b'MEMBERSHIP APPLICATIONName: ______________________________________________________________________________________Company: __________________________________________________________________________________Address: ____________________________________________________________________________________City: ___________________________________________________State: _______Zip +4:_____________Day Phone: __________________Mobile Phone: ___________________Fax: _____________________E-Mail: ______________________________________________________________________________________Power ofAnnual Gross Closings:$ _______________ Referred by: ______________________________________Membership PLEASE LIST ALL LICENSES HELD:License No.Regulator/Issuer (i.e., DRE, NMLS, etc.)___________________________________________________________________________________________Mission Statement ___________________________________________________________________________________________The California Mortgage___________________________________________________________________________________________Association is committed___________________________________________________________________________________________to providing legislative advocacy, legal resources and education programs forHas your license or that of an affiliated company ever been suspended or revoked or have there our members to enhancebeen any complaints within the last ten years?If yes, please provide details:their professionalism.We_____________________________________________________________________________________________believe that the public_____________________________________________________________________________________________goodisservedwhen professionals serve the public. Tell us about your professional work history:_____________________________________________________________________________________________Regular Member _____________________________________________________________________________________________Any reputable individual,_____________________________________________________________________________________________sole proprietorship, corporation, limited liability company, orTell us about your current company history and business focus, branches, employees, and other partnership primarilypertinent details:engaged in the_____________________________________________________________________________________________Mortgage Business in_____________________________________________________________________________________________the state of California._____________________________________________________________________________________________Affiliate MemberAny reputable individual,How did you become aware of CMA?sole proprietorship,_____________________________________________________________________________________________corporation, limited liability company_____________________________________________________________________________________________or partnership who regularly providesDo you know other CMA members?If yes, who?services or products to persons engaged in the_____________________________________________________________________________________________Mortgage Business. _____________________________________________________________________________________________Educational Member PROFESSIONAL REFERENCESAny reputable individual,Name __________________________________________ License Number (if a licensee) _________________sole proprietorship,Firm Name_________________________________________________________________________________corporation, limited liability company orRelationship ________________________________________________________________________________partnership engaged inPhone ________________________________ E-mail_____________________________________________the Mortgage Business who is not subject to theName __________________________________________ License Number (if a licensee) _________________provisions of BusinessFirm Name_________________________________________________________________________________& Professions Code Relationship ________________________________________________________________________________10232(a)-(b) ("thresholdPhone ________________________________ E-mail_____________________________________________broker"), or under any (revised 8/11/16)successor statute. Name __________________________________________ License Number (if a licensee) _________________Firm Name_________________________________________________________________________________Relationship ________________________________________________________________________________Points of InterestWinter 2020/P20h21o ne ________________________________ E-mail______________________________________P__a_g_e_ _2_7'