Mortgage Banking Questionnaire

July 1, 1999

To: The Institution Addressed Re: Related Business Activities

The enclosed Questionnaire asks about related business activities conducted by the institution addressed and any wholly-owned or majority-owned subsidiaries. This information is needed to update our records of all mortgage banker licensees or mortgage broker registrants. Your cooperation is requested to ensure the Questionnaire is promptly completed and returned to the Mortgage Banking Division.

Each member of the licensee or registrant who must be reported to the Superintendent pursuant to NY Banking Law Section 594 or 594-b (i.e., executive officer, partner, director and 10-percent owner) must complete and sign the Questionnaire. If multiple copies of the survey must be filed, copy and distribute Questionnaire to each covered party. Assemble and return all responses as a package. The completed survey must be received in the Banking Department no later than thirty days from the date of this letter. In the event all responses cannot be obtained by the deadline, the licensee or registrant should submit all available Questionnaires together with a written explanation for the missing information.

Mortgage Banking Questionnaire July 1, 1999

Within the past 12 months, has the institution addressed and/or any owner, partner, director or executive officer of the institution addressed had a financial interest in a related business as defined below? [Place an “X” in the appropriate space.]

_____ Yes _____ No.

If answered “yes” to Item #1, enter the number of related businesses below and separately provide the following information with respect to each related business:

_____ Number of related businesses being reported.

• the name and address of the related business;
• the name of each owner, partner, director or executive officer of the institution addressed with a financial interest in a related business;
• describe the nature of each interest held;
• describe the nature of the business conducted; and
• if incorporated, kindly provide the date and state of incorporation.

Signature and Date

Print Name and Title

Name of Reporting Mortgage Broker or Mortgage Banker

Address

Related Business: For purposes of the above questions, a “related business” should be understood to comprise a financial interest held by an owner, partner, director or executive officer of the institution addressed in one or more of the following commercial activities:

• real estate sales and brokerage,
• residential real estate appraisal,
• consumer credit reports,
• courier/package delivery service,
• home improvement contracting,
• notary public,
• legal representation,
• credit counseling,
• residential fire and insurance sales and brokerage,
• private mortgage insurance,
• mortgage closing and settlement services,
• making, soliciting, processing, placing or negotiating a residential mortgage loan by an entity other than the institution addressed, and
• any service the cost of which is financed by a residential mortgage loan arranged or financed by the institution addressed.