MORTGAGE PROTECTION INSURANCE APPLICATION FORM

Transcription

1 APPLICATION FORM Part 1: General Questions Policies will be issued in the joint name of the Applicant and any servicing subsidiary listed below. 1. Applicant's Name: 2. Address: 3. Year established: Charter: State National Other 4. Type of institution (i.e. Bank, Savings & Loan, Credit Union, or other): 5. Trade affiliation(s) (i.e. State Bankers Assoc., American Bankers Assoc., etc.) 6. Name(s) & address(es) of servicing subsidiary company(ies): ne Part 2: Questions Concerning the Applicant's Mortgage Portfolio "Applicant" is to be understood as Applicant plus servicing subsidiary(ies) named in Part 1. "Value" should, where possible, exclude the value of loans secured solely by land. For the purposes of this insurance, "Mortgages" includes 2 nd Mortgages and Home Equity Loans. 1. Does Applicant's standard mortgage agreement require mortgagor to procure and maintain insurance in an amount not less than the amount of Applicant's mortgage interest and in compliance with any coinsurance clause in such insurance for perils of: Fire, Extended Coverage? Vandalism? All Risk / Package-Type Policy / Mobile Homeowners form? 2. What type of coverage is most often obtained by mortgagors? 3. For construction loans, does Applicant require mortgagors to carry a Builders Full All Risks policy? 4. Does Applicant require hazard policies for mortgaged properties to be provided by insurers with at least a "B" Best's rating? 5. Does Applicant check that insurance required of the mortgagor is in force: (a) at loan closing? (b) and at policy anniversary? If (b) is, what type of checking system do you employ? 6. Does Applicant carry a "force-placed" program which automatically covers a property on which Applicant is or becomes aware the mortgagor has no coverage? 7. Total Number (#) & Value ($) of OREO foreclosed properties each of the 3 prior years: 1 st prior year: # $ 2 nd prior year: # $ 3 rd prior year: # $ 8. Losses under Applicant's force-placed policy each of the past 3 years: 1 st prior year: # $ 2 nd prior year: # $ 3 rd prior year: # $ 9. Breakdown of All Mortgages - include # / $ from Q 11. Commercial & Q nd & Home Equity Loans: a serviced by Applicant for own interest (wholly or partly owned) # $ b serviced by Applicant for others (no owner interest) # $ c serviced by others for Applicant's interest (wholly or partly owned) # $ d total mortgages serviced (both owned and non-owned) = 9a+9b+9c # $ 10. Of 9.b loans serviced by Applicant for others (no owner interest), approximate % are located in: CA % FL % AL,GA,LA,MS,NC,SC,TX % CT,DE,ME,MD,MA,NH,NJ,NY,RI,VA % MORTGAGE PROTECTION APPLICATION 8/3/2006 Page 1 of 5

2 11. Commercial Mortgages only (Commercial Mortgages are any not secured by 1-4 family owner-occ residences) (also include in Q 9.): # $ nd Mortgages & Home Equity Loans (also include in Q 9.): # $ (a) of above, on how many does Applicant hold the 1 st mortgage: # (b) of those on which Applicant does not hold the 1 st mortgage, what procedures, if any, are followed to determine the existence and maintenance of hazard insurance? 13. Approximate % of serviced loans subject to VA, FHA, SBA or other Mortgage Guarantee Insurance: % 14. What procedures are followed to give proper notice of delinquency to mortgage guarantors? 15. Approximate # of loans on which Applicant escrows for: (a) Hazard Insurance (b) Life & Disability (c) Real Estate Taxes. 16. How does Applicant monitor Applicant's or mortgagor's payment of Real Estate Taxes? 17. Does the Applicant provide mortgages in areas designated as "Special Flood Hazard Areas" in accordance with the Flood Disaster Protection Act of 1973, as amended? Part 4: Geographic Breakdown of Loans Attach Geographic Breakdown of Loans Sheet, as appropriate. 1. Total mortgages serviced (wholly & partly owned only) = 9a+9c: # $ 2. Total of 1. above mortgages for all states except those listed below: # $ (a) AL,GA,LA,MS,NC,SC,TX (include list by state) ne # $ (b) FL ne # $ (c) CA (include list by county) ne # $ (d) CT,DE,ME,MD,MA,NH,NJ,NY,RI,VA (incl list by state) ne # $ 3. Total Commercial only mortgages secured by properties located in: (a) New York City, NY (include list by zip code) ne # $ (b) Washington, DC (include list by zip code) ne # $ Part 5: Miscellaneous If ': to any below, attach Miscellaneous Supplemental Sheet. 1. Does Applicant provide or service mobile and manufactured home loans? 2. Has Applicant agreed to undertake any Custodial Services for FHLMC, FNMA, GNMA? 3. Does Applicant require mortgagors to obtain Title Insurance and/or the equivalent, as appropriate to local practice, at loan closing? 4. Does Applicant currently have, or did have within the past 3 years, Mortgage Errors & Omissions, Mortgage Impairment or Mortgage Protection coverage? Part 6: Declarations If ': to any below, attach Miscellaneous Supplemental Sheet. 1. Has Applicant applied for a Mortgage Errors & Omissions, Mortgage Impairment or Mortgage Protection policy and been declined? (Missouri applicants need not respond.) 2. Has Applicant suffered any losses during the past 5 years, or is Applicant aware of any circumstances likely to give rise to a loss, from physical damage insurance perils mortgagors are required to insure against, or from its servicing errors & omissions? 3. Has Applicant suffered any losses during the past 10 years from physical damage insurance perils other than those mortgagors are required to insure against? I / we hereby declare that the above statements and particulars are true, that I / we have not suppressed or misstated and material facts, and I / we agree that this Application form shall be the basis of the Contract with Underwriters. Signed at this day of, 20 Applicant signature Title Phone Fax MORTGAGE PROTECTION APPLICATION 8/3/2006 Page 2 of 5

3 LOAN GEOGRAPHIC BREAKDOWN SUPPLEMENTAL SHEET APPLICANT MAY IGNORE & DISCARD THIS SHEET PROVIDED IT HAS NO LOANS IN THE LOCATIONS LISTED BELOW Part 4: Geographic Breakdown of Loans - Complete only those items which apply. Southeastern Atlantic and Gulf Coast State Loans: Alabama 1 st & 2 nd tier coastal counties % State Total: # $ Georgia 1 st & 2 nd tier coastal counties % State Total: # $ Louisiana 1 st & 2 nd tier coastal parishes % State Total: # $ Mississippi 1 st & 2 nd tier coastal counties % State Total: # $ rth Carolina 1 st & 2 nd tier coastal counties % State Total: # $ South Carolina 1 st & 2 nd tier coastal counties % State Total: # $ Texas 1 st & 2 nd tier coastal counties % State Total: # $ California Loans (by County): Does Applicant require Earthquake coverage on properties located in California? San Francisco, San Mateo # $ Contra Costa, Alameda # $ Del rte, Humboldt, Lake Marin, Mendocino, Napa, Solano, Sonoma # $ Monterey, San Benito, Santa Cruz, Santa Clara # $ Los Angeles # $ Orange # $ Kern, San Luis Obispo, Santa Barbara, Ventura # $ San Diego # $ Alpine, Imperial, Inyo, Mono, Riverside, San Bernardino # $ All other counties no included in above list # $ Middle and rtheastern Atlantic Coast State Loans: Connecticut 1 st & 2 nd tier coastal counties % State Total: # $ Delaware 1 st & 2 nd tier coastal counties % State Total: # $ Maine 1 st & 2 nd tier coastal counties % State Total: # $ Maryland 1 st & 2 nd tier coastal counties % State Total: # $ Massachusetts 1 st & 2 nd tier coastal counties % State Total: # $ New Hampshire 1 st & 2 nd tier coastal counties % State Total: # $ New Jersey 1 st & 2 nd tier coastal counties % State Total: # $ New York 1 st & 2 nd tier coastal counties % State Total: # $ Rhode Island 1 st & 2 nd tier coastal counties % State Total: # $ Virginia 1 st & 2 nd tier coastal counties % State Total: # $ Total Commercial Mortgages secured by properties located in the following New York City zip codes (if Applicant has any such properties, it will also be necessary to provide a listing of each individual property with its value and zip code): 10001, 10002, 10003, 10004, 10005, 10006, 10007, 10009, 10010, 10011, 10012, 10013, 10014, 10016, 10017, 10018, 10019, 10020, 10022, 10036, 10038, # $ Total Commercial Mortgages secured by properties located in the following Washington DC zip codes (if Applicant has any such properties, it will also be necessary to provide a listing of each individual property with its value and zip code): 20001, 20002, 20003, 20004, 20005, 20006, 20007, 20008, 20009, 20010, 20011, 20012, 20015, 20016, 20017, 20018, 20019, 20020, 20024, 20032, 20036, 20037, 20057, 20059, 20064, 20332, # $ MORTGAGE PROTECTION APPLICATION 8/3/2006 Page 3 of 5 Supplemental Sheet - Part 4: Geographic Breakdown of Loans

4 MISCELLANEOUS SUPPLEMENTAL SHEET APPLICANT MAY IGNORE & DISCARD THIS SHEET PROVIDED EACH QUESTION IN APPLICATION PART 5 AND APPLICATION PART 6 WAS ANSWERED "NO" APPLICANT MUST COMPLETE ONLY THOSE PARTS 5 & 6 QUESTIONS ANSWERED "YES" Part 5: Miscellaneous (Complete only those Questions answered "" on the Application) 1. Mobile and manufactured Home Loans serviced: # $ (a) States where mobile & manu homes are located: (b) Were any of the losses reported under Part 2 Q 8. to mobile & manu homes? If "yes," provide # and $ of mobile and manu home losses: # $ 2. Custodial services for FHLMC, FNMA and/or GNMA: (a) Number of loan files Applicant holds in custody for: FHLMC FNMA GNMA. (b) What custodial services has Applicant agreed to undertake for these files? (c) Describe the location, fire protection and security provided by Applicant for these files: (d) What back-up records exist in case of loss to the original files? (e) How does Applicant control and track file access, removal and return? (f) Is Applicant aware of any outstanding custodial errors & omissions claim(s), or circumstances likely to give rise to such a claim? If "," explain: 3. Title Errors & Omissions: (a) Percentage of loans on which Applicant requires evidence of Title Insurance (and/or the local equivalent) at loan closing: %. Describe requirements: (b) Describe Applicant's loan policy provisions with respect to title examinations / searches: (c) Estimated # of mortgage loans to me made in the next 12 mos.: # (d) Is Applicant aware of any outstanding Title Insurance errors & omissions claim(s), or circumstances likely to give rise to such a claim? If "," explain: 4. Previous Mortgage Errors & Omissions, Mortgage Impairment or Mortgage Protection Policy: Insurer: Premium: $ Limit $ Deductible $ Policy Period: from to. Part 6: Declarations 1. Describe reason(s) for denial of coverage: 2. Give details of Mortgage E & O or Impairment losses during past 5 years from perils mortgagor is required to insure against and/or Applicant's servicing errors & omissions: 3. Give details of Mortgage E & O or Impairment losses during past 10 years from perils mortgagor is not required to insure against: MORTGAGE PROTECTION APPLICATION 8/3/2006 Page 4 of 5 Supplemental Sheet - Part 5: Miscellaneous & Part 6: Declarations

5 FRAUD WARNINGS SHEET APPLICANT MAY DISCARD THIS SHEET AFTER READING Any person who knowingly and with intent to injure, defraud or deceive any insurance company, files a statement of fact containing any false, incomplete or misleading information is guilty of a felony. ARKANSAS AND LOUISIANA FRAUD WARNING Any person who knowingly presents a false or fraudulent claim for payment of a loss or benefit or knowingly presents false information on an application for insurance is guilty of a crime and may be subject to fines and confinement in prison. COLORADO FRAUD WARNING It is unlawful to knowingly provide false, incomplete or misleading facts or information to an insurance company for the purpose of defrauding or attempting to defraud the company. Penalties may include imprisonment, fines, denial of insurance and civil damages. Any insurance company or agent of an insurance company who knowingly provides false, incomplete or misleading facts or information to a policyholder or claimant for the purpose of defrauding or attempting to defraud the policyholder or claimant with regard to a settlement or award payable from insurance proceeds shall be reported to the Colorado Division of Insurance within the Department of Regulatory Agencies. KENTUCKY FRAUD WARNING Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance containing any materially false information or conceals for the purpose of misleading information concerning any fact material thereto, commits a fraudulent insurance act, which is a crime. MAINE, TENNESSEE AND VIRGINIA FRAUD WARNING It is a crime to knowingly provide false, incomplete or misleading information to an insurance company for the purpose of defrauding the company. Penalties include imprisonment, fines and denial of insurance benefits. NEW JERSEY FRAUD WARNING Any person who includes any false or misleading information on an application for an insurance policy is subject to criminal and civil penalties. NEW MEXICO FRAUD WARNING Any person who knowingly presents a false or fraudulent claim for payment of a loss or benefit or knowingly presents false information in an application for insurance is guilty of a crime and may be subject to civil fines and criminal penalties. NEW YORK FRAUD WARNING Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance or statement of claim containing any materially false information, or conceals for the purpose of misleading, information concerning any fact material thereto, commits a fraudulent insurance act, which is a crime and shall also be subject to a civil penalty not to exceed five thousand dollars and the stated value of the claim for each such violation. NORTH DAKOTA FRAUD WARNING Any person who knowingly and with the intent to injure, defraud, or deceive any insurance company, files a statement of fact containing any false incomplete or misleading information may be guilty of a felony. OHIO FRAUD WARNING Any person who, with intent to defraud or knowing that he is facilitating a fraud against an insurer, submits an application or files a claim containing a false or deceptive statement is guilty of insurance fraud. The state s citation explicitly notes that the absence of such a warning shall not constitute a defense against prosecution for insurance fraud. PENNSYLVANIA FRAUD WARNING Any person who knowingly and with intent to defraud any insurance company or other person, files an application for insurance or statement of claim containing any materially false information or conceals for the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance act, which is a crime and subjects such person to criminal and civil penalties. MORTGAGE PROTECTION APPLICATION 8/3/2006 Supplemental Sheet - Fraud Warnings Page 5 of 5