FIS 2135 (3/10) Office of Financial and Insurance Regulation Page 1 of 1
Bond - Mortgage Loan Originator – Individual Instructions for form FIS 2135 (Revised 6/19)
• FIS 2135 is to be submitted by an individual that is not covered under the company bond FIS
2137.
• The surety bond is to be completed by a surety company that is approved to write surety
bonds in the State of Michigan.
• Bond Number: Required – the number is to be provided by the surety company.
• Loan Originator NMLS ID No.: Required - number issued by NMLS to the individual loan
originator.
• Name of Principal: Required - name of the individual loan originator.
• Bond Amount: Required - as determined below:
o $10,000 - if the individual is applying for a loan originator license for the first time.
o $10,000 - if the individual is currently licensed as a loan originator that did not close any
mortgage loans in the preceding calendar year, or the sum of the principal amounts of
mortgage loans closed by the mortgage loan originator in the preceding calendar year is
less than $12,000,000.
o $25,000 - if the sum of the principal amounts of mortgage loans closed by the licensed
mortgage loan originator in the preceding calendar year is $12,000,000 or more and less
than $24,000,000.
o $50,000 - if the sum of the principal amounts of mortgage loans closed by the mortgage
loan originator in the preceding calendar year is $24,000,000 or more.
• The surety bond must be signed by the Attorney in Fact and the individual loan originator
(Principal).
• The original surety bond is to be submitted to DIFS with the Surety Power of Attorney to one of
the addresses below.
When complete, please mail to: Our Delivery address is:
DIFS – Consumer Finance DIFS – Consumer Finance
PO Box 30220 530 W. Allegan Street, 7
th
Floor
Lansing MI 48909-7720 Lansing MI 48933
FIS 2135 (6/19) Department of Insurance and Financial Services Page 1 of 1 Bond No. __________________
Originator NMLS ID No. __________________
Bond - Mortgage Loan Originator - Individual
Complete and attach this form with original signatures to your new application or renewal checklist.
_____________________________________________ _____________________________________________
Name of Principal Name of Surety
_____________________________________________ _____________________________________________
Complete physical address and Complete physical address
_____________________________________________ _____________________________________________
City State Zip Code City State Zip Code
are held and firmly bound unto the State of Michigan, Department of Insurance and Financial Services (“Office”), for the use of said
State or Office on behalf of, and to the benefit of, said state or any person or persons who may have a cause of action against the
above Principal under the provisions of Act No. 75, Public Acts of 2009, as amended (hereinafter, the “Mortgage Loan Originator
Licensing Act”),in the sum of $________________________ , lawful money of the United States, to be paid to the Director, Department
of Insurance and Financial Services of said State of Michigan on behalf of the People of the State of Michigan, or its assigns, for
payment to be well and truly made, we bind ourselves, our heirs, executors, administrators, successors, and legal representatives,
jointly and severally, firmly by these presents.
Any claim for payment under this bond shall be made through the Director of the Department of Insurance and Financial Services of
the State of Michigan.
Whereas, the above bounden principal has received, or is about to receive, a license from the Director, Department of Insurance and
Financial Services of said State of Michigan authorizing the PRINCIPAL to engage in the business of a mortgage loan originator under
the provisions of the Act.
The condition of this obligation is such, that if the said principal will conform to and comply with each and every provision of the Act,
and all rules and regulations lawfully promulgated thereunder by the Director, Department of Insurance and Financial Services of the
State of Michigan, and will pay to said State and to such person or persons, any and all monies that may become due or owing to said
State and to such person or persons from the obligor, principal, and by virtue of the provisions of said Act, then this obligation shall be
void, otherwise it is to remain in full force and effect.
The term of this bond shall be continuous. The Surety may terminate the bond upon giving a sixty-day notice, delivered in writing, to
the Department of Insurance and Financial Services of the State of Michigan and the Principal; however, the liability of the surety for
the acts of the Principal shall continue during the sixty-day period. The notice shall not release the Surety from liability which accrues
before the termination becomes final, but which is discovered after that date.
Sealed with our seals, and dated this _______ day of ________________________, 20___.
In the presence of
Witness Signature Surety Signature
Witness name, typed or printed Surety name, typed or printed
Witness Signature Principal Signature
Witness name, typed or printed Principal name, typed or printed
Authorized under Act No. 75 of the Public Acts of 2009, as amended. Required for Mortgage Loan Originator applicants and licensees. Failure to properly file may result in denial or revocation of your license or
application for licensure.
