Step 1 of 3 33% Qualified applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, marital or veteran status, or disability. All qualified applicants will be given equal opportunity and selection decisions are based on job-related factors.Personal DataName* First Middle Last List All Alias (Names) Including MaidenPresent Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home Phone*Cell Phone*Email* Are you eligible for employment in the U.S.?*YesNoIf hired, can you furnish proof of eligibility to work in the U.S.?*YesNoDesired PositionPosition applied for*Rate of pay expected (if applicable)Are you seeking:* Full-time Part-time Specify days and hours*If your application is considered favorable, on what date would you be available for work?*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year20202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Are there any other experiences, skills, or qualifications which you feel relate to the position for which you are applying? EducationSchoolsPlease include high school, college, other schooling, and any additional training or skills.NameLocationYrs. CompletedMajor/Degree Employment HistorySchoolsPlease provide information for previous TEN years.Dates (start-end)Employer Name, Address, PhoneName of SupervisorMajor DutiesEnding WageReason for Leaving Licenses/CertificationsDo you currently hold any licenses or certifications sanctioned by State or Federal regulatory agencies, i.e. real estate broker license, mortgage loan originator license.*YesNoSchoolsLicense/CertificationIssuing AuthorityStatus (Active, Inactive, Revoked) MilitaryWere you in the U.S. Armed Forces?*YesNoWhat branch?FromMonth123456789101112Day12345678910111213141516171819202122232425262728293031Year20202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920ToMonth123456789101112Day12345678910111213141516171819202122232425262728293031Year20202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Rank at dischargeList duties in the service, including special training How did you hear about us?How did you hear about us?* Priority Mortgage Employee Walk-In Advertisement Employment Agency Friend/Relative Other Please specifyEmployment At WillEmployment relationships of all employees are terminable at any time at the discretion of Priority Mortgage Corp. or any individual employee and are considered to be “at will.” Employment may be terminated at any time at the discretion of either Priority Mortgage Corp. or the employee. Supervisors and all other Company representatives involved in the hiring process will refrain from making any statement or providing any assurance of job security or continued employment to prospective or newly hired employees. Similarly, in their dealings with employees, supervisors must not make any promises or assurances of continued employment in the event of satisfactory performance. No manager or supervisor in the company, other than the Chief Executive Officer of the Company, is authorized to enter into an employment contract (written or oral) with any employee.Initial*General Employee Conduct - DO NO HARMIt is the expectation of Priority Mortgage Corp., that all employed by the Company take responsibility for acceptable conduct and behavior; adhere to acceptable business principles in matters of personal conduct; and exhibit a high degree of personal integrity at all times. Employees are to refrain from any behavior that may be offensive or harmful to clients, co-workers, business associates and ultimately the reputation of Priority Mortgage Corp. Employee conduct at all times is a reflection of the Company and all employees are expected to observe the highest standards of professionalism and courtesy at all times. I hereby attest that I in no way will violate the above upon active employment with Priority Mortgage Corp.Date*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year20202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Signature*HUD PolicyThe HUD Handbook 4060.1, REV‐2 , Chapter 2, Part A, 2‐9 states a loan officer must work exclusively for the lender and cannot work as a real estate agent (even on a part-time basis) for another company at the same time they are working for the lender. Lender employees, such as loan officers, underwriters, processors and other support personnel must work exclusively for the lender and cannot work (even on a part-time basis) for other lenders or other companies engaged in the real estate, mortgage finance business, or a related field at the same time they are working for the lender. I hereby attest that I in no way will violate the above upon active employment with Priority Mortgage Corp.Date*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year20202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Signature*Certification and AssentI certify the answers given by me to the foregoing questions and statements are true and correct without consequential omissions of any kind. I agree the company shall not be liable in any respect if my employment is terminated because of falsifying of statements, answers or omissions made by me in the application. I also authorize the companies, schools or persons named above to give any information regarding my employment, character or qualifications. I hereby release said entities from liability for any damage for issuing this information. I further acknowledge that any incorrect or misleading statements may render this application void and if employed, would be cause for termination. I also understand that employment and continued employment may be conditional upon securing and retaining my Loan Officer’s License, issued by the State(s) of Florida, Ohio and or West Virginia (applicable to Loan Officer Applicants). Finally, I acknowledge, in the event I should no longer be employed by Priority Mortgage Corp., and provide said company as a reference for future employers, I will not find them (Priority Mortgage Corp. or any manager/owner) to be liable for information provided to potential employer(s). I hereby acknowledge that I have read and understand the above statement. Date*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year20202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Signature*