Mortgage Insurance Application
Delegated Full Package Modification–RMIC Cert #
Mortgage Insurance / Borrower-Paid MI Lender-Paid MI
Coverage: / FNMA/FHLMC standard
Other % / Financed $ (If less than entire premium)1
Base Loan Amount $
Payment Option: ZIP® Monthly Monthly Annual Single Premium
Premium Refund: Refund No Refund
Plan Type: Monthlies/ZIP® Monthlies Steady Annuals Singlemax Plus
A-Minus2 Housing Finance Agency LPMIpreferred® Other
Renewal Type: Level Outstanding Balance Single or One Time
FICO & AUS3 Info FICO required on all submission methods. Nontraditional Credit
Representative FICO Score:
Borrower 1 Borrower 2
Borrower 3 Borrower 4 / Complete for DU/LP:
Eligible Ineligible
DU: / Approve Refer Refer w/Caution IV Out of Scope
EA Level: 1 2 3
LP: / Accept A-Minus Caution
Other Approved AUS System: Result:
HMDA Codes
(page 2) / Borrower 1:
Borrower 2: / Race
Race / Gender
Gender / Ethnicity
Ethnicity

Republic Mortgage Insurance Company 101 North Cherry Street • Winston-Salem, NC 27101

Republic Mortgage Insurance Company of Florida 800.999.RMIC (7642) • www.rmic.com

Republic Mortgage Insurance Company of North Carolina AD-5010 (4.09) Revised (7.10)

Loan Submission Fax Numbers: / 877-764-2669 (Delegated loans)
800-250-3503 (All other loans)
RMIC Master Policy # / Originated by: Retail4 Non-Retail
Insured’s Name
Complete if Originator is other than Insured.
Originator’s Name / Address
City, State, ZIP
NMLS Loan Originator Identifier5
NMLS Loan Origination Company Identifier5
Loan Information Doc Type: Full/Alt Doc Waiver6 Other
3/2 Loan Interest Only (Period: years) Affordable Housing Manuf. Home
Lender Program Code/Name
Property:
Units: / Detached Attached
1 2 3 4 / Single Family PUD Townhouse
Condo Co-op Other
If submitting the FNMA 1008/FHLMC 1077: Seller Contribution $
Self-Employed:
Intends to Occupy: / Brwr 1 2 3 4
Brwr 1 2 3 4 / If submitting the FNMA 1003/
FHLMC 65: Appraised Value $
Non-Fixed Payment (if applicable) / Index Value % Index Margin %
Months to Initial Rate Change
Months to Subsequent Rate Change
Potential Negative Amortization7 / Cap Per Initial Adjustment %
Cap Per Subsequent Adjustment %
Lifetime Cap %
Temporary Buydown: / 1-0% 2-1% 3-2-1%
Other / Term: months
Balloon Loan: Term: months
Contact Person / Date
Phone / Fax
Email
Signature of Insured’s Authorized Representative/Agent: X

How to Order RMIC Mortgage Insurance

Full Package

To submit loans for MI with Full Package, send the following:

• RMIC Mortgage Insurance Application

• Completed and signed Residential Mortgage Loan Application (Form 1003/65)

• Credit Report

• Property Appraisal with photographs

• Income Verification

• Assets Verification, if applicable

• Executed Sales Contract, if applicable

• AUS Findings, if applicable

• Additional information pertinent to the underwriting decision

Subsequent steps which may be necessary to complete the process:

• Submit supporting documents as required

• Resubmit to RMIC for additional evaluations as loan terms change during

the process

RMIC Delegated Underwriting

To submit loans for MI through Delegated Underwriting, send the following:

• Completed RMIC Mortgage Insurance Application

• Completed Fannie Mae 1008 or Freddie Mac 1077

The Insured certifies that the loan conforms to the terms and conditions of RMIC’s Delegated Underwriting Agreement, Origination of Loan Endorsement and the RMIC Master Policy, including compliance with RMIC’s underwriting guidelines.

Representative FICO Score

Required for all submission methods

Obtain a FICO (credit score) from a minimum of two credit bureaus per borrower dated within 90 days of submission to RMIC. If only one credit score per borrower or one credit score per file is submitted, it must be the representative score(s).

To determine the representative score(s):

• When two credit bureaus are utilized, choose the lower of the two scores.

• If three credit bureaus are utilized, the middle score should be used.

• If multiple borrowers are associated with the loan file, the lower of all the
individual representative score(s) must be used.

• Indicate if nontraditional credit is used; loans with no FICO scores or loans
with non-viable FICO scores must meet RMIC’s guidelines for nontraditional
credit. RMIC’s nontraditional credit guidelines require a minimum of four
sources of nontraditional credit references with a payment history of at least
12 months. If the rental housing payment includes utilities, a minimum of 3
sources of nontraditional credit is required.

1Financed Amount

This field should be completed if a single premium plan is being used and less than the entire premium is being financed into the loan amount. This field does not have to be completed if the entire single premium is being financed. This field should only be used when the Financed checkbox is checked. If the Financed checkbox is checked and this field is blank, RMIC will assume that the entire single premium is being financed. The financed premium amount can be confirmed by subtracting the Base Loan Amount from the Insured Loan Amount on the RMIC Commitment/Certificate.

2A-Minus Loans

A-Minus must be indicated if the loan meets RMIC’s A-Minus guidelines. Refer to RMIC’s A-Minus underwriting guidelines at www.rmic.com.

3AUS Automated Underwriting System

4Retail

In order for a loan to qualify as Retail, the same entity, with their own personnel, must perform all of the following functions:

• Originate and process; and

• Underwrite (contract underwriting or having the loan underwritten by the
investor is permissible); and

• Fund and close in their own name; and

• Order mortgage insurance coverage under their own RMIC Master Policy.

Loans must be funded from a warehouse line in the lender’s name or using the lender’s own funds. “Table-funded” loans are considered non-Retail loans. The originating lender may sell or assign the closed loan to an aggregator or investor and still be considered Retail. A correspondent who performs all of the above functions is considered Retail.

5Loan Originator Identifiers

Effective for mortgage loan applications taken on or after July 1, 2010, the Federal Housing Finance Agency (FHFA) requires that Fannie Mae and Freddie Mac obtain loan-level Nationwide Mortgage Licensing System and Registry (NMLS) identifiers for the Loan Originator, Loan Origination Company, Field Appraiser, and Supervisory Appraiser. Both agencies have provided instructions to seller customers for providing these identifiers (Fannie Mae Announcement 09-11 and FAQs dated February 4, 2010, Freddie Mac Bulletin 2009-27). RMIC requests the NMLS Loan Originator and Loan Origination Company Identifiers on loans where the originator is other than the Insured.

6Doc Waiver This box should be selected if RMIC has provided written approval
of an Automated Underwriting System or Program that does not require the
documentation of assets and/or income stated on the loan application.

7PNA Not available for 15-year terms or in the state of NY.

HMDA Codes

This information is provided to the FFIEC. Not used for underwriting.

RACE

1 – American Indian or Alaskan Native

2 – Asian

3 – Black or African American

4 – Native Hawaiian or Other Pacific Islander

5 – White

6 – Information not provided by applicant in mail, Internet, or telephone application

7 – Not applicable (applicant is a partnership or corporation*)

8 – No co-applicant (only used in co-applicant field)

GENDER

1 – Male

2 – Female

3 – Information not provided by applicant in mail, Internet, or telephone application

4 – Not applicable (applicant is a partnership or corporation*)

5 – No co-applicant (only used in co-applicant field)

ETHNICITY

1 – Hispanic or Latino

2 – Not Hispanic or Latino

3 – Information not provided by applicant in mail, Internet, or telephone application

4 – Not applicable (applicant is a partnership or corporation*)

5 – No co-applicant (only used in co-applicant field)

*RMIC does not insure loans to partnerships or corporations.

Insured, by its authorized representative/agent, represents that the information provided to RMIC on this form and all additional documentation and information provided to RMIC, whether prepared or submitted by the Insured, originator (if different from Insured), borrower, appraiser or any other person or entity, is true, correct and complete. This representation is relied upon by RMIC in insuring this loan.

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. (Not applicable in OR and VT. Civil penalty not applicable in KY.)

ME, TN, VA, WA: 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.

LA, MA, NV: Any person who knowingly presents a false or fraudulent claim for payment of a loss or a benefit or knowingly presents false information in an application for insurance is guilty of a crime and may be subject to fines and confinement in prison.

OH: 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.

FL, NH: Any person who knowingly and with intent to injure, defraud, or deceive any insurer files a statement of claim or an application containing any false, incomplete, or misleading information is guilty of a felony of the third degree.

D.C.: WARNING: It is a crime to provide false or misleading information to an insurer for the purpose of defrauding the insurer or any other person. Penalties include imprisonment and/or fines. In addition, an insurer may deny insurance benefits if false information materially related to a claim was provided by the applicant.