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2601 N Lamar Blvd Austin TX 78705 occc.texas.gov Phone: 512-936-7605 Fax: 512-936-7610 EMPLOYMENT VERIFICATION FORM To be completed by the mortgage loan originator s employer MLO s NMLS Unique ID Number : MLO Applicant s Full Legal Name: I, hereby certify to the best of my (Name of certifying officer) knowledge, information , and belief, that: (Name of applicant) Is a bona fide W-2 employee OR Is an exclusive agent (Select only one) Of (Legal name of company or organization) (Company or organization Address as on file with OCCC) Company or Organization OCCC License/Registration : Furthermore, I certify that the employer: Holds a Texas Regulated Loan License Has a pending application for a Texas Regulated Loan License Holds a Texas Property Tax Loan License Has a pending application for a Texas Property Tax Loan License Is registered under Chapter 347 of the Texas Finance Code for manufactured home credit transactions Has filed for Chapter 347 registration, but has not received a registration receipt The undersigned affirms that all answers on the Employment Verification Form are true and complete..
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