Form Fis 2137 - Bond - Mortgage Loan Originator - Company - Michigan Department Of Insurance And Financial Services Page 2

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FIS 2137 (10/16) Department of Insurance and Financial Services Page 1 of 2
Bond No.
__________________
Sponsoring Company NMLS ID No. __________________
Bond - Mortgage Loan Originator - Company
Complete this form with original signatures.
_____________________________________________
_____________________________________________
Name of Principal/Sponsoring Company
Name of Surety
_____________________________________________
_____________________________________________
and
Complete physical address
Complete physical address
_____________________________________________
_____________________________________________
City
State
Zip Code
City
State
Zip Code
are held and firmly bound unto the State of Michigan, Department of Insurance and Financial Services (“Office”), for the use of said
State or Office on behalf of, and to the benefit of, said state or any person or persons who may have a cause of action against any
individual operating as a loan originator on behalf of the above Principal under the provisions of Act No. 75, Public Acts of 2009, as
amended (hereinafter, the “Mortgage Loan Originator Licensing Act”), in the sum of $________________________ , lawful money of
the United States, to be paid to the Director, Department of Insurance and Financial Services of said State of Michigan on behalf of the
People of the State of Michigan, or its assigns, for payment to be well and truly made, we bind ourselves, our heirs, executors,
administrators, successors, and legal representatives, jointly and severally, firmly by these presents.
Any claim for payment under this bond shall be made through the Director of the Department of Insurance and Financial Services of
the State of Michigan.
WHEREAS, the above PRINCIPAL employs mortgage loan originators that are licensed or about to be licensed by the Director,
Department of Insurance and Financial Services of said State of Michigan under the provisions of the Act to act as a mortgage loan
originator on behalf of the above PRINCIPAL; and,
WHEREAS, the Act requires as a condition precedent to the issuance of a mortgage loan originator license that a mortgage loan
originator be bonded in a certain amount based upon provisions of the Act; and,
WHEREAS, the Act provides that, in lieu of an individual bond from each licensed mortgage loan originator, the Director may accept a
single surety bond from a sponsoring company that covers each and every mortgage loan originator that it employs; and,
WHEREAS, the above PRINCIPAL desires to provide a single surety bond to cover each and every loan originator that it employs or
has an exclusive agent agreement and provides this bond for that purpose.
NOW, THEREFORE, the condition of this obligation is such, that if each and every individual operating as a loan originator on behalf of
the above said principal will conform to and comply with each and every provision of the Act, and all rules and regulations lawfully
promulgated thereunder by the Director, Department of Insurance and Financial Services of the State of Michigan, and will pay to said
State and to such person or persons, any and all monies that may become due or owing to said State and to such person or persons
from the obligor, principal, and by virtue of the provisions of said Act, then this obligation shall be void, otherwise it is to remain in full
force and effect.
This bond shall be effective________________________, 20___, and shall be in force for the term ending December 31, 20___. This
bond may be continued in force for an additional term or terms by suitable continuation certificates executed by the surety with the
approval of the Director, pursuant to such regulations as may hereafter be provided.

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