Claim of Exemption from the NC SAFE Act
or Non-Profit Enrollment

Entity Name:

Type of Institution:

Is the institution registered with
the NC Secretary of State?:
Registration is required to process a claim of exemption

Yes

Contact Information

First Name:

Last Name:

Phone:

Email Address:

Institution Information

Assumed Name:

No DBA:

Street address:

Suite, unit, etc (optional):

City:

State:

Zip:

NMLS Number:

Tax ID:

Non-Profit Mortgage Business Information

Please describe how your organization promotes affordable housing, or provides homeownership education, or similar services.

Please describe how your organization conducts its activities in a manner that serves public or charitable purposes, rather than commercial purposes.

How does your organization receive funding and revenue?

Please describe how your mortgage loan originators are compensated. Are they incentivized?

Please describe how your organization provides and identifies residential mortgage loan terms favorable to the borrowers.

Are the mortgage loans and terms offered by your organization comparable to mortgage loans and housing assistance provided under government housing assistance programs?

Provide proof of nonprofit status:

Internal Revenue Service (“IRS”) 501(c)(3) designation letter; or
statement from a State taxing body or the State attorney general certifying that:
1. the entity is a nonprofit organization operating within the State; and
2. no part of the entity’s net earnings may lawfully benefit any private shareholder or individual; or
entity's certificate of incorporation or organization, or similar document if it clearly establishes the nonprofit status of the applicant; or
Any of the preceding items described, if that item applies to a State or national parent organization, together with a statement by the State or parent organization that the applicant is a local nonprofit affiliate.

Provide a business plan for the activities you plan to perform on residential mortgage loans for North Carolina consumers.

Consumer Assistance: 919-733-3016 | Email : [email protected]
Home Page

Physical Address: 316 W. Edenton Street, Raleigh, NC 27603 (Google Map)
Mailing Address: 4309 Mail Service Center, Raleigh, NC 27699-4309