NOTE: The downloadable forms listed below are in Adobe Acrobat "PDF" format unless otherwise indicated. You may "fill in fields and save your data" in the following electronic forms using Adobe Reader 7 or 8. Click here to download the free  Adobe Reader 8.      

Please visit the NMLS website to submit MU1, MU2, MU3, and MU4 filings as well as to update information.   Mortgage Licensing & Compliance Forms
Form Name	Form #	Fees	Applies To	Purpose
Uniform Individual Mortgage Application & Consent Form	MU4	$155(including $30 NMLS fee) (+$47 for Criminal Background/ Credit Check for a total of $202)	Mortgage Loan Originators	Obtain or amend license as a Mortgage Loan Originator, permitting the licensee to accept, or offer to accept, mortgage loan applications for North Carolina real estate. Update personal information on file with the Commissioner, to include change of name, address, phone number, e-mail address or employment.
Authority For Release of Information Form	MLA01	$0	Mortgage Loan Originators Owners, Directors, etc.	To give authorization to perform a fingerprint search of the State and Federal criminal history record.
Mortgage Broker Surety Bond	MLA02 Mortgage Broker Surety Bond $75,000 MLA02-A Mortgage Broker Surety Bond $125,000 MLA02-B Mortgage Broker Surety Bond $250,000	NA	Mortgage Brokers	Establish and maintain financial responsibility as a Licensee.
Mortgage Lender Surety Bond	MLA03 Mortgage Lender Surety Bond $150,000 MLA03-A Mortgage Lender Surety Bond $250,000 MLA03-B Mortgage Lender Surety Bond $500,000	NA	Mortgage Lenders	Establish and maintain financial responsibility as a licensee.
Mortgage Servicer Surety Bond	MLA03-S Mortgage Servicer Surety Bond	NA	Mortgage Servicers	Establish and maintain financial responsibility as a licensee.
Claim of Exemption to the S.A.F.E. Mortgage Licensing Act	MLA04	$0	Mortgage Lenders exempt from licensure (primarily banks and credit unions)	Satisfy claim for exemption from licensure. Note: Individuals employed as Mortgage Loan Originators of exempt entities are not required to be licensed nor to file to claim their exempt status.
Notice of Amortization Information & Examples	MLA09	NA	Mortgage Lenders Mortgage Brokers	Required notice for NC home loans per NCGS 24.
North Carolina Mortgage Licensing Act Annual Report Questionnaire Form	Please click on the following link to submit  2009 annual report information starting January  1, 2010(https://www.nccob.org/online/NMLS/default.aspx)	NA	Mortgage Lenders Mortgage Brokers	To fulfill annual reporting requirements.
Surety Bond Under the Good Funds Settlement Act	MLA11 Formerly "NCMB-20"	NA	Mortgage Lenders	Helps guarantee good funds for real-estate settlements.
Affidavit regarding Net Branching for Qualifying Individual	MLA16	$0	Qualifying Individual	To confirm the Qualifying Individual's understanding of the Commissioner's Declaratory Ruling 2003-01 regarding Net Branching.
Verification of Deposit Account	MLA17	NA	Mortgage Lenders Mortgage Brokers	To fulfill annual reporting requirements.
Model Mortgage Broker Disclosure Form	MLA18	NA	Mortgage Brokers	Model Form that can be used to comply with requirements of N.C.G.S. § 53-244.109(5)
Additional Information
Mortgage Lending Act Fee Schedule	Fee Schedule	NA	All	Overview of fees.

Rev. 08/30/2010