Please print this form, fill in the needed information and return by fax to us.

AGENT SIGN-UP FORM

Part 1 – Firm Information

 1). Firm Name____________________________________________________________

 2). Firm Address__________________________________________________________

 3). City________________________ State___________ Zip_______________________

 4). Phone (     )___________________       5). Fax (     )___________________________

 6). Email Address_________________________________________________________

 7). Type of Business (check all that apply):

             ___Mortgage Broker               ___Direct Lender                    ___Loan Officer

             ___Wholesale Lender             ___Real Estate Broker            ___Title Company

             ___Escrow Company              ___Appraiser                          ___Signing Service

             ___Other__________________________________________________________

 8). Contact Person_________________________________________________________
                                         (please print)

7). How much do you plan to charge for each signup? _____________________

Part 2 – Agreement

The client firm listed in this agreement will be provided the following:

• Loan analysis software, including installation, training and support.

• Procedure Manual, including step by setup instructions on using The Mortgage MAXIMIZER when originating loans.

• Other presentation material developed by The Mortgage MAXIMIZER, in Microsoft Word format.

Upon receipt of enrollment documents, The Mortgage MAXIMIZER will do the following:

• Directly furnish the borrower a Verification of Enrollment and Biweekly Debit Date Schedule.

• Accurately service the borrower’s loan(s) in accordance with the Enrollment Agreement.

• Provide ongoing customer service to all borrowers.

Fee Structure:

• The client firm will pay a monthly license fee of $50, to be paid by automatic debit from Client Firm’s bank account.

• The client firm will pay The Mortgage MAXIMIZER a fee of $75 per loan enrolled in the program.

• The Client Firm may charge the borrower any enrollment fee deemed appropriate.

• The Mortgage MAXIMIZER charges each enrolled borrower a transaction fee of $3.95 per debit.

Startup cost:

By authorized signature below, the Client Firm hereby authorizes The Mortgage MAXIMIZER to electronically debit its designated bank account in the amount of $50, said debit to begin on the first Friday of each month with a prorated amount for based on the date of signup for this program.  A voided check must be included for this purpose. 

IMPORTANT:  Please fax this signed document with voided check on “high or fine” resolution to our secure toll free fax number 1 (877) 429-8619.  We will prorate your account for the rest of this month and make arrangements to deliver the software to you so you can start right away.  We send the software priority US mail unless you provide us with your overnight number for Fed X, UPS or Airborne below.

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