the request of Company, obtain additional information or take additional actions to
facilitate the underwriting of an Application and the closing of the Loan.
Broker will not solicit an Applicant obligated on a Loan to refinance such Loan during the six (6)
month period following the date that Company (or a settlement agent working on behalf of
Company) disbursed the proceeds of such Loan (the “Funding Date”).
Broker shall be exclusively responsible for all of its own costs and expenses in connection with
Broker’s business and its handling of Applications including but not limited to payments due its
mortgage loan originators.
2. DUTIES OF COMPANY
Company may, from time-to-time, authorize Broker to accept Applications that conform to the
underwriting and other Program requirements of one or more Programs oered by Company,
provided that Company may, at its sole discretion, change or discontinue any Program, or withdraw
Broker’s authority to accept Applications for one or more Programs, and further provided that
Broker shall never be deemed to have been authorized to solicit or accept a Consumer Purpose
Loan.
Company will notify Broker of Company’s interest rates for available Programs, provided that
Company may change one or more of its interest rates at any time without prior notice by
posting such change on its website, or by e-mailing such change to Broker, or by communicating
such change to Broker by another reasonable method as selected by Company.
With respect to a specific Application, Company will issue a written communication from Company
to one or more Applicants, setting forth the interest rate and various other terms and conditions
under which Company will fund the Loan (the “Interest Rate Lock Agreement”) only if Company
determines that a request for an Interest Rate Lock Agreement was underwritten and made in
accordance with Company’s policies, procedures, guidelines, and Program requirements.
Company may, at its sole discretion, obtain appraisals from an appraisal management company
approved by Company, as well as inspections, environmental reports and engineering reports.
D.
E.
F.
G.
H.
I.
J.
K.
L.
A.
B.
C.
D.
This document is limited to current Hometown Equity Mortgage, LLC, DBA theLender and practice and should not be construed as legal advice, legal opinion, or
any other advice on specific facts or circumstances. Such policy and practice is subject to change. The recipient should contact its legal counsel for legal advice. For
business and professional use only. Not for consumer distribution. All loans subject to approval and not all products are available in every state. Certain conditions and
fees apply. Hometown Equity Mortgage, LLC, DBA theLender NMLS #133519. Equal Housing Opportunity – All Rights Reserved. 01.2021
- 6 -
theAGREEMENT
FOR BUSINESS PURPOSE LOANS
Company will underwrite Applications submitted to Company by Broker, at such time as
Company receives such documentation and information as Company requires to perform an
underwriting review.
Upon underwriting an Application, Company will provide a written notice (the “Approval Notice”) to
Broker to provide to the Applicant if the Application is approved, or otherwise will provide a written
declination or suspension notice (“the Adverse Action Notice”); Approval Notices may include (i)
conditions and stipulations that must be satisfied prior to the loan proposed by the Application (the
“Proposed Loan”) being settled, and (ii) additional conditions and stipulations that must be
satisfied prior to the Loan being funded. Broker will promptly and timely provide the Approval
Notice or Adverse Action Notice to the Applicant.
Once the Applicants have accepted an Approval Notice for such Loan, and provided that Company
has determined that required pre-closing conditions and stipulations have been satisfied;
Company will (i) prepare a note, security instrument and other loan documents for execution by the
loan applicants, and as applicable by guarantors and non-borrower co- signors, and (ii) arrange for
the closing of the Loan.
Following closing of the Loan in a manner satisfactory to Company, and provided Company
determines that all remaining, required conditions and stipulations have been satisfied, Company
will fund the Proposed Loan.
Company shall be under no obligation to approve any minimum number or percentage of Applica-
tions, or any Applications at all.
3. BROKER COMPENSATION
Upon the funding of a Loan that was Originated by Broker, Company will pay Broker an amount
equal to the amount set forth in the Broker Originator Compensation Certification (the “Broker
Compensation”).
Where and as allowed under Applicable Law, if the Applicants associated with a Loan have
authorized that fees and points due Broker be deducted from Loan proceeds, then Company will
deduct such fees and points as have been agreed by such Applicants from Loan proceeds and remit
same to Broker.
Broker may NOT be compensated by both Company and the Applicants in the same transaction,
unless Applicant receives a disclosure clearly stating that compensation will be paid to Broker by
both Company and the Applicant and such payment is allowed by Applicable Law.
Broker will not steer an Applicant into a Loan or Program that will benefit the Applicant less than
other loans or programs. Further, broker will not incentivize any of its employees to steer an
Applicant into a Loan or Program that will benefit the Applicant less than other loans or programs.
4. REPRESENTATIONS AND WARRANTIES OF THE BROKER
Broker is duly organized and in good standing in the state of its formation, and qualified to conduct
business in each state where a Subject Property is situated.
E.
F.
G.
H.
I.
A.
B.
C.
D.
A.
Broker represents and warrants that as of the date of this Agreement, and as of each date on which
Broker submits an Application to Company, and as of the Funding Date of any Loan, all of the following
are true and active:
This document is limited to current Hometown Equity Mortgage, LLC, DBA theLender and practice and should not be construed as legal advice, legal opinion, or
any other advice on specific facts or circumstances. Such policy and practice is subject to change. The recipient should contact its legal counsel for legal advice. For
business and professional use only. Not for consumer distribution. All loans subject to approval and not all products are available in every state. Certain conditions and
fees apply. Hometown Equity Mortgage, LLC, DBA theLender NMLS #133519. Equal Housing Opportunity – All Rights Reserved. 01.2021
- 7 -
theAGREEMENT
FOR BUSINESS PURPOSE LOANS
Broker, its employees, and all other persons required to be licensed under Applicable Law hold
the requisite licenses to accept and process each Application; and Broker will notify Company if a
license issued to Broker is revoked or a licensing authority determines not to renew a license issued
to Broker.
Broker will not discuss any Program with prospective Applicants or solicit or accept Applications
for any program, unless the program is a Program oered by Company and for which Company has
expressly authorized Broker to utilize.
Upon Company’s funding of a Loan, such Loan will be solely the property of Company, and Broker
waives all claims of interest or ownership in such Loan, including the servicing of such Loan.
Broker has the requisite corporate authority, power and capacity to enter into this Agreement, and
Broker’s compliance with the terms and conditions of this Agreement will not violate the terms of
any governing organizational instrument of Broker or any other instrument or agreement to which
Broker is a party.
No Loan is subject to any right of rescission, set-o, counterclaim or defense, and none of the terms
of any Loan and none of the rights thereunder are unenforceable, in whole or in part, on account
of any action by Broker, and no such right or rescission, set-o, counterclaim or defense has been
asserted by any borrower obligated on a Loan orby any third party.
No instance of fraud, misrepresentation or material omission occurred, exists, or was committed
with respect to any Loan or Application.
Each Application submitted by Broker to Company is for a business, and/or commercial purpose,
and no Applicant or family relationship thereof will live in the Subject Property. None of the
Applications are for Consumer Purpose Loans.
All Applicable Laws, along with related rules and regulations, applicable to the Loans and this
Agreement have been strictly complied with, including but not limited to the the Flood Disaster
Protection Act, Truth-in-Lending Act (as to verifying that the loan is not a Consumer Purpose Loan),
Equal Credit Opportunity Act, Anti-Money Laundering and all applicable statutes or regulations
governing fraud, lack of consideration, unconscionability, consumer credit transactions, predatory
and abusive lending, interest charges, and disclosure requirements.
In connection with Brokers activities in general, and at the time of each Loan submission, Broker
has in place an eective written quality control plan/procedures, a specific process for resolving
quality control discrepancies, and a method for tracking any and all corrective actions taken.
Without limiting any other provision of this Agreement, Broker shall not discriminate with respect to
any Application and related Loan in violation of Applicable Laws. Broker acknowledges that Com-
pany: (i) has implemented a fair lending policy; and (ii) will monitor Applications for fair lending
performance in conformity with its internal fair lending policy and with applicable laws and reserves
the right to terminate this Agreement for Broker’s failure to comply with any and all fair lending laws
and regulations or Company’s fair lending policies.
All fees charged to borrowers are appropriate and reasonably related to the value of the services
rendered and comply with all Applicable Laws.
Broker shall provide each borrower with any and all disclosures it is required to provide pursuant to
all Applicable Laws including, but not limited to, a Good Faith Estimate of charges the borrower is
likely to incur in connection with the Loan settlement as required pursuant to RESPA and applicable
regulations thereunder. Each such Good Faith Estimate shall be in form and substance acceptable to
Company.
B.
C.
D.
E.
F.
G.
H.
I.
J.
K.
L.
M.
This document is limited to current Hometown Equity Mortgage, LLC, DBA theLender and practice and should not be construed as legal advice, legal opinion, or
any other advice on specific facts or circumstances. Such policy and practice is subject to change. The recipient should contact its legal counsel for legal advice. For
business and professional use only. Not for consumer distribution. All loans subject to approval and not all products are available in every state. Certain conditions and
fees apply. Hometown Equity Mortgage, LLC, DBA theLender NMLS #133519. Equal Housing Opportunity – All Rights Reserved. 01.2021
- 8 -
theAGREEMENT
FOR BUSINESS PURPOSE LOANS
Broker shall conduct its aairs in connection with the Loans so as to avoid any ethical improprieties
or conflicts of interest. Without limitation, Broker shall not have any direct or indirect ownership
interest in any collateral for the Loan or any business or personal aliation with, or ownership
interest in, any third party vendors providing services with respect to the Loan... Broker shall
disclose in writing upon Loan submission to Company any and all personal or monetary involvement
in the transactions associated with or relating to the Loan.
All information submitted by Broker to Company in connection with the Loan Application,
including all written materials and financial statements, is true, correct and complete.
Broker and/or Applicants for Loans submitted to Company by Broker, will, upon a request from
Company, execute such documents and writings as are necessary to make the Loan saleable in the
secondary mortgage market or eligible for securitization.
Broker has no knowledge with respect to any Loan, the Applicants for the Loan, or the Subject
Property, that can reasonably be expected to cause an institutional secondary mortgage market
investor to regard the purchase of the Loan as an unacceptable investment, cause any Loan to
become delinquent, or adversely aect the value or marketability of any such Loan.
All services provided, products sold and/or licensed, forms utilized, and/or compensation paid pur-
suant to this Agreement are (and will remain throughout the term of this Agreement) in compliance
with Applicable Laws and this Agreement.
5. REPRESENTATIONS AND WARRANTIES OF COMPANY
Company is duly organized and in good standing in the state of its formation and is authorized to
conduct business in each state where it conducts business and oers Programs.
Company has the requisite corporate authority, power and capacity to enter into this Agreement,
and Company’s compliance with the terms and conditions of this Agreement will not violate the
terms of any governing organization instrument of Company or any other instrument or agreement
to which Company is a party.
6. COMPLIANCE MONITORING
Broker agrees that Company may monitor Broker’s compliance with licensing laws and Broker’s
creditworthiness, including by subscribing to license compliance services and obtaining reports
regarding Brokers credit.
Broker agrees that Company reserves the right to conduct a complete quality control audit on one
or more Loans and Applications and may re-verify any documentation or information provided to
support the creditworthiness of any Loan or Application, including but not limited to documentation
and information regarding creditworthiness and appraised value. Company may, at its option,
perform inspections of the Subject Property securing a Loan or of the Subject Property for an
Application.
Broker shall maintain in its possession or control for Company’s inspection on demand evidence of
such compliance with respect to every Loan submitted to Company by Broker. Company, and any
supervisory agents or examiners representing a state or federal governmental agency having
jurisdictions over Company, shall have the right, at any time and after reasonable notice to Broker
and without charge, to: (i) examine and audit Broker’s books of account, records, reports,
compensation plans, payroll records, policies and procedures, systems, and other documentation in
any form in connect with any Loan; (ii) make copies and extracts thereof; and (iii) discuss the aairs
N.
O.
P.
Q.
R.
A.
B.
A.
B.
C.
Company represents and warrants each of the following:
This document is limited to current Hometown Equity Mortgage, LLC, DBA theLender and practice and should not be construed as legal advice, legal opinion, or
any other advice on specific facts or circumstances. Such policy and practice is subject to change. The recipient should contact its legal counsel for legal advice. For
business and professional use only. Not for consumer distribution. All loans subject to approval and not all products are available in every state. Certain conditions and
fees apply. Hometown Equity Mortgage, LLC, DBA theLender NMLS #133519. Equal Housing Opportunity – All Rights Reserved. 01.2021
- 9 -
theAGREEMENT
FOR BUSINESS PURPOSE LOANS
and accounts of Broker relating to such compliance with Broker’s ocers and employees, at such
times and places and with such frequency as Company may reasonably requests.
No later than ninety (90) days after the end of Broker’s fiscal year, Broker shall deliver to
Company Broker’s annual financial statements, which will be prepared in accordance with general
accepted accounting principles, and either be audited by a certified public accountant, or which
will be executed by the Broker’s President, Controller, Managing Member, General Partner or Sole
Proprietor, and which will include both a balance sheet and an income statement for the fiscal year
most recently ended. Upon Company’s request, Broker shall provide additional information about its
financial condition to Company in accordance with a request therefor from Company. Upon
Company’s request, Broker shall deliver to Company evidence that Broker is insured under an errors
and omissions policy which names Company as an additional insured.
Broker agrees to comply with applicable Programs and guidelines of Company. Company may
change its Programs and guidelines from time-to-time without prior notice to Broker, and Company
may inform Broker of changes to its policies and procedures in any reasonable fashion, including a
posting on Company’s website, or a communication delivered to Broker by e-mail.
In the event any Loan funded by theLender hereunder is paid in full within 220 calendar days of
the date such Loan was funded by theLender, the Broker shall, within 30 days after notice from
theLender, pay theLender (a) an administrative fee plus the amount demanded by theLender, in-
cluding all costs and expenses reasonably incurred by theLender, (b) the greater of (i) the equiv-
alent of all monies received by Broker from Lender with regard to such loans as well as all monies
that Broker received at the direction of borrower which borrower received from Lender in the form
of credits or such fees as paid by Borrower to Broker as borrower-paid-compensation with regard to
such loans or (ii) an amount equal to 100 basis points (1%) multiplied by the original Loan amount.
No portion of any sums paid by Broker to Lender pursuant to the EPO may be charged back to the
borrower by Broker.
7. BROKER INDEMNITY AND REPURCHASE OBLIGATIONS
To the extent permitted by law, Broker hereby indemnifies and holds harmless Company and its
past, present and future directors, ocers, shareholders, employees, attorneys, agents, representa-
tives, subsidiaries, aliates and assigns, and holds them harmless from and against, any claims,
losses, damages, demands, costs or other liabilities, including reasonable attorneys’ fees and the
costs of investigation, arising out of any of the following:
Broker immediately shall notify Company if a claim is made by a third party with respect to this
Agreement, Applications, or Loans, and Broker shall assume the defense of any such claim for which
Broker is required to indemnify Company and pay all expenses in connection therewith, including
counsel fees, and promptly pay, discharge and satisfy any judgment or decree which may be
entered against it or the Company in respect of such claim. Company may elect, in its sole
D.
E.
F.
A.
B.
Broker’s breach or failure to perform any of Broker’s covenants, representations, warranties,
agreements, duties and/or obligations arising under this Agreement;
Any third party claims, including third party repurchase claims related to actions or inactions of
Broker;
Any acts, omissions or services provided by Broker, its agents, employees, representatives, attor-
neys, ocers, directors, or partners;
Any claim by a borrower or Applicant resulting from Company’s failure or refusal to fund a loan,
or
Any claim by any third party that Broker is a joint venture, partner, representative, employee or
agent of or otherwise is aliated with Company.
i.
ii.
iii.
iV.
V.
This document is limited to current Hometown Equity Mortgage, LLC, DBA theLender and practice and should not be construed as legal advice, legal opinion, or
any other advice on specific facts or circumstances. Such policy and practice is subject to change. The recipient should contact its legal counsel for legal advice. For
business and professional use only. Not for consumer distribution. All loans subject to approval and not all products are available in every state. Certain conditions and
fees apply. Hometown Equity Mortgage, LLC, DBA theLender NMLS #133519. Equal Housing Opportunity – All Rights Reserved. 01.2021
- 10 -
theAGREEMENT
FOR BUSINESS PURPOSE LOANS
discretion, to assume the defense of any such claim, and Broker shall pay all reasonable
out-of- pocket expenses in connection therewith, including counsel fees and promptly pay,
discharge and satisfy any judgment or decree which may be entered against it or Company.
This indemnification and hold harmless provision shall survive the termination of this Agreement.
If a Loan is a Purchase Remedy Mortgage Loan, then Company shall provide notice to Broker that
Broker must repurchase such Loan, and Broker will purchase such Loan from Company. In such
event, the purchase price that Broker will pay to Company will be the sum of (i) the unpaid principal
owed on the Loan, plus (ii) accrued interest owing on the Loan, plus (iii) all lender paid compen-
sation, if any, paid to Broker by Company with regard to the Loan as well as all monies that Broker
received at the direction of borrower which borrower received from Lender in the form of credits or
such fees as paid by Borrower to Broker as borrower-paid-compensation with regard to such loans,
plus (iv) a repurchase fee plus (v) Company’s costs for collecting and securing the Loan including
foreclosure costs, attorney fees, property preservation fees and advances for real estate taxes, insur-
ance and other property expenses, plus (vi) any penalties or other amounts other than those listed
above paid to third parties with respect to the repurchase.
Company is hereby authorized, at any time and without presentment, demand, protest or other no-
tice of any kind to Broker or to any other person, any such notice being expressly waived, to set o
from any amounts due Broker from Company, any and all amounts due Company from Broker. This
remedy is in addition to any other remedy Company may have at law or equity.
“Purchase Remedy Mortgage Loan” means a Loan that (i) at the sole discretion of Company, after
its consideration of relevant facts and circumstances, is the subject of a fraud, misrepresentation or
material omission, (ii) a Loan with regard to which, Broker or any of its employees are not properly
licensed if and as required under Applicable Law, (iii) a Loan that a third party requested
Company repurchase and/or (iv) a Loan for which one (1) or more of the first six (6) payments due
is paid more than thirty (30) days after the date on which such payment was due.
8. NOTICES
C.
D.
E.
F.
All notices given pursuant to this Agreement will be given in writing and will be deemed given to a
party hereto when either (i) personally delivered at such party’s Notice Address (as defined below), (ii)
addressed to a party’s Notice Address and deposited into the US Mail, using certified mail with return
receipt service, with postage prepaid; or (iii) addressed to such party’s Notice Address and given, for
overnight delivery service, to a nationally recognized overnight delivery carrier, provided the carrier,
upon making a delivery provides proof of delivery, and further provided that charges due the carrier are
either prepaid or put on account in a method that is satisfactory to the carrier, so that the carrier makes
or attempts overnight delivery in its customary manner without delay for lack of payment.
The address for each of the parties to provide notice to the other party (for each, the “Notice Address”)
is as follows:
Company:
Hometown Equity Mortgage, LLC dba theLender
Attn: Chief Compliance Ocer
25531 Commercentre Drive, Suite 250 Lake Forest, CA 92630
Broker:
__________________________________________________
__________________________________________________
__________________________________________________
This document is limited to current Hometown Equity Mortgage, LLC, DBA theLender and practice and should not be construed as legal advice, legal opinion, or
any other advice on specific facts or circumstances. Such policy and practice is subject to change. The recipient should contact its legal counsel for legal advice. For
business and professional use only. Not for consumer distribution. All loans subject to approval and not all products are available in every state. Certain conditions and
fees apply. Hometown Equity Mortgage, LLC, DBA theLender NMLS #133519. Equal Housing Opportunity – All Rights Reserved. 01.2021
- 11 -
theAGREEMENT
FOR BUSINESS PURPOSE LOANS
9. TERM AND TERMINATION
This Agreement shall be eective as of the above-referenced date and shall continue until
terminated by either party hereto. Either party hereto may terminate this Agreement at any time by
giving written notice to the other party hereto at the Notice Address. If Company terminates this
Agreement, such termination will be eective immediately, except with regard to Applications for
which Company has issued an Interest Rate Lock Agreement. For each Application for which
Company has issued an Interest Rate Lock Agreement, this Agreement shall continue, until the
earlier of the Application (i) resulting in a funded Loan, (ii) Application being declined, or (iii) the
expiration of the Interest Rate Lock Agreement for the Application.
Notwithstanding the foregoing, if Company terminates this Agreement due to a breach by Broker
of its obligations or promises hereunder or of a representation or warranty given herein, Company
may, at its discretion, terminate this Agreement immediately upon giving notice of such termination
to Broker.
With regard to any Loan or Application; Brokers covenants, representations, warranties,
agreements, duties and obligations set forth in this Agreement shall survive the termination of this
Agreement. In addition, Brokers indemnification set forth in Section 7 hereof shall survive the
termination of this Agreement.
10. CONFIDENTIALITY, PRIVACY AND SECURITY
Broker acknowledges and agrees that confidential data and non-public personal information
relating to Applicants, as well as Company’s marketing, strategies, business operations, and business
systems (collectively, the “Confidential Information”) may come into Broker’s possession in
connection with this Agreement. Broker understands that Company is a is subject to a number of
federal and state laws regarding the privacy.
Broker shall maintain the confidentiality of and protect Company’s Confidential Information in
accordance with all relevant state and federal laws, regulations, rules and guidelines, including, but
not limited to, the California Financial Information Privacy Act, the Gramm-Leach-Bliley Act of 1999,
the Fair Credit Reporting Act, all applicable regulations related thereto, and the requirements
imposed upon “service providers” (which shall include, without limitation, Brokers ocers, agents,
successors, and assigns) pursuant to Applicable Laws. Broker, on behalf of itself and its ocers, em-
ployees, agents, successors and assigns, understands and agrees to implement, utilize, and maintain
best industry practices to secure and protect Confidential Information from unauthorized access,
destruction, use, modification, or disclosure, and agrees that it will not retain copies of any such
information and that it will not use or disclose such Confidential Information to its commercial
advantage or in any other manner except in the performance of this Agreement. In addition, Broker
agrees that it will structure all practices, procedures, communications, and transactions involving the
sharing and/or dissemination of information other than Transaction Information and Experience In-
formation (as these terms are defined in the Fair Credit Reporting Act and all applicable regulations
and interpretations applicable thereto) between Broker and Company such that Company will not
be considered to be a “Consumer Reporting Agency” for purposes of the Fair Credit Reporting Act.
A.
B.
C.
A.
B.
This document is limited to current Hometown Equity Mortgage, LLC, DBA theLender and practice and should not be construed as legal advice, legal opinion, or
any other advice on specific facts or circumstances. Such policy and practice is subject to change. The recipient should contact its legal counsel for legal advice. For
business and professional use only. Not for consumer distribution. All loans subject to approval and not all products are available in every state. Certain conditions and
fees apply. Hometown Equity Mortgage, LLC, DBA theLender NMLS #133519. Equal Housing Opportunity – All Rights Reserved. 01.2021
- 12 -
theAGREEMENT
FOR BUSINESS PURPOSE LOANS
If Broker is requested or required (by oral questions, interrogatories, requests for information or
documents, subpoena or other judicial, governmental or administrative process) to disclose any
Confidential Information, Broker will provide Company with prompt written notice thereof so that
Company may seek an appropriate protective order or waive, in such instance, compliance with the
applicable provisions of this Agreement. If, failing the entry of a protective order or the receipt of a
waiver hereunder, Broker, in the opinion of its counsel, is compelled to disclose Confidential
Information, Broker may disclose that portion of the Confidential Information which its counsel
advises it in writing that it is compelled to disclose. Broker expressly consents to the entry of a
protective order with regard to this nondisclosure agreement, it being understood that mere money
damages would be insucient in the event of a breach of this Section.
Broker shall have an internal written security program in place at all times that shall reflect and
require compliance with Brokers obligations pursuant to this Section. The security program shall
comply with Applicable Laws and meet or exceed industry standards.
For electronic communications, Company and Broker will only transmit Confidential Information to
each other in an encrypted format. Broker will store all Confidential Information in a manner which
utilizes the highest level of security available, including, without limitation, industry standard or
higher encryption for electronically-stored Confidential Information.
Except as otherwise provided by Applicable Laws governing Broker’s record retention requirements,
Broker shall immediately, permanently, and irretrievably destroy, delete, and erase all hard copy and
all electronically-stored Confidential Information once use of such Confidential Information is no
longer required pursuant to the terms of this Agreement in accordance with Applicable Laws,
including the FTC’s Final Regulation on Consumer Information and Records Disposal (16 CFR 682),
and certify in writing within thirty (30) days that it has done so. In the event that there is a breach of
Broker’s systems which in any way involves Confidential Information, Broker shall take appropriate
action prevent further unauthorized access to or use of Company’s Confidential Information,
including, but not limited to, providing immediate written notice to Company and conducting a
prompt and thorough data security investigation to determine the nature, extent, and duration of
the security breach.
Broker agrees to indemnify and hold Company harmless in the event of a breach of this
confidentiality agreement in any manner by Broker or its ocers, employees, agents, successors,
and assigns.
Company (and/or its regulator(s)) may, at any time during the term of this Agreement and upon
reasonable notice to Broker, inspect Broker’s practices and controls and/or require reasonable
documentation from Broker to verify that Broker has complied with its obligations pursuant to this
Section.
The parties agree that this Section shall survive the termination of this Agreement.
C.
D.
E.
F.
G.
H.
I.
This document is limited to current Hometown Equity Mortgage, LLC, DBA theLender and practice and should not be construed as legal advice, legal opinion, or
any other advice on specific facts or circumstances. Such policy and practice is subject to change. The recipient should contact its legal counsel for legal advice. For
business and professional use only. Not for consumer distribution. All loans subject to approval and not all products are available in every state. Certain conditions and
fees apply. Hometown Equity Mortgage, LLC, DBA theLender NMLS #133519. Equal Housing Opportunity – All Rights Reserved. 01.2021
- 13 -
theAGREEMENT
FOR BUSINESS PURPOSE LOANS
11. MISCELLANEOUS PROVISIONS
No waiver or modification of this Agreement shall be valid unless executed in writing by both parties
hereto. Notwithstanding the foregoing, Company reserves the right, at its sole discretion,to amend,
update, and modify the Agreement as necessary to comply with Applicable Law.
Any waiver or breach of any term or condition of this Agreement shall not be deemed a waiver of
any other or subsequent breach, whether of a like or dierent nature.
In the event of litigation between the parties hereto, the prevailing party shall be entitled to recover
its attorneys’ fees from the other party. For the purposes hereof, the prevailing party shall be such
party as is awarded or receives any monetary amount from the other party, irrespective of
whether such amount is de minimis, and irrespective of whether receipt is a result of trial, arbitration
or settlement.
This Agreement shall be governed and interpreted in accordance with the laws of the State of
California without regard to conflict of law provisions, and broker agrees to exclusive personal
jurisdiction and venue in the state and federal courts of the United States located in the State of
California, County of Orange. Broker hereby waives application of diversity of citizenship and
expressly waives application of inconvenient forum.
A copy or copies of this Agreement, and/or electronic or facsimile reproductions of this Agreement
may be used for any and all purposes and such copies and/or electronic or facsimile reproductions
will have the same force and eect of a fully executed, original document.
The section and sub-section headings contained in this Agreement are for reference purposes only
and shall not aect the meaning or interpretation of this Agreement.
This Agreement constitutes the entire agreement between the parties hereto and supersedes all
prior agreements, representations and understandings of the parties hereto whether written or oral.
Nothing in this Agreement shall create or be deemed to create a partnership, joint venture, agency
or employment relationship between Company and Broker, and Broker will not hold itself out as a
branch or aliate of Company and will not represent that it can bind Company.
A.
B.
C.
D.
E.
F.
G.
H.
[SIGNATURE PAGE(S) IMMEDIATELY FOLLOW]
This document is limited to current Hometown Equity Mortgage, LLC, DBA theLender and practice and should not be construed as legal advice, legal opinion, or
any other advice on specific facts or circumstances. Such policy and practice is subject to change. The recipient should contact its legal counsel for legal advice. For
business and professional use only. Not for consumer distribution. All loans subject to approval and not all products are available in every state. Certain conditions and
fees apply. Hometown Equity Mortgage, LLC, DBA theLender NMLS #133519. Equal Housing Opportunity – All Rights Reserved. 01.2021
- 14 -
theAGREEMENT
FOR BUSINESS PURPOSE LOANS
BY SIGNING BELOW, the parties hereto have executed this Agreement as of the Eective Date.
COMPANY
Hometown Equity Mortgage, LLC DBA theLender
Signature: _________________________________________________________________
Printed Name: Alan Vidal
Title: Chief Compliance Ocer
Date: _________________________________________________________________
BROKER
________________________________________________________________
Signature: _________________________________________________________________
Printed Name: _________________________________________________________________
Title: _________________________________________________________________
Date: _________________________________________________________________
This document is limited to current Hometown Equity Mortgage, LLC, DBA theLender and practice and should not be construed as legal advice, legal opinion, or
any other advice on specific facts or circumstances. Such policy and practice is subject to change. The recipient should contact its legal counsel for legal advice. For
business and professional use only. Not for consumer distribution. All loans subject to approval and not all products are available in every state. Certain conditions and
fees apply. Hometown Equity Mortgage, LLC, DBA theLender NMLS #133519. Equal Housing Opportunity – All Rights Reserved. 01.2021
CERTIFICATIONS
AND AUTHORIZATIONS
Broker Originator Compensation Agreement Certification:
Broker/Principal certifies by execution of this application that the Broker Origination
Compensation Certification has been reviewed and Broker/Principal agrees to the terms and
conditions of this Certification. Broker Originator Compensation Certificate (see page 16)
Background Check Certification
Broker certifies that it has an eective policy in place for performing background checks on all
its employees, compliant with Applicable Laws (as defined in the Commercial/Business Purpose
Property Mortgage Broker Agreement) and performs periodic reviews to ensure compliance with
such policy.
BSA/AML Policy Certification
Broker certifies that it has an eective anti-money laundering policy and training in accordance
with the Bank Secrecy Act (commonly known as “BSA/AML”) and performs periodic reviews to
ensure compliance with such policy.
Loan Fraud Zero Tolerance Policy Certification
Broker certifies that it has an eective zero tolerance loan fraud policy in place and performs
periodic reviews to ensure compliance with such policy. Applicant has read theLenders Loan
Fraud Zero Tolerance Policy and understands theLender’s position on “Loan Fraud.” Loan Fraud
Zero Tolerance
Broker Aliation Disclosure with Authorization
Broker and each of the undersigned persons hereby authorize theLender to obtain references and
similar background information to be used for evaluation of the Brokers eligibility to do business
with theLender.
Principal Owners/Broker of Record: (Attach additional pages if necessary). Percent of ownership must
total 100%. If ownership is not individual, please provide ownership down to the individual level.
Include Broker of Record, even if no ownership interest.
Broker authorizes and certifies to the above-listed certifications and certifies that all information provided
to theLender in connection with this application is accurate and agrees to update theLender in the event
that any such information changes in any material respect.
Company’s Legal Name: ________________________________________________________________
Typed Name and Title of Authorized Ocer: ______________________________________________
Signature of Ocer: ____________________________________________________________________
Date: ________________________________________________________________________________
Email: _______________________________________________________________________________
Name Title SSN
Date of
Birth
State of
Residence
Percent of
Ownership
Signature
This document is limited to current Hometown Equity Mortgage, LLC, DBA theLender and practice and should not be construed as legal advice, legal opinion, or
any other advice on specific facts or circumstances. Such policy and practice is subject to change. The recipient should contact its legal counsel for legal advice. For
business and professional use only. Not for consumer distribution. All loans subject to approval and not all products are available in every state. Certain conditions and
fees apply. Hometown Equity Mortgage, LLC, DBA theLender NMLS #133519. Equal Housing Opportunity – All Rights Reserved. 01.2021
BROKER ORIGINATOR
COMPENSATION CERTIFICATION
Broker Originator Compensation Certification
To accept loan applications that a Broker submits to Hometown Equity Mortgage, LLC, dba
theLender (further referred to as “theLender”)
Broker represents, warrants and covenants to theLender that:
SO AGREED:
BROKER
_______________________________________________________________________
Signature: ________________________________________________________
Printed Name: _____________________________________________________
Title: _____________________________________________________________
Date: _____________________________________________________________
Broker does not steer and does not incentivize its employees to steer borrowers into loan
programs that are less beneficial to the borrower than other programs.
Broker understands all applicable laws, regulations, laws, and the applicable theLender loan
program (“collectively, the “Requirements”) related to commercial and business purpose loans,
has eective policies and procedures in place to address the Requirements, and will comply with
the Requirements.
Broker understands the dierence between a consumer purpose loan and business purpose loan
and will make certain that no loans submitted to theLender related to this loan application are
consumer purpose loans that require compliance with TILA or RESPA.
Broker will not act in a manner that will violate deceptive trade practice or similar laws.
Broker acknowledges that total points and fee including Lender fees are not to exceed 5 points.
1.
2.
3.
4.
5.
This document is limited to current Hometown Equity Mortgage, LLC, DBA theLender and practice and should not be construed as legal advice, legal opinion, or
any other advice on specific facts or circumstances. Such policy and practice is subject to change. The recipient should contact its legal counsel for legal advice. For
business and professional use only. Not for consumer distribution. All loans subject to approval and not all products are available in every state. Certain conditions and
fees apply. Hometown Equity Mortgage, LLC, DBA theLender NMLS #133519. Equal Housing Opportunity – All Rights Reserved. 01.2021
AUTHORIZATION
TO OBTAIN SCREENING INFORMATION
AUTHORIZATION TO OBTAIN SCREENING INFORMATION
- 17 -
By providing my signature below, I hereby authorize Hometown Equity Mortgage, LLC dba theLender
(hereinafter referred to as “theLender”) to verify information provided in the Commercial/Business
Purpose Mortgage Loan Broker Approval Application.
By providing my consent below, theLender is also authorized to submit the name of the Company,
and all employees of the company, for screening through any mortgage industry background
database, including but not limited to, LexisNexis, FraudGuard, and/or the Mortgage Asset Research
Institute (“MARI”).
By signing below, I/we hereby release, discharge and hold harmless any person or entity providing
information to theLender in connection with applying to become an approved Commercial/Business
Purpose Loan Broker with theLender and any recipient of such information, including theLender,
from any and all liability arising from or in connection with the furnishing, receipt, and review of such
information.
Company Corporate Entity Name: ______________________________________________________
Address: ___________________________________________________________________________
FEIN: ______________________________________________________________________________
Principal / Owner Name:
SSN:
Address:
Phone Number:
Date of Birth:
Ownership Percentage:
Signature:
Date:
This document is limited to current Hometown Equity Mortgage, LLC, DBA theLender and practice and should not be construed as legal advice, legal opinion, or
any other advice on specific facts or circumstances. Such policy and practice is subject to change. The recipient should contact its legal counsel for legal advice. For
business and professional use only. Not for consumer distribution. All loans subject to approval and not all products are available in every state. Certain conditions and
fees apply. Hometown Equity Mortgage, LLC, DBA theLender NMLS #133519. Equal Housing Opportunity – All Rights Reserved. 01.2021
AUTHORIZATION
TO OBTAIN SCREENING INFORMATION
- 18 -
Principal / Owner Name:
SSN:
Address:
Phone Number:
Date of Birth:
Ownership Percentage:
Signature:
Date:
Principal / Owner Name:
SSN:
Address:
Phone Number:
Date of Birth:
Ownership Percentage:
Signature:
Date:
Principal / Owner Name:
SSN:
Address:
Phone Number:
Date of Birth:
Ownership Percentage:
Signature:
Date:
** Please use additional sheets as necessary to provide information for additional Owners/Principals.
This document is limited to current Hometown Equity Mortgage, LLC, DBA theLender and practice and should not be construed as legal advice, legal opinion, or
any other advice on specific facts or circumstances. Such policy and practice is subject to change. The recipient should contact its legal counsel for legal advice. For
business and professional use only. Not for consumer distribution. All loans subject to approval and not all products are available in every state. Certain conditions and
fees apply. Hometown Equity Mortgage, LLC, DBA theLender NMLS #133519. Equal Housing Opportunity – All Rights Reserved. 01.2021
LOAN FRAUD
ZERO TOLERANCE
Loan Fraud Zero Tolerance
Broker and its employees must be aware that the company/broker/principal(s) bear the
responsibility for all actions of its employees or licensees. Broker is responsible for the content,
quality and accuracy of each application taken and each loan submitted to Hometown Equity
Mortgage, LLC, dba theLender.
THE SUBMISSION OF A LOAN APPLICATION CONTAINING FALSE INFORMATION IS A CRIME!
CONSEQUENCES
The eect of “Loan Fraud” is costly to all parties involved. Hometown Equity Mortgage, LLC, dba
theLender stands behind the quality of its loan production. Fraudulent loans cannot be sold into
the secondary market and, if sold, could require repurchase by Hometown Equity Mortgage, LLC,
dba theLender. Fraudulent loans damage our reputation with our investors and mortgage insurance
providers, and could cause Hometown Equity Mortgage, LLC, dba theLender’s selling privileges to be
suspended and/or terminated by its investors.
The price paid by those who participate in “Loan Fraud” is even more costly. The following is a list of
a few of the potential consequences that may be incurred.
(Continued on next page)
TYPES OF LOAN FRAUD
Submission of inaccurate information, including false statements on loan application(s) and
falsification of documents purporting to substantiate credit, employment, deposit or
asset information, personal information including identity, ownership/non-ownership of real
property, etc.
Forgery of partially or predominantly accurate information.
Incorrect statements regarding current occupancy or intent to maintain minimum
continuing occupancy as stated in the security instrument or occupancy adavit.
Lack of due diligence by loan ocer/interviewer/processor, including failure to obtain all
information required by the application and failure to request further information as
dictated by Borrowers response to other questions.
Unquestioned acceptance of information or documentation which is known, should be
known, or should be suspected to be inaccurate.
A. Simultaneous or consecutive processing of multiple owner-occupied loans from
one applicant supplying dierent information on each application.
B. Allowing an applicant or interested third-party to “assist” with processing the
loan.
Loan Ocer’s non-disclosure of relevant information.
1.
2.
3.
4.
5.
6.
This document is limited to current Hometown Equity Mortgage, LLC, DBA theLender and practice and should not be construed as legal advice, legal opinion, or
any other advice on specific facts or circumstances. Such policy and practice is subject to change. The recipient should contact its legal counsel for legal advice. For
business and professional use only. Not for consumer distribution. All loans subject to approval and not all products are available in every state. Certain conditions and
fees apply. Hometown Equity Mortgage, LLC, DBA theLender NMLS #133519. Equal Housing Opportunity – All Rights Reserved. 01.2021
LOAN FRAUD
ZERO TOLERANCE
Loan Fraud Zero Tolerance
- 20 -
The undersigned has read the foregoing and understands Hometown Equity Mortgage, LLC, dba
theLender’s position on “Loan Fraud.
Initial: ______________________________________ Date: _______________________________
Consequences to Broker
Criminal prosecution.
Loss of state licensing to perform mortgage loans.
Loss of lender/investor access due to exchange of information between lenders, mortgage
insurance companies including submission of information to investors, police agencies, and
state regulating agencies.
Civil Action by applicant/borrower or other parties to the transaction.
Agreement to indemnify and hold harmless Hometown Equity Mortgage, LLC, dba
theLender.
Loss of HUD approval.
Loss of funding facilities.
Consequences to Broker Employees
Criminal prosecution.
Civil action by Hometown Equity Mortgage, LLC, dba theLender.
Civil action by other parties to a Transaction, such as borrower, seller or real estate agent/
broker.
Agreement to indemnify and hold harmless Hometown Equity Mortgage, LLC.
Employee termination.
Loss of professional license, if any.
1.
2.
3.
4.
5.
6.
7.
1.
2.
3.
4.
5.
6.
This document is limited to current Hometown Equity Mortgage, LLC, DBA theLender and practice and should not be construed as legal advice, legal opinion, or
any other advice on specific facts or circumstances. Such policy and practice is subject to change. The recipient should contact its legal counsel for legal advice. For
business and professional use only. Not for consumer distribution. All loans subject to approval and not all products are available in every state. Certain conditions and
fees apply. Hometown Equity Mortgage, LLC, DBA theLender NMLS #133519. Equal Housing Opportunity – All Rights Reserved. 11.2020
ADDENDUM TO BROKER AGREEMENT
This Addendum to Broker Agreement (“Addendum”) is entered into by and between Hometown Equity
Mortgage, LLC (“Lender”), and the mortgage broker identified below (“Broker”) (hereinafter collectively
referred to as the “Parties”) as of the date execution stated below.
Recitals
A. Broker entered into that certain Broker Agreement (“Agreement”) with Lender, dba
theLender and currently is an Approved Broker of Lender.
B. Broker may from time to time submit application packages for residential mortgage loans to
Lender, operating as Hometown Equity Mortgage, LLC, for underwriting review, and possible
funding under the terms and conditions of the Agreement.
NOW THEREFORE, in consideration of the RECITALS set forth above and subject to the mutual promises
and covenants set forth below, the receipt and suciency of which are hereby acknowledged, the Parties
hereby agree as follows:
1. Binding Eect. The Agreement, and any amendments or addendums thereto, shall apply to
mortgage loan applications submitted to Lender in any name in which Lender does business.
2. Lender Paid Compensation. For any loan submitted to Lender that Broker requests to be paid
by Lender, and in accordance with Regulation Z (12 CFR Part 226). Broker shall be
compensated in the same amount as specified in their then current lender paid compensation
election, regardless of the name in which Lender is doing business.
3. Continuing Eect. This Addendum shall not aect Brokers or Lender’s rights and obligations
with respect to any loans submitted or funded under the Agreement.
Broker
________________________________
Executed as of _______________________
LENDER
___________________________
Alan Vidal, Chief Compliance Ocer
By ______________________________
Title _____________________________
click to sign
signature
click to edit
This document is limited to current Hometown Equity Mortgage, LLC, DBA theLender and practice and should not be construed as legal advice, legal opinion, or
any other advice on specific facts or circumstances. Such policy and practice is subject to change. The recipient should contact its legal counsel for legal advice. For
business and professional use only. Not for consumer distribution. All loans subject to approval and not all products are available in every state. Certain conditions and
fees apply. Hometown Equity Mortgage, LLC, DBA theLender NMLS #133519. Equal Housing Opportunity – All Rights Reserved. 02.2022
BUSINESS PURPOSE LOAN SIGN UP
I want to do Business Purpose Loans in the States indicated below. I Certify that I have complied with
each State’s compliance requirements.
Please sign me up!
Signature Date
BOLD = State requires licensing
Company represents and warrants each of the following:
A. Company is duly organized and in good standing in the state of its formation and is authorized to
conduct business in each state where it conducts business and oer Programs.
ALASKA
ALABAMA
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 JERSEY (you rep and warrant you are
authorized to conduct business and
oer programs in this state.)
NEW HAMPSHIRE
NEW MEXICO
NEW YORK (you rep and warrant you are authorized to
conduct business and oer programs in
this state.)
NORTH CAROLINA
OHIO
OKLAHOMA
OREGON
PENNSYLVANIA
RHODE ISLAND
SOUTH CAROLINA
TENNESSEE
TEXAS
UTAH
VIRGINIA
WASHINGTON
WEST VIRGINIA
WISCONSIN
WYOMING
click to sign
signature
click to edit
Form W-9
(Rev. October 2018)
Department of the Treasury
Internal Revenue Service
Request for Taxpayer
Identification Number and Certification
a
Go to www.irs.gov/FormW9 for instructions and the latest information.
Give Form to the
requester. Do not
send to the IRS.
Print or type.
See Specific Instructions on page 3.
1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank.
2 Business name/disregarded entity name, if different from above
3 Check appropriate box for federal tax classification of the person whose name is entered on line 1. Check only one of the
following seven boxes.
Individual/sole proprietor or
single-member LLC
C Corporation S Corporation Partnership Trust/estate
Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=Partnership)
a
Note: Check the appropriate box in the line above for the tax classification of the single-member owner. Do not check
LLC if the LLC is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is
another LLC that is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single-member LLC that
is disregarded from the owner should check the appropriate box for the tax classification of its owner.
Other (see instructions)
a
4 Exemptions (codes apply only to
certain entities, not individuals; see
instructions on page 3):
Exempt payee code (if any)
Exemption from FATCA reporting
code (if any)
(Applies to accounts maintained outside the U.S.)
5 Address (number, street, and apt. or suite no.) See instructions.
6 City, state, and ZIP code
Requester’s name and address (optional)
7 List account number(s) here (optional)
Part I Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid
backup withholding. For individuals, this is generally your social security number (SSN). However, for a
resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other
entities, it is your employer identification number (EIN). If you do not have a number, see How to get a
TIN, later.
Note: If the account is in more than one name, see the instructions for line 1. Also see What Name and
Number To Give the Requester for guidelines on whose number to enter.
Social security number
––
or
Employer identification number
Part II Certification
Under penalties of perjury, I certify that:
1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and
2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue
Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am
no longer subject to backup withholding; and
3. I am a U.S. citizen or other U.S. person (defined below); and
4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct.
Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because
you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid,
acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments
other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions for Part II, later.
Sign
Here
Signature of
U.S. person
a
Date
a
General Instructions
Section references are to the Internal Revenue Code unless otherwise
noted.
Future developments. For the latest information about developments
related to Form W-9 and its instructions, such as legislation enacted
after they were published, go to www.irs.gov/FormW9.
Purpose of Form
An individual or entity (Form W-9 requester) who is required to file an
information return with the IRS must obtain your correct taxpayer
identification number (TIN) which may be your social security number
(SSN), individual taxpayer identification number (ITIN), adoption
taxpayer identification number (ATIN), or employer identification number
(EIN), to report on an information return the amount paid to you, or other
amount reportable on an information return. Examples of information
returns include, but are not limited to, the following.
• Form 1099-INT (interest earned or paid)
• Form 1099-DIV (dividends, including those from stocks or mutual
funds)
• Form 1099-MISC (various types of income, prizes, awards, or gross
proceeds)
• Form 1099-B (stock or mutual fund sales and certain other
transactions by brokers)
• Form 1099-S (proceeds from real estate transactions)
• Form 1099-K (merchant card and third party network transactions)
• Form 1098 (home mortgage interest), 1098-E (student loan interest),
1098-T (tuition)
• Form 1099-C (canceled debt)
• Form 1099-A (acquisition or abandonment of secured property)
Use Form W-9 only if you are a U.S. person (including a resident
alien), to provide your correct TIN.
If you do not return Form W-9 to the requester with a TIN, you might
be subject to backup withholding. See What is backup withholding,
later.
Cat. No. 10231X
Form W-9 (Rev. 10-2018)
Form W-9 (Rev. 10-2018)
Page 2
By signing the filled-out form, you:
1. Certify that the TIN you are giving is correct (or you are waiting for a
number to be issued),
2. Certify that you are not subject to backup withholding, or
3. Claim exemption from backup withholding if you are a U.S. exempt
payee. If applicable, you are also certifying that as a U.S. person, your
allocable share of any partnership income from a U.S. trade or business
is not subject to the withholding tax on foreign partners' share of
effectively connected income, and
4. Certify that FATCA code(s) entered on this form (if any) indicating
that you are exempt from the FATCA reporting, is correct. See What is
FATCA reporting, later, for further information.
Note: If you are a U.S. person and a requester gives you a form other
than Form W-9 to request your TIN, you must use the requester’s form if
it is substantially similar to this Form W-9.
Definition of a U.S. person. For federal tax purposes, you are
considered a U.S. person if you are:
• An individual who is a U.S. citizen or U.S. resident alien;
• A partnership, corporation, company, or association created or
organized in the United States or under the laws of the United States;
• An estate (other than a foreign estate); or
• A domestic trust (as defined in Regulations section 301.7701-7).
Special rules for partnerships. Partnerships that conduct a trade or
business in the United States are generally required to pay a withholding
tax under section 1446 on any foreign partners’ share of effectively
connected taxable income from such business. Further, in certain cases
where a Form W-9 has not been received, the rules under section 1446
require a partnership to presume that a partner is a foreign person, and
pay the section 1446 withholding tax. Therefore, if you are a U.S. person
that is a partner in a partnership conducting a trade or business in the
United States, provide Form W-9 to the partnership to establish your
U.S. status and avoid section 1446 withholding on your share of
partnership income.
In the cases below, the following person must give Form W-9 to the
partnership for purposes of establishing its U.S. status and avoiding
withholding on its allocable share of net income from the partnership
conducting a trade or business in the United States.
• In the case of a disregarded entity with a U.S. owner, the U.S. owner
of the disregarded entity and not the entity;
• In the case of a grantor trust with a U.S. grantor or other U.S. owner,
generally, the U.S. grantor or other U.S. owner of the grantor trust and
not the trust; and
• In the case of a U.S. trust (other than a grantor trust), the U.S. trust
(other than a grantor trust) and not the beneficiaries of the trust.
Foreign person. If you are a foreign person or the U.S. branch of a
foreign bank that has elected to be treated as a U.S. person, do not use
Form W-9. Instead, use the appropriate Form W-8 or Form 8233 (see
Pub. 515, Withholding of Tax on Nonresident Aliens and Foreign
Entities).
Nonresident alien who becomes a resident alien. Generally, only a
nonresident alien individual may use the terms of a tax treaty to reduce
or eliminate U.S. tax on certain types of income. However, most tax
treaties contain a provision known as a “saving clause.” Exceptions
specified in the saving clause may permit an exemption from tax to
continue for certain types of income even after the payee has otherwise
become a U.S. resident alien for tax purposes.
If you are a U.S. resident alien who is relying on an exception
contained in the saving clause of a tax treaty to claim an exemption
from U.S. tax on certain types of income, you must attach a statement
to Form W-9 that specifies the following five items.
1. The treaty country. Generally, this must be the same treaty under
which you claimed exemption from tax as a nonresident alien.
2. The treaty article addressing the income.
3. The article number (or location) in the tax treaty that contains the
saving clause and its exceptions.
4. The type and amount of income that qualifies for the exemption
from tax.
5. Sufficient facts to justify the exemption from tax under the terms of
the treaty article.
Example. Article 20 of the U.S.-China income tax treaty allows an
exemption from tax for scholarship income received by a Chinese
student temporarily present in the United States. Under U.S. law, this
student will become a resident alien for tax purposes if his or her stay in
the United States exceeds 5 calendar years. However, paragraph 2 of
the first Protocol to the U.S.-China treaty (dated April 30, 1984) allows
the provisions of Article 20 to continue to apply even after the Chinese
student becomes a resident alien of the United States. A Chinese
student who qualifies for this exception (under paragraph 2 of the first
protocol) and is relying on this exception to claim an exemption from tax
on his or her scholarship or fellowship income would attach to Form
W-9 a statement that includes the information described above to
support that exemption.
If you are a nonresident alien or a foreign entity, give the requester the
appropriate completed Form W-8 or Form 8233.
Backup Withholding
What is backup withholding? Persons making certain payments to you
must under certain conditions withhold and pay to the IRS 24% of such
payments. This is called “backup withholding.” Payments that may be
subject to backup withholding include interest, tax-exempt interest,
dividends, broker and barter exchange transactions, rents, royalties,
nonemployee pay, payments made in settlement of payment card and
third party network transactions, and certain payments from fishing boat
operators. Real estate transactions are not subject to backup
withholding.
You will not be subject to backup withholding on payments you
receive if you give the requester your correct TIN, make the proper
certifications, and report all your taxable interest and dividends on your
tax return.
Payments you receive will be subject to backup withholding if:
1. You do not furnish your TIN to the requester,
2. You do not certify your TIN when required (see the instructions for
Part II for details),
3. The IRS tells the requester that you furnished an incorrect TIN,
4. The IRS tells you that you are subject to backup withholding
because you did not report all your interest and dividends on your tax
return (for reportable interest and dividends only), or
5. You do not certify to the requester that you are not subject to
backup withholding under 4 above (for reportable interest and dividend
accounts opened after 1983 only).
Certain payees and payments are exempt from backup withholding.
See Exempt payee code, later, and the separate Instructions for the
Requester of Form W-9 for more information.
Also see Special rules for partnerships, earlier.
What is FATCA Reporting?
The Foreign Account Tax Compliance Act (FATCA) requires a
participating foreign financial institution to report all United States
account holders that are specified United States persons. Certain
payees are exempt from FATCA reporting. See Exemption from FATCA
reporting code, later, and the Instructions for the Requester of Form
W-9 for more information.
Updating Your Information
You must provide updated information to any person to whom you
claimed to be an exempt payee if you are no longer an exempt payee
and anticipate receiving reportable payments in the future from this
person. For example, you may need to provide updated information if
you are a C corporation that elects to be an S corporation, or if you no
longer are tax exempt. In addition, you must furnish a new Form W-9 if
the name or TIN changes for the account; for example, if the grantor of a
grantor trust dies.
Penalties
Failure to furnish TIN. If you fail to furnish your correct TIN to a
requester, you are subject to a penalty of $50 for each such failure
unless your failure is due to reasonable cause and not to willful neglect.
Civil penalty for false information with respect to withholding. If you
make a false statement with no reasonable basis that results in no
backup withholding, you are subject to a $500 penalty.
Form W-9 (Rev. 10-2018)
Page 3
Criminal penalty for falsifying information. Willfully falsifying
certifications or affirmations may subject you to criminal penalties
including fines and/or imprisonment.
Misuse of TINs. If the requester discloses or uses TINs in violation of
federal law, the requester may be subject to civil and criminal penalties.
Specific Instructions
Line 1
You must enter one of the following on this line; do not leave this line
blank. The name should match the name on your tax return.
If this Form W-9 is for a joint account (other than an account
maintained by a foreign financial institution (FFI)), list first, and then
circle, the name of the person or entity whose number you entered in
Part I of Form W-9. If you are providing Form W-9 to an FFI to document
a joint account, each holder of the account that is a U.S. person must
provide a Form W-9.
a. Individual. Generally, enter the name shown on your tax return. If
you have changed your last name without informing the Social Security
Administration (SSA) of the name change, enter your first name, the last
name as shown on your social security card, and your new last name.
Note: ITIN applicant: Enter your individual name as it was entered on
your Form W-7 application, line 1a. This should also be the same as the
name you entered on the Form 1040/1040A/1040EZ you filed with your
application.
b. Sole proprietor or single-member LLC. Enter your individual
name as shown on your 1040/1040A/1040EZ on line 1. You may enter
your business, trade, or “doing business as” (DBA) name on line 2.
c. Partnership, LLC that is not a single-member LLC, C
corporation, or S corporation. Enter the entity's name as shown on the
entity's tax return on line 1 and any business, trade, or DBA name on
line 2.
d. Other entities. Enter your name as shown on required U.S. federal
tax documents on line 1. This name should match the name shown on the
charter or other legal document creating the entity. You may enter any
business, trade, or DBA name on line 2.
e. Disregarded entity. For U.S. federal tax purposes, an entity that is
disregarded as an entity separate from its owner is treated as a
“disregarded entity.” See Regulations section 301.7701-2(c)(2)(iii). Enter
the owner's name on line 1. The name of the entity entered on line 1
should never be a disregarded entity. The name on line 1 should be the
name shown on the income tax return on which the income should be
reported. For example, if a foreign LLC that is treated as a disregarded
entity for U.S. federal tax purposes has a single owner that is a U.S.
person, the U.S. owner's name is required to be provided on line 1. If
the direct owner of the entity is also a disregarded entity, enter the first
owner that is not disregarded for federal tax purposes. Enter the
disregarded entity's name on line 2, “Business name/disregarded entity
name.” If the owner of the disregarded entity is a foreign person, the
owner must complete an appropriate Form W-8 instead of a Form W-9.
This is the case even if the foreign person has a U.S. TIN.
Line 2
If you have a business name, trade name, DBA name, or disregarded
entity name, you may enter it on line 2.
Line 3
Check the appropriate box on line 3 for the U.S. federal tax
classification of the person whose name is entered on line 1. Check only
one box on line 3.
IF the entity/person on line 1 is
a(n) . . .
THEN check the box for . . .
• Corporation Corporation
• Individual
• Sole proprietorship, or
• Single-member limited liability
company (LLC) owned by an
individual and disregarded for U.S.
federal tax purposes.
Individual/sole proprietor or single-
member LLC
• LLC treated as a partnership for
U.S. federal tax purposes,
• LLC that has filed Form 8832 or
2553 to be taxed as a corporation,
or
• LLC that is disregarded as an
entity separate from its owner but
the owner is another LLC that is
not disregarded for U.S. federal tax
purposes.
Limited liability company and enter
the appropriate tax classification.
(P= Partnership; C= C corporation;
or S= S corporation)
• Partnership Partnership
• Trust/estate Trust/estate
Line 4, Exemptions
If you are exempt from backup withholding and/or FATCA reporting,
enter in the appropriate space on line 4 any code(s) that may apply to
you.
Exempt payee code.
• Generally, individuals (including sole proprietors) are not exempt from
backup withholding.
• Except as provided below, corporations are exempt from backup
withholding for certain payments, including interest and dividends.
• Corporations are not exempt from backup withholding for payments
made in settlement of payment card or third party network transactions.
• Corporations are not exempt from backup withholding with respect to
attorneys’ fees or gross proceeds paid to attorneys, and corporations
that provide medical or health care services are not exempt with respect
to payments reportable on Form 1099-MISC.
The following codes identify payees that are exempt from backup
withholding. Enter the appropriate code in the space in line 4.
1—An organization exempt from tax under section 501(a), any IRA, or
a custodial account under section 403(b)(7) if the account satisfies the
requirements of section 401(f)(2)
2—The United States or any of its agencies or instrumentalities
3—A state, the District of Columbia, a U.S. commonwealth or
possession, or any of their political subdivisions or instrumentalities
4—A foreign government or any of its political subdivisions, agencies,
or instrumentalities
5—A corporation
6—A dealer in securities or commodities required to register in the
United States, the District of Columbia, or a U.S. commonwealth or
possession
7—A futures commission merchant registered with the Commodity
Futures Trading Commission
8—A real estate investment trust
9—An entity registered at all times during the tax year under the
Investment Company Act of 1940
10—A common trust fund operated by a bank under section 584(a)
11—A financial institution
12—A middleman known in the investment community as a nominee or
custodian
13—A trust exempt from tax under section 664 or described in section
4947
Form W-9 (Rev. 10-2018)
Page 4
The following chart shows types of payments that may be exempt
from backup withholding. The chart applies to the exempt payees listed
above, 1 through 13.
IF the payment is for . . . THEN the payment is exempt
for . . .
Interest and dividend payments All exempt payees except
for 7
Broker transactions Exempt payees 1 through 4 and 6
through 11 and all C corporations.
S corporations must not enter an
exempt payee code because they
are exempt only for sales of
noncovered securities acquired
prior to 2012.
Barter exchange transactions and
patronage dividends
Exempt payees 1 through 4
Payments over $600 required to be
reported and direct sales over
$5,000
1
Generally, exempt payees
1 through 5
2
Payments made in settlement of
payment card or third party network
transactions
Exempt payees 1 through 4
1
See Form 1099-MISC, Miscellaneous Income, and its instructions.
2
However, the following payments made to a corporation and
reportable on Form 1099-MISC are not exempt from backup
withholding: medical and health care payments, attorneys’ fees, gross
proceeds paid to an attorney reportable under section 6045(f), and
payments for services paid by a federal executive agency.
Exemption from FATCA reporting code. The following codes identify
payees that are exempt from reporting under FATCA. These codes
apply to persons submitting this form for accounts maintained outside
of the United States by certain foreign financial institutions. Therefore, if
you are only submitting this form for an account you hold in the United
States, you may leave this field blank. Consult with the person
requesting this form if you are uncertain if the financial institution is
subject to these requirements. A requester may indicate that a code is
not required by providing you with a Form W-9 with “Not Applicable” (or
any similar indication) written or printed on the line for a FATCA
exemption code.
A—An organization exempt from tax under section 501(a) or any
individual retirement plan as defined in section 7701(a)(37)
B—The United States or any of its agencies or instrumentalities
C—A state, the District of Columbia, a U.S. commonwealth or
possession, or any of their political subdivisions or instrumentalities
D—A corporation the stock of which is regularly traded on one or
more established securities markets, as described in Regulations
section 1.1472-1(c)(1)(i)
E—A corporation that is a member of the same expanded affiliated
group as a corporation described in Regulations section 1.1472-1(c)(1)(i)
F—A dealer in securities, commodities, or derivative financial
instruments (including notional principal contracts, futures, forwards,
and options) that is registered as such under the laws of the United
States or any state
G—A real estate investment trust
H—A regulated investment company as defined in section 851 or an
entity registered at all times during the tax year under the Investment
Company Act of 1940
I—A common trust fund as defined in section 584(a)
J—A bank as defined in section 581
K—A broker
L—A trust exempt from tax under section 664 or described in section
4947(a)(1)
M—A tax exempt trust under a section 403(b) plan or section 457(g)
plan
Note: You may wish to consult with the financial institution requesting
this form to determine whether the FATCA code and/or exempt payee
code should be completed.
Line 5
Enter your address (number, street, and apartment or suite number).
This is where the requester of this Form W-9 will mail your information
returns. If this address differs from the one the requester already has on
file, write NEW at the top. If a new address is provided, there is still a
chance the old address will be used until the payor changes your
address in their records.
Line 6
Enter your city, state, and ZIP code.
Part I. Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box. If you are a resident alien and
you do not have and are not eligible to get an SSN, your TIN is your IRS
individual taxpayer identification number (ITIN). Enter it in the social
security number box. If you do not have an ITIN, see How to get a TIN
below.
If you are a sole proprietor and you have an EIN, you may enter either
your SSN or EIN.
If you are a single-member LLC that is disregarded as an entity
separate from its owner, enter the owner’s SSN (or EIN, if the owner has
one). Do not enter the disregarded entity’s EIN. If the LLC is classified as
a corporation or partnership, enter the entity’s EIN.
Note: See What Name and Number To Give the Requester, later, for
further clarification of name and TIN combinations.
How to get a TIN. If you do not have a TIN, apply for one immediately.
To apply for an SSN, get Form SS-5, Application for a Social Security
Card, from your local SSA office or get this form online at
www.SSA.gov. You may also get this form by calling 1-800-772-1213.
Use Form W-7, Application for IRS Individual Taxpayer Identification
Number, to apply for an ITIN, or Form SS-4, Application for Employer
Identification Number, to apply for an EIN. You can apply for an EIN
online by accessing the IRS website at www.irs.gov/Businesses and
clicking on Employer Identification Number (EIN) under Starting a
Business. Go to www.irs.gov/Forms to view, download, or print Form
W-7 and/or Form SS-4. Or, you can go to www.irs.gov/OrderForms to
place an order and have Form W-7 and/or SS-4 mailed to you within 10
business days.
If you are asked to complete Form W-9 but do not have a TIN, apply
for a TIN and write “Applied For” in the space for the TIN, sign and date
the form, and give it to the requester. For interest and dividend
payments, and certain payments made with respect to readily tradable
instruments, generally you will have 60 days to get a TIN and give it to
the requester before you are subject to backup withholding on
payments. The 60-day rule does not apply to other types of payments.
You will be subject to backup withholding on all such payments until
you provide your TIN to the requester.
Note: Entering “Applied For” means that you have already applied for a
TIN or that you intend to apply for one soon.
Caution: A disregarded U.S. entity that has a foreign owner must use
the appropriate Form W-8.
Part II. Certification
To establish to the withholding agent that you are a U.S. person, or
resident alien, sign Form W-9. You may be requested to sign by the
withholding agent even if item 1, 4, or 5 below indicates otherwise.
For a joint account, only the person whose TIN is shown in Part I
should sign (when required). In the case of a disregarded entity, the
person identified on line 1 must sign. Exempt payees, see
Exempt payee
code,
earlier.
Signature requirements. Complete the certification as indicated in
items 1 through 5 below.
Form W-9 (Rev. 10-2018)
Page 5
1. Interest, dividend, and barter exchange accounts opened
before 1984 and broker accounts considered active during 1983.
You must give your correct TIN, but you do not have to sign the
certification.
2. Interest, dividend, broker, and barter exchange accounts
opened after 1983 and broker accounts considered inactive during
1983. You must sign the certification or backup withholding will apply. If
you are subject to backup withholding and you are merely providing
your correct TIN to the requester, you must cross out item 2 in the
certification before signing the form.
3. Real estate transactions. You must sign the certification. You may
cross out item 2 of the certification.
4. Other payments. You must give your correct TIN, but you do not
have to sign the certification unless you have been notified that you
have previously given an incorrect TIN. “Other payments” include
payments made in the course of the requester’s trade or business for
rents, royalties, goods (other than bills for merchandise), medical and
health care services (including payments to corporations), payments to
a nonemployee for services, payments made in settlement of payment
card and third party network transactions, payments to certain fishing
boat crew members and fishermen, and gross proceeds paid to
attorneys (including payments to corporations).
5. Mortgage interest paid by you, acquisition or abandonment of
secured property, cancellation of debt, qualified tuition program
payments (under section 529), ABLE accounts (under section 529A),
IRA, Coverdell ESA, Archer MSA or HSA contributions or
distributions, and pension distributions. You must give your correct
TIN, but you do not have to sign the certification.
What Name and Number To Give the Requester
For this type of account: Give name and SSN of:
1. Individual The individual
2. Two or more individuals (joint
account) other than an account
maintained by an FFI
The actual owner of the account or, if
combined funds, the first individual on
the account
1
3. Two or more U.S. persons
(joint account maintained by an FFI)
Each holder of the account
4. Custodial account of a minor
(Uniform Gift to Minors Act)
The minor
2
5. a. The usual revocable savings trust
(grantor is also trustee)
b. So-called trust account that is not
a legal or valid trust under state law
The grantor-trustee
1
The actual owner
1
6. Sole proprietorship or disregarded
entity owned by an individual
The owner
3
7. Grantor trust filing under Optional
Form 1099 Filing Method 1 (see
Regulations section 1.671-4(b)(2)(i)
(A))
The grantor*
For this type of account: Give name and EIN of:
8. Disregarded entity not owned by an
individual
The owner
9. A valid trust, estate, or pension trust
Legal entity
4
10. Corporation or LLC electing
corporate status on Form 8832 or
Form 2553
The corporation
11. Association, club, religious,
charitable, educational, or other tax-
exempt organization
The organization
12. Partnership or multi-member LLC
The partnership
13. A broker or registered nominee
The broker or nominee
For this type of account: Give name and EIN of:
14. Account with the Department of
Agriculture in the name of a public
entity (such as a state or local
government, school district, or
prison) that receives agricultural
program payments
The public entity
15.
Grantor trust filing under the Form
1041 Filing Method or the Optional
Form 1099 Filing Method 2 (see
Regulations section 1.671-4(b)(2)(i)(B))
The trust
1
List first and circle the name of the person whose number you furnish.
If only one person on a joint account has an SSN, that person’s number
must be furnished.
2
Circle the minor’s name and furnish the minor’s SSN.
3
You must show your individual name and you may also enter your
business or DBA name on the “Business name/disregarded entity”
name line. You may use either your SSN or EIN (if you have one), but the
IRS encourages you to use your SSN.
4
List first and circle the name of the trust, estate, or pension trust. (Do
not furnish the TIN of the personal representative or trustee unless the
legal entity itself is not designated in the account title.) Also see Special
rules for partnerships, earlier.
*Note: The grantor also must provide a Form W-9 to trustee of trust.
Note: If no name is circled when more than one name is listed, the
number will be considered to be that of the first name listed.
Secure Your Tax Records From Identity Theft
Identity theft occurs when someone uses your personal information
such as your name, SSN, or other identifying information, without your
permission, to commit fraud or other crimes. An identity thief may use
your SSN to get a job or may file a tax return using your SSN to receive
a refund.
To reduce your risk:
• Protect your SSN,
• Ensure your employer is protecting your SSN, and
• Be careful when choosing a tax preparer.
If your tax records are affected by identity theft and you receive a
notice from the IRS, respond right away to the name and phone number
printed on the IRS notice or letter.
If your tax records are not currently affected by identity theft but you
think you are at risk due to a lost or stolen purse or wallet, questionable
credit card activity or credit report, contact the IRS Identity Theft Hotline
at 1-800-908-4490 or submit Form 14039.
For more information, see Pub. 5027, Identity Theft Information for
Taxpayers.
Victims of identity theft who are experiencing economic harm or a
systemic problem, or are seeking help in resolving tax problems that
have not been resolved through normal channels, may be eligible for
Taxpayer Advocate Service (TAS) assistance. You can reach TAS by
calling the TAS toll-free case intake line at 1-877-777-4778 or TTY/TDD
1-800-829-4059.
Protect yourself from suspicious emails or phishing schemes.
Phishing is the creation and use of email and websites designed to
mimic legitimate business emails and websites. The most common act
is sending an email to a user falsely claiming to be an established
legitimate enterprise in an attempt to scam the user into surrendering
private information that will be used for identity theft.
Form W-9 (Rev. 10-2018)
Page 6
The IRS does not initiate contacts with taxpayers via emails. Also, the
IRS does not request personal detailed information through email or ask
taxpayers for the PIN numbers, passwords, or similar secret access
information for their credit card, bank, or other financial accounts.
If you receive an unsolicited email claiming to be from the IRS,
forward this message to phishing@irs.gov. You may also report misuse
of the IRS name, logo, or other IRS property to the Treasury Inspector
General for Tax Administration (TIGTA) at 1-800-366-4484. You can
forward suspicious emails to the Federal Trade Commission at
spam@uce.gov or report them at www.ftc.gov/complaint. You can
contact the FTC at www.ftc.gov/idtheft or 877-IDTHEFT (877-438-4338).
If you have been the victim of identity theft, see www.IdentityTheft.gov
and Pub. 5027.
Visit www.irs.gov/IdentityTheft to learn more about identity theft and
how to reduce your risk.
Privacy Act Notice
Section 6109 of the Internal Revenue Code requires you to provide your
correct TIN to persons (including federal agencies) who are required to
file information returns with the IRS to report interest, dividends, or
certain other income paid to you; mortgage interest you paid; the
acquisition or abandonment of secured property; the cancellation of
debt; or contributions you made to an IRA, Archer MSA, or HSA. The
person collecting this form uses the information on the form to file
information returns with the IRS, reporting the above information.
Routine uses of this information include giving it to the Department of
Justice for civil and criminal litigation and to cities, states, the District of
Columbia, and U.S. commonwealths and possessions for use in
administering their laws. The information also may be disclosed to other
countries under a treaty, to federal and state agencies to enforce civil
and criminal laws, or to federal law enforcement and intelligence
agencies to combat terrorism. You must provide your TIN whether or
not you are required to file a tax return. Under section 3406, payers
must generally withhold a percentage of taxable interest, dividend, and
certain other payments to a payee who does not give a TIN to the payer.
Certain penalties may also apply for providing false or fraudulent
information.