Institution Type & License Number(s)

Institution Type

Credit Union
Mortgage Banker
Mortgage Broker

Enter all numbers that apply

Company Information

Organizational Principals


Provide one of the following

Add an Organizational Principal

Provide one of the following

Provide one of the following

Provide one of the following

Provide one of the following


Agency Investor Approvals


Other Investor Approvals

Submission Preference
Delegated (submit electronically)
Non-Delegated (submit full file)
Contact with MGIC Account Manager
Yes No
Comments (optional)
Master Policy Contact

If additional information is needed for this application or for any future Master Policy questions/communications, contact will be made to this individual.

Same as Authorized Submitting Representative

Authorized Submitting Representative

The authorized submitter certifies that he/she has been duly authorized to submit this application on behalf of the lender.

I have applied for an MGIC Master Policy, providing company information pertaining to location, principals, institution type, and key contact information. I certify that all of the information is true and complete.

To the best of my ability, I have made no misrepresentation on the application, nor did I omit any pertinent information.

I understand and agree that MGIC reserves the right to verify with my company the information provided on the application.