"Mortgage Loan Modification Services Provider Renewal Application Form" - Delaware

This printable "Mortgage Loan Modification Services Provider Renewal Application Form" is a document issued by the Delaware Department of Justice specifically for Delaware residents.

Download a PDF of the latest edition of the form down below or find it through the department's forms library.

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Download "Mortgage Loan Modification Services Provider Renewal Application Form" - Delaware

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BEFORE THE DIRECTOR OF THE CONSUMER PROTECTION DIVISION
OF THE DEPARTMENT OF JUSTICE
IN RE:
)
)
)
Applicant's Business Name
)
Application No.
)
)
)
)
)
)
)
Applicant's Business Address
)
)
)
)
Date of Application
)
Mortgage Loan Modification Services Provider Renewal Application
This is a renewal application form for use by persons already approved and registered as a
Mortgage Loan Modification Services Provider with the Consumer Protection Unit of the
Department of Justice.
It is unlawful to act as a Mortgage Loan Modification Services Provider by taking any action
specified in the Delaware Mortgage Loan Modification Services Act, 6 Del. C. § 2400C, et seq.,
after the date your initial registration expires and until you have been issued a renewal certificate
from the Consumer Protection Unit of the Department of Justice.
Application fees should be made payable to: The Consumer Protection Fund. The completed
renewal application form, fee, and all required exhibits should be sent to:
Mortgage Loan Modification Services Provider Program
Delaware Attorney General's Office
Consumer Protection Unit
820 N. French Street, 5th Floor
Wilmington, DE 19801
Each renewal application must answer all questions and attach all required information. If a
question is not applicable or if there has been no change since the initial application, please
respond with "N/A". For purposes of this renewal application, no change shall mean that
nothing substantial or material has changed or been altered in any way. Additional pages may be
included in the application if needed.
Initial
Page 1 of 4
BEFORE THE DIRECTOR OF THE CONSUMER PROTECTION DIVISION
OF THE DEPARTMENT OF JUSTICE
IN RE:
)
)
)
Applicant's Business Name
)
Application No.
)
)
)
)
)
)
)
Applicant's Business Address
)
)
)
)
Date of Application
)
Mortgage Loan Modification Services Provider Renewal Application
This is a renewal application form for use by persons already approved and registered as a
Mortgage Loan Modification Services Provider with the Consumer Protection Unit of the
Department of Justice.
It is unlawful to act as a Mortgage Loan Modification Services Provider by taking any action
specified in the Delaware Mortgage Loan Modification Services Act, 6 Del. C. § 2400C, et seq.,
after the date your initial registration expires and until you have been issued a renewal certificate
from the Consumer Protection Unit of the Department of Justice.
Application fees should be made payable to: The Consumer Protection Fund. The completed
renewal application form, fee, and all required exhibits should be sent to:
Mortgage Loan Modification Services Provider Program
Delaware Attorney General's Office
Consumer Protection Unit
820 N. French Street, 5th Floor
Wilmington, DE 19801
Each renewal application must answer all questions and attach all required information. If a
question is not applicable or if there has been no change since the initial application, please
respond with "N/A". For purposes of this renewal application, no change shall mean that
nothing substantial or material has changed or been altered in any way. Additional pages may be
included in the application if needed.
Initial
Page 1 of 4
1) List any changes to the Corporate/Business Name of the Mortgage Loan Modification
Services Provider ("MLMSP"):
2) List all other names used or to be used by the MLMSP:
3) List the name and title of all officers, members or owners of the MLMSP:
4) List the MLMSP's main mailing address and any other address used or proposed to be used by
the MLMSP:
5) List the telephone number(s) used or proposed to be used by the MLMSP:
6) List all Internet website(s) used or proposed to be used by the MLMSP:
7) List all email(s) used or proposed to be used by the MLMSP:
Initial
Page 2 of 4
The Mortgage Loan Modification Services Provider (MLMSP) must provide each of the
following items with this renewal application, labeled as the appropriate exhibit number
(check those you are attaching):
EXH. 1
A copy of: (1) any written script of all telephonic or broadcast advertising and other statements;
(2) all print or electronic advertising and other promotional material, and (3) each different
contract, and any forms to be attached to the contract that have been changed, altered or revised
from its original form submitted with the initial application that will be used or proposed to be
used by the MLMSP in connection with acting as a MLMSP.
EXH. 2
A copy of a currently effective surety bond in the amount of one hundred thousand dollars
($100,000), executed by a corporate surety admitted to do business in this State.
EXH. 3
A check in the amount of five hundred dollars ($500), for the renewal application fee, made
payable to The Consumer Protection Fund.
FOR ANY ITEMS THAT ARE NOT ATTACHED, PLEASE STATE WHY SUCH
ITEMS HAVE NOT BEEN PROVIDED.
YOUR RENEWAL APPLICATION CANNOT BE PROCESSED UNTIL ALL
THE INFORMATION AND ALL DOCUMENTS REQUESTED HAVE BEEN
PROVIDED.
THIS RENEWAL IS VALID FOR A PERIOD OF ONE (1) YEAR FROM THE
DATE GRANTED AND MUST BE RENEWED ANNUALLY THEREAFTER.
Initial
Page 3 of 4
AFFIDAVIT
State of
)
) SS.
County of
)
I, the undersigned, swear and affirm that:
1. I have carefully read this Renewal Application for registration as a Mortgage Loan
Modification Services Provider, together with the Initial Application for registration
dated
, including all attachments and forms. The
information contained herein is the product of a diligent and reasonable effort and is true,
accurate and complete to the best of my knowledge, information and belief;
2. I am a high managerial agent, owner or officer of the Applicant acting with the
authority of the Applicant; and
3. I understand that if I intentionally made a false statement in this Renewal Application,
or if someone else made a false statement that I know or believe to be false, I may be
subject to criminal prosecution.
Signature of Affiant
Print Name of Affiant
Title
SWORN TO AND SUBSCRIBED before me this
day of
201
, as witnessed by my Hand and Seal of office.
NOTARY PUBLIC
My commission expires:
SEAL:
Initial
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