CCPA Form

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BROKER PORTAL

Please fill out the CCPA Request Form below

First Name

Last Name

Date of Birth (if individual filling out form is the consumer)

Select one (Required)

Please Indicate Your Relationship with Open Wholesale (DBA of Open Mortgage)

Individual Customer

Individual Customer Prospect

Business Customer

Business Prospect

I share a single dwelling with a customer/potential customer

Supplier/Vendor

Potential supplier/vendor

Authorized Agent of a Customer/Potential Customer

Please Specify Your Request *

Do Not Sell My Personal Information

Request a Copy of My Data

Delete Marketing Data – This will remove you from marketing lists

Delete All Data – Delete all data that you hold about me.** This will include deletion of all account information you may have provided us and could affect the services we are able to offer you. (**In accordance with all applicable state and regulatory guidelines)

Additional Comments:

I declare that the info I’ve provided is accurate & complete

Thanks for submitting your request. A team member will contact you shortly if any further action is necessary.

3211 Internet Blvd., Suite 300, Frisco, TX 75034

NMLS# 222730

1-888-602-6626

FHA Lender ID: 7906300005
VA Lender ID: 9010450000

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© 2024 Open Mortgage Wholesale, a DBA of GenWay Home Mortgage, Inc. Corporate Office is located at 3211 Internet Boulevard, Suite 300, Frisco, TX 75034. For Advertisement Purpose Only. All Rights Reserved. NMLS# 222730. Tel: 1-888-602-6626. To see the states where the company is licensed and where the DBA is used, please visit www.nmlsconsumeraccess.org. This website is for informational purposes only and is intended for industry professionals only. This is not an advertisement to extend credit as defined by TILA/Regulation Z nor an application for credit as defined by RESPA/Regulation X. Credit and collateral are subject to approval. Program and other restrictions may apply. Programs, rates, terms, and conditions are subject to change without notice.

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