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2601 N Lamar Blvd Phone: 512-936-7605
Austin TX 78705 Fax: 512-936-7610
occc.texas.gov
EMPLOYMENT VERIFICATION FORM
To be completed by the mortgage loan originator's employer
MLO's NMLS Unique ID Number :
MLO Applicant's Full Legal Name:
__________
I,
________________________________ hereby
certify to the best of my
(Name of certifying officer)
knowledge, information , and belief, that:
___________
(Name of applicant)
Is a bona fide W-2 employee
Is an exclusive agent
Of
OR
(Select only one)
(Legal name of company or organization)
(Company or organization Address as on file with OCCC)
Company or Organization
OCCC License/Registration #:
Furthermore, I certify that the employer:
Holds a Texas Regulated Loan License
Has a pending application for a Texas Regulated Loan License
Holds a Texas Property Tax Loan License
Has a pending application for a Texas Property Tax Loan
License
Is registered under Chapter 347 of the Texas Finance Code for manufactured home credit
transactions
Has filed for Chapter 347 registration, but has not received a registration receipt
The undersigned affirms that all answers on the Employment Verification Form are tru
e and complete.
Signature
Date
Print Name
Tit le
ADM 98
______________________________________________________________________
_______________________________
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