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New Branch Application

Please complete the form below and upload all applicable files to apply.
Contact Information
Full Name:*
First NameLast Name
Title:*
Home Address:
Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Home Phone:
Area CodePhone Number
Cell Number
Area CodePhone Number
E-mail:*
example@example.com

Current Branch Information
Current Company:*
Branch Manager's Name:*
Are you the owner of this company?*
YesNo
If so, please enter the following Business Information:
Business Ownership Information

Tax ID#

Principal(s)

Percentage of Ownership

Type of Business
Company Address:*
Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Business Phone:*
Area CodePhone Number
Cell Phone:
Area CodePhone Number
Fax Number:
Area CodePhone Number
Additional Branch Locations:
Current Website Address:
Mailing Address (If Different):
Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Date Business Started:
MonthDayYear
Does the Branch Manager(s) Originate?
YesNo
If yes, what percentage of the production does this account for?
Office Type:
RetailHome Office
Business Tax ID:
Does your building have Liability Insurance?
YesNo
Mortgage Experience (ex. 5 years 4 months):*

Disclosures
Disclosures*
Yes No

Criminal Conviction

Lender Termination

License Revoked
If you marked yes to any one of the above questions, please provide a letter of explanation stating why and the details regarding the matter.

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Credit Score:
Have you filed a personal bankruptcy petition or been the subject of an involuntary bankruptcy petition?
YesNo
If yes, please explain:
Based upon events that occurred while you exercised control over any organization, have you filed a bankruptcy petition or been the subject of an involuntary bankruptcy petition?
YesNo
If yes, please explain:
Has a bonding company ever denied, paid out on, or revoked a bond for you?
YesNo
If yes, please explain:
Do you have any unsatisfied judgments or liens against you?
YesNo
If yes, please explain:

Branch Overhead
Office Lease:
Equipment Lease:
Telephone:
Utilities:
Office Supplies:
Total Monthly Expenses:

Loan Production
Total # of Employees:

Past 6 Months Production (Loans & Volume) by Loan Type - (Previous Number of Closings Must Match Production Report)

	Average Loan Amount	# of Closings Month 6	# of Closings Month 5	# of Closings Month 4	# of Closings Month 3	# of Closings Month 2	# of Closings Month 1
Conventional
FHA
VA
Jumbo
Other

Projected Monthly Volume by Loan Type - Projected number of Closings

	Average Loan Amount	# of Closings Month 6	# of Closings Month 5	# of Closings Month 4	# of Closings Month 3	# of Closings Month 2	# of Closings Month 1
Conventional
FHA
VA
Jumbo
Other

What is Branch's current volume? (Closings in the next 30 days)
Current Pipeline Report - (Loans still in Pipeline)
Total Number of Loans Purchase Refinance Brokered

Conventional

FHA

VA

Jumbo

Other
Please add any additional notes or comments:

File Uploads and Signature
If any of the information on this form is not applicable, please explain why:
Company Roster:

Include all employees' resumes, phone numbers, and current wages
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Authorization to pull credit on Principals:

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Credit Reports:

Personal and Business
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Current State License #s for Branch and Loan Officers:
Prior 2 Year Financial Statements:

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2 Years Tax Returns:

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Original Lease/Rental Agreement:

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Description of Office Equipment/Facilities:

Copy machines, computers, printers, phones, office supplies
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Liability Insurance (If applicable):

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LLC Documentation:

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W-9:

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Branch Ledger:

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Copy of Employees' Licenses:

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Copy of Employees' Contracts:

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PLEASE READ CAREFULLY AND SIGN THAT YOU UNDERSTAND AND ACCEPT THIS INFORMATION.

I certify that the information on this application, and its supporting documents, is accurate and complete. I understand and agree that failure to fully complete the form, or misrepresentation or omission of facts, represents grounds for elimination from consideration for employment, or termination after employment if discovered at a later date. I authorize City First Mortgage Services, L.L.C. to investigate, without liability, all statements contained in this application and supporting materials. I authorize references and former employers, without liability, to make full response to any inquiries in connection with this application for employment. If requested, I agree to submit to a physical exam, criminal and credit background investigation, and/or screening for illegal substances upon conditional offer of employment. I understand that this document is NOT an offer of employment, and that an offer of employment, if tendered, does NOT constitute a contract for continued guaranteed employment. I understand that employees of City First Mortgage Services, L.L.C. serve at-will, and the employment relationship may be terminated at any time by either party, or any or no reason, other than a reason prohibited by law.
This form may be printed, filled out and emailed to City 1st Mortgage at branchdevelopment@city1st.com. To speed up the process, fill out this form online and type your name below as an official e-signature. You will be contacted shortly to ensure that all of the information is accurate. If you have any questions, please contact Branch Development at 801-299-1770 ext 2026.
By typing your name below, You agree that this is valid as your signature.*
I agree
Applicant Signature:*
First NameLast Name
Applicant Signature:
First NameLast Name
Signed Date:
MonthDayYear
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