Form: MLA 15 1
Rev. 05/22/2014
OFFICE OF THE COMMISSIONER OF BANKS
Mortgage Department
EMPLOYER CERTIFICATION
1. I received the Order and Decision dated , under docket
Number , concerning ’s (Licensee’s Name)
license as a mortgage loan originator under the North Carolina Secure and Fair
Enforcement Mortgage Licensing Act (the “NC SAFE Act”).
2. I have read and reviewed the Order and Decision.
3. I am an officer or qualifying individual in the undersigned firm, which now employs or
intends to employ the above-named individual as a mortgage loan originator.
4. I understand that the conditions imposed require the individual’s employer to be licensed
under the NC SAFE Act and to exercise oversight as required by law.
5. The undersigned firm has in place both internal and external verified quality control
procedures and measures which are reasonably designed to prevent mortgage fraud and
other violations of mortgage lending laws and regulations.
6. The activities of the above-named individual will be covered by these quality control
measures.
7. The above-named individual will be supervised either by me, another qualifying
individual, or a branch manager who is under my supervision.
8. The activities of the above-named individual will be supervised to ensure compliance
with the Order and Decision, the NC SAFE Act, and all applicable federal and state laws
and regulations.
9. I request that the Office of the Commissioner of Banks rely upon this certification so that
the undersigned firm may employ the above-named individual as a mortgage loan
originator.
10. The undersigned firm shall comply promptly and fully with any OCOB request for
information or assistance in resolving any complaint, examination, or investigation.
Form: MLA 15 2
Rev. 05/22/2014
Name and Address of Firm; type or print:
Signature of Officer or
Qualifying Individual: _____________________________________
[Signature]
[Print name]
[Title]
[Contact number]
Please request the sponsorship through the NMLS, email a copy of this form to
cgering@nccob.gov, and return the original to:
U.S. Mail
Office of the Commissioner of Banks
Attn: Mortgage Department
4309 Mail Service Center
Raleigh, North Carolina 27699-4039
FedEx or UPS
Office of the Commissioner of Banks
Attn: Mortgage Department
316 W. Edenton Street
Raleigh, North Carolina 27603
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