Emphasys User Request Form

Emphasys User Request Form: Back Office Staff
Lending Institution*
Name of Employer, include DBA if applicable
Lending Institution NMLS #*
Parent Co NMLS, not DPA NMLS
Name (Do not enter name in all caps)*

First NameLast Name
Phone Number*

Area CodePhone Number
E-mail*
Title of Person Making Request (This form is NOT FOR LOAN ORIGINATORS)*
Processor, Clerk, Shipper, Closer etc. LOAN OFFICER IS NOT AN ACCEPTABLE TITLE.
Additional Notes
Should be Empty:

Emphasys User Request Form: Back Office Staff