STATE OF CALIFORNIA DEPARTMENT OF CORPORATIONS INFORMATION ON THE APPLICATION FOR A LENDER’S AND/OR BROKER’S LICENSE CALIFORNIA FINANCE LENDERS LAW The following is provided as general information to prospective applicants and is not to be construed as and is not an interpretation of the provision of the provisions of the California Finance Lenders Law (commencing with Section 22000 of the Financial Code). If you do not know if you need a license you should contact an attorney, as the Department does not offer legal advice. DEFINITION OF A “FINANCE LENDER” In general, a “Finance Lender” is defined as any person who is engaged in the business of making consumer loans or commercial loans. These loans may be unsecured, secured by personal property and for loans over $5,000 by real property or a combination of real and personal property. The definition of a “Finance Lender” in its entirety is contained in Financial Code Section 22009. DEFINITION OF THE BROKER (NEGOTIATOR) LICENSE A broker (negotiator) license authorizes the licensee to engage in the business of negotiating loans or performing any act as a negotiator in connection with loans made by a lender licensed under the California Finance Lenders Law. Licensees are NOT PERMITTED to broker loans to banks, savings & loans, credit unions, or thrift & loans under this license. A broker may NOT make any direct loans under this broker license. LICENSE APPLICATIONS x Application forms may be obtained from any office of the Department as well as from our website at www.corp.ca.gov . The office locations are as follows: 320 W. 4th Street, Suite 750 71 Stevenson Street, Suite 2100 1515 K Street, Suite 200 1350 Front Street, Room 2034 Los Angeles, CA 90013 San Francisco, CA 94105 Sacramento, CA 95814 San Diego, CA 92101 1-866-ASK-CORP (866-275-2677) x Questions regarding completing and filing an application should be directed to 1-866-ASKCORP (866-275-2677). x Completed applications should be filed with the Los Angeles office. The application MUST be accompanied by $300 in NON-REFUNDABLE fees plus the cost of fingerprinting. (see Page 1 of the application). x Under the Law an applicant may be licensed as an individual, partnership, corporation or other form of “Person” as defined in Financial Code Section 22008. Once a license has been issued it is NOT transferable or assignable. 1422 – CFLL Instructions 1 American LegalNet, Inc. www.FormsWorkflow.com x SURETY BOND REQUIRED: Section 22112 was added to the California Finance Lenders Law on January 1, 1996. This section requires each licensee to obtain and maintain a surety bond in the amount of twenty five thousand dollars ($25,000). Instructions and a surety bond form acceptable to the Department are enclosed in this packet. GENERAL INFORMATION Federal Laws Applicable to Consumer Lenders The two comprehensive bodies of federal laws affecting lenders are the Truth in Lending Act, which is implemented by Regulation Z, and the Equal Credit Opportunity Act, which is implemented by Regulation B. Information concerning these laws and regulations may be obtained by calling the Federal Reserve Bank of San Francisco at (415) 974-2000. Obtaining copies of the California Finance Lenders law and Regulations Each applicant is required to obtain and read Division 9 of the California Financial Code (commencing with Section 22000) known as the “California Finance Lenders Law” and the California Code of Regulations (contained in Title 10, Chapter 3, commencing with Section 1404) prior to the submission of the application package. You should obtain the California Finance Code and the Regulations prior to the submission of the application to the Department. These items may be purchased from the following organizations: West Group 50 California Street, 19th Floor San Francisco, CA 94111 (800) 888-3600 GENERAL REQUIREMENTS OF LICENSEES The following are a few of the areas that should be consider prior to filing an application for a California Finance Lenders License . x x x x x x Licensees are subject to periodic regulatory examinations that the licensee must pay for. Licensees must pay an annual assessment each year. Licensees must file an Annual Report by March 15th each year. Licensees are subject to statutory books and record requirements. Licensees are responsible for compliance with all applicable laws and regulations. Licensees must maintain a $25,000 surety bond at all times. 1422 – CFLL Instructions 2 American LegalNet, Inc. www.FormsWorkflow.com STATE OF CALIFORNIA DEPARTMENT OF CORPORATIONS INSTRUCTIONS FOR COMPLETING THE APPLICATION FOR A LICENSE UNDER THE CALIFORNIA FINANCE LENDERS LAW (CFLL) ASSISTANCE WITH THE APPLICATION: Refer to these instructions while completing the CFLL application. If you have questions about the application that are not answered by these instructions, call the Department of Corporations’ toll-free telephone number at (866) 275-2677. Departmental personnel cannot provide individual legal or accounting advice. Applicants who need such advice must consult a qualified professional. FEES AND PROCESSING OF THE APPLICATION: The application and all exhibits must be typewritten. All signatures must be original and not a copy. Attach additional sheets if you need more space to complete an answer to any of the questions, answer every question in the application, unless these instructions direct otherwise, and label these answers by the corresponding question number or exhibit letter. The application, including all exhibits, must be accompanied by a nonrefundable application fee of $200, an investigation fee of $100, and fingerprint processing fees. The applicable fingerprint processing fee is $20 per individual if the individual resides in California. If the individual resides outside of California, the applicable fingerprint processing fee is $86 per individual. The application fee, investigation fee, and fingerprint processing fees are not refundable if the application is denied or withdrawn. Detailed instructions for the fingerprint processing requirements are listed below under “Exhibit C.” Make check(s) payable to the Department of Corporations for the total amount of all fees. The application, exhibits, and fees must be filed only in the Los Angeles office of the Department of Corporations, located at 320 West 4th Street, Suite 750, Los Angeles, California 90013. Applications which do not include all required information and exhibits will not be processed. THE CFLL APPLICATION: References to exhibits in these instructions pertain to specific documents that must be submitted with the CFLL application. The headings used in these instructions correspond to the application item numbers and exhibit letters in the CFLL application. COVER PAGE OF APPLICATION: Check one box only to reflect the type of license for which you are applying, either “Lender” or “Broker” or “Both.” Do not check more than one box. 1422 – CFLL Instructions 1 American LegalNet, Inc. www.FormsWorkflow.com ITEM NUMBER 1 OF APPLICATION: 1.a. Name of Applicant: Provide the applicant’s legal name. For individuals (sole proprietors), list first, middle and last name. If a sole proprietor applicant has no middle name, indicate, e.g., “John [no middle name] Smith.” Note: Some foreign entities are required by the California Secretary of State’s office to use an assumed name for all business they conduct in California. Such entities should provide that assumed name as the “Name of Applicant” and may only use that name. Such entities are not permitted to use a fictitious business name. 1.b. Fictitious Business Name: An applicant who intends to conduct CFLL business under a fictitious business name that is different from its legal name should list the fictitious business name here. Enter the name exactly as it appears on the Fictitious Business Name Statement as filed with the county clerk. The fictitious business name must be provided in addition to the legal name. Applicants who intend to conduct business under a fictitious business name are required to comply with the rules governing the filing of a fictitious business name as set forth in the Business and Professions Code, beginning at Section 17900. 1.c. Filing of Fictitious Business Name: Provide the name of the county in which the fictitious business name is filed. The fictitious business name must be filed in the county of the applicant’s main office address. ITEM NUMBER 2 OF APPLICATION: Applicant is Organized and Will Do Business as: Check the appropriate box to indicate the organizational form of the applicant. ITEM NUMBER 3 OF APPLICATION: Applicant’s Licensed Place of Business: Provide the applicant’s full proposed place of CFLL business, including number and street, city, county, state, and zip code. An additional CFLL license is required for each additional business location. ITEM NUMBER 4 OF APPLICATION (Sole Proprietor Applicants ONLY): This item is to be completed only by applicants who are sole proprietors and not organized as any other form of business. 4.a. Name of Sole Proprietor Applicant: List the sole proprietor’s full first, middle, and last name. If the applicant has no middle name, indicate, e.g., “John [no middle name] Smith.” 1422 – CFLL Instructions 2 American LegalNet, Inc. www.FormsWorkflow.com 4.b. Person(s) Who Will Be In Charge of the Place of Business: Provide the full name, address, telephone number, and e-mail address of all managers as “person(s) who will be in charge of the place of business.” “Managers” are persons with authority to manage the operations of the organization in California. 4.c. Agent for Service of Process (Sole Proprietor Applicants Outside of California ONLY): Provide the name and address of the applicant’s agent for service of process in California. Provide this information if the applicant has an agent in California who is authorized to accept service on its behalf. As an example, it is common for persons to authorize their attorney to accept service of process on their behalf. Indicate if there is no authorized agent for service of process in California by stating “none”. ITEM NUMBER 5 OF APPLICATION (Partnership Applicants ONLY): This item of the application must be completed only by applicants organized as a general or limited partnership. 5.a. Organization: Include the full date (month, day, and year) and the state where the partnership was organized. 5.b. General Partners: Provide the requested information for all general partners and indicate if the general partner is a managing general partner by checking the box. 5.c. Person(s) Who Will Be In Charge of the Place of Business: Provide the full name, address, telephone number, and e-mail address of all managers as “person(s) who will be in charge of the place of business.” “Managers” are persons with authority to manage the operations of the organization in California. 5.d. and 5.e. Other Persons: List the full name of any other person with direct involvement in the applicant’s proposed activities under the CFLL license in 5.d. and any person that owns or controls, directly or indirectly, 10% or more of the applicant in 5.e. 5.f. Agent for Service of Process (General Partnership Applicants ONLY): Provide the name and address of the applicant’s agent for service of process in California. Provide this information if the applicant has an agent in California who is authorized to accept service on its behalf. For example, it is common for persons to authorize their attorney to accept service of process on their behalf. Indicate if there is no authorized agent for service of process in California by stating “none”. 1422 – CFLL Instructions 3 American LegalNet, Inc. www.FormsWorkflow.com ITEM NUMBER 6 OF APPLICATION (Corporations and Other Business Entities): Complete this item of the application only if the applicant is applying as a corporation, limited liability company, joint venture, association, joint stock company, trust, unincorporated organization, government, or political subdivision of a government. 6.a. Organization: Include the full date (month, day, year) of organization and the state where the applicant was organized. 6.b. Officers and Directors: List the full name of each of the officers, directors, managers, and trustees. 6.c. Person(s) Who Will Be In Charge of the Place of Business: Provide the full name, address, telephone number, and e-mail address of all managers as “person(s) who will be in charge of the place of business.” “Managers” are persons with authority to manage the operations of the organization in California. 6.d. and 6.e Other Persons: List the full name of any other person with direct responsibility for the applicant’s proposed activities under the CFLL license in 6.d. and any other person that owns or controls, directly or indirectly, 10% or more of the applicant in Item 6.e. ITEM NUMBER 7 OF APPLICATION: Regulatory or Other Action: Financial Code Section 22109 states that an application may be denied if the applicant or other interested parties have committed specific acts. Check the appropriate box to indicate whether the applicant has been subject to any administrative or criminal action, or any civil action involving an act of dishonesty, fraud, or deceit in California, any other state, or foreign jurisdiction. Describe, if applicable, by providing the information requested. Attach a copy of each action. ITEM NUMBER 8 OF APPLICATION: Other Business at Location: Financial Code Section 22154 requires written authorization from the California Corporations Commissioner to conduct non-CFLL business from a CFLL-licensed location. Check the appropriate box. Describe, if applicable, any other business that will be conducted from the same location as the CFLLlicensed business. If none, so state. 1422 – CFLL Instructions 4 American LegalNet, Inc. www.FormsWorkflow.com ITEM NUMBER 9 OF APPLICATION: Bonding Agent: Provide the name, address, and telephone number of the bonding agent that the Department can contact regarding the applicant’s surety bond. ITEM NUMBER 10 OF APPLICATION: 10.a. Proposed Activities: This item of the application requires the applicant to provide basic information regarding its proposed activities. Check the appropriate boxes to indicate the type of collateral that will be securing the loans that you are making or brokering, and indicate the corresponding minimum dollar amount of the loans made or brokered. Check all boxes that are applicable. There is a statutory minimum of $5,000 or more for commercial purpose loans and consumer loans secured by real estate. 10.b. Business Plan: Provide a short description of how the applicant plans to conduct business under the CFLL license. Include any information necessary for the California Corporations Commissioner to have an understanding of the type of business that the applicant plans to conduct under this license. ITEM NUMBER 11 OF APPLICATION: Qualification of Securities: Check the appropriate box to indicate whether the applicant’s offer and sale of securities have been qualified in California. Under the Corporate Securities Law of 1968, companies, individuals or other entities that offer and sell securities including common stock, debt, limited partnership interests or limited liability company membership interests, employee stock options, etc. in California must claim an exemption or qualify the offering by filing an application. If exempt, the applicant must have the appropriate limited/small offering exemption notice on file with the Department. Please contact our Customer Service Office at 1-866-ASK-CORP (1-866-275-2677) for further information. EXHIBITS EXHIBIT A: Balance Sheet Exhibit A requires each applicant (i.e., the person identified as “Name of Applicant” in Item Number 1) to submit a financial statement in the form of a balance sheet prepared according to generally accepted accounting principles that is dated no more than 90 days before the date that the application is filed with the Department. For example, if the applicant is a corporation, then submit a balance sheet for the corporation. If the applicant is a sole proprietor, then submit a personal balance sheet. Label the balance sheet as Exhibit A. The applicant must meet and maintain a minimum net worth of $25,000 at all times. (Financial Code Section 22104.) If the applicant does not meet this net worth requirement as evidenced by the balance sheet submitted with the application then the application cannot be approved. Applicants needing assistance should consult an accountant. 1422 – CFLL Instructions 5 American LegalNet, Inc. www.FormsWorkflow.com EXHIBIT B: Surety Bond Provide the original surety bond, including riders and endorsements, in the amount of $25,000. A bond form and instructions are enclosed. To complete the bond form: 1. Read the instructions on the bond form before completing the bond. 2. The bond and the cover page of the bond must be in the name of the applicant as provided in Item Number 1 of this application under “Name of Applicant”. 3. The bond must be signed by the applicant (if the applicant is a sole proprietor), or by one of the individuals named in Item Number 4, 5, or 6 of the application and who is authorized to sign on behalf of the applicant, in the space designated “Signature of Principal”. 4. The signature of the applicant must be notarized. 5. The bond must contain the original power-of-attorney-form issued by the surety bond company. 6. The bond must be signed by the surety bond company in the space designated “Signature of Attorney-in-Fact for Surety” and the signature must be notarized. EXHIBIT C: Statement of Identity and Questionnaire Each individual (natural person) named in Item Numbers 4, 5, and 6 of the application must complete a Statement of Identity and Questionnaire. Submit the Statement of Identity and Questionnaire with the fingerprint information and the cost of fingerprint processing (discussed below). The 10-year employment and residence histories in the Statement of Identity and Questionnaire must be complete and accurate. Attach copies of all pertinent court and other documents requested. The Statement of Identity and Questionnaire must be notarized if executed outside the State of California. If an entity owns or controls 10% or more of the applicant, a Statement of Identity Questionnaire and fingerprints must be submitted for each officer, director, general partner, or managing member, as applicable, unless the applicant or entity can make the following representation in a separate cover letter that is incorporated by reference into the CFLL application: 1. ________________________________________ is a passive investor and is not responsible in any (Name of Entity) way for the conduct of the applicant’s lending activities in California. Therefore, it is unnecessary to investigate any individuals managing or controlling _____________________________. (Name of Entity) 2, Describe whether the entity has engaged in any act that would constitute a reason for the California Corporations Commissioner to deny a license under Financial Code Section 22109 and if so, fully disclose the acts. 1422 – CFLL Instructions 6 American LegalNet, Inc. www.FormsWorkflow.com A public company may submit fingerprints only for persons not included on the public company’s Form 10K, Form 10-Q or other similar document filed with the Securities and Exchange Commission. The applicant must submit a copy of Form 10-K, Form 10-Q, or other similar document that includes the name of the individuals not submitting fingerprints. Statement of Identity and Questionnaires must still be completed for all individuals. For purposes of this paragraph, “public company” means a company whose securities are listed or designated on a national securities exchange certified by the California Corporations Commissioner under Subdivision (o) of Section 25100 of the California Corporations Code. Fingerprints All individuals named in Item Numbers 4, 5, and 6 of the application must submit fingerprints and related information to the Department of Corporations with the application, for the purposes of conducting a criminal history background check. (Financial Code Section 22101.5.) Applicants must pay for the cost of processing the fingerprints. In-State Individuals: Each individual named in Item Numbers 4, 5, and 6 of the application who resides in California must complete a “Request for Live Scan Service” form. The triplicate form can be printed from the Department of Corporation’s website at www.corp.ca.gov. At the home page, select “Applications & Forms” and then select “Financial Services Divisions”. Under “California Consumer Finance Lenders”, select “Request for Live Scan Service – Applicant Submission (BC8018CFLL)” and print the form. Adobe Reader 7.x is required to download the form correctly. The individuals must take the three-part form to a live scan location to have their fingerprints taken by the operator and submitted electronically to the California Department of Justice for processing. The applicant will be required to pay the fees charged by the California Department of Justice for processing the fingerprints directly to the live scan operator. The Attorney General’s website at http://caag.state.ca.us/fingerprints/publications/contact.htm has current information concerning the Department of Justice’s fees and the location of live scan terminals. You may also call the Department of Corporations at (866) 275-2677 for information concerning the location of live scan terminals. Submit the “Requesting Agency Copy” of the “Request for Live Scan Service” form and a processing fee of $20 per individual for live scan submission with the CFLL application and the Statement of Identity and Questionnaire to the Department of Corporations. Make the check for the fingerprint processing fees payable to the Department of Corporations. Out-of-State Individuals: Individuals residing outside of California are encouraged to come to California, if practical, to have their fingerprints taken and submitted electronically through California’s Live Scan process, to significantly decrease the processing time. However, an out-of-state individual named in Item Numbers 4, 5, and 6 may provide fingerprint images to the Department of Corporations on fingerprint cards. Call the Department of Corporations at (866) 275-2677 to obtain fingerprint cards. The Department of Corporations will mail the fingerprint cards to you. In addition, you must also complete a “Request for Exemption from Mandatory Electronic Fingerprint Submission Requirement” form, available from the Attorney General’s website at http://caag.state.ca.us/fingerprints/pdf/bcii9004.pdf. The fee to process the fingerprint card is $86 per individual, which includes the Department of Corporation’s processing fee of $20 and the Department of Justices’ processing fee of $66. Make the check for all fees payable to the Department of Corporations. Submit the fingerprint cards, “Request for Exemption from Mandatory Electronic Fingerprint Submission Requirement” form, the fees, and the Statement of Identity and Questionnaire with the CFLL application to the Department of Corporations. 1422 – CFLL Instructions 7 American LegalNet, Inc. www.FormsWorkflow.com EXHIBIT D: (Sole Proprietor Applicants ONLY): Proof of Legal Presence Exhibit D is the “Statement of Citizenship, Alienage, and Immigration Status for Application of Department of Corporations License or Certificate,” which must be completed and submitted by sole proprietor applicants. Include copies of the acceptable proof of citizenship as outlined in List A of the Statement of Citizenship, Alienage, and Immigration Status. Complete this form and submit proof of your citizenship only if applying for the license as a sole proprietor. Officers of corporations, limited liability companies or partnerships are not required to complete this form. EXHIBIT E: Authorization for Disclosure of Financial Records Exhibit E is the “Customer Authorization for Disclosure of Financial Records”. Submit this form as part of the application package. The form must be signed by an individual named in Item Numbers 4, 5, or 6 of the application and who is authorized to sign on behalf of the applicant. EXHIBIT F: Fictitious Business Name Statement Submit a copy of the current Fictitious Business Name Statement with the “filed stamp” from the county clerk’s office. The applicant’s name must appear as a registrant on the Fictitious Business Name Statement. Label this document as Exhibit F. EXHIBIT G: All Corporate Applicants Incorporated In Any State Corporations must submit an ORIGINAL certificate of qualification or good standing from the Secretary of State or other authority of the applicant’s state of incorporation. The name on the certificate must match the name listed in Item Number 1 of the application. The certificate must also indicate the original date of incorporation. Label this document as Exhibit G. EXHIBIT H: (Foreign Corporations ONLY): Additional Requirements for Applicants Incorporated In States Other Than California Applicants incorporated OUTSIDE the State of California must submit an original certificate of qualification or good standing issued by the California Secretary of State, in addition to the document required in Exhibit G. Foreign corporations must register and qualify the corporation to conduct business in the State of California as a foreign corporation through the California Secretary of State. The name on the certificate must match the name listed in Item Number 1 of the application. Label the document as Exhibit H. EXHIBIT I: All General Partnership Applicants Organized In Any State Partnership Agreement Provide a copy of the original partnership agreement. The agreement must indicate the original date of organization. Label the document as Exhibit I. 1422 – CFLL Instructions 8 American LegalNet, Inc. www.FormsWorkflow.com EXHIBIT J: Applicants Organized In Any State as a Limited Partnership or Limited Liability Company Limited partnerships and limited liability companies must submit an ORIGINAL certificate of qualification or good standing from the Secretary of State or other authority of the applicant’s state of organization. The name on the certificate must match the name in Item Number 1 of the application. The certificate must also indicate the original date of organization. Label the document as Exhibit J. EXHIBIT K: (Foreign Business Entities ONLY): Additional Requirements for Applicants Organized as a Limited Partnership or Limited Liability Company in States Other Than California In addition to the document required in Exhibit J, foreign limited partnerships and foreign limited liability companies must provide an original certificate of qualification or good standing from the California Secretary of State. Foreign entities must register and qualify the entity to conduct business in the State of California. The name on the certificate must match the name listed in Item Number 1 of the application. Label the document as Exhibit K. EXECUTION SECTION: Complete the required information. The Execution Section must be signed by the applicant in the case of a sole proprietor applicant or, for other types of applicants, by an individual who is named in Item Numbers 4, 5, or 6 of the application and who is authorized to sign on behalf of the applicant. By signing the application, the applicant agrees with the representations listed and agrees to appoint the California Corporations Commissioner to receive service of process on behalf of the applicant. 1422 – CFLL Instructions 9 American LegalNet, Inc. www.FormsWorkflow.com CFLL APPLICATION CHECKLIST Application Question Number or Exhibit Letter 1. Name Foreign Domestic Corporation LLC X X Foreign LLC X Foreign Domestic General or General or Limited Limited Partnership Partnership X X Sole Proprietor X Domestic Corporation X 2. Business Type X X X X X X X 3. Place of Business 4. Sole Proprietor Licensee Information 5. Partnership Licensee Information 6. Corporation & Other Licensee Information 7. Regulatory or Other Action 8. Other Business at Location X X X X X X X X X X X X X X X X X X X X X X X X X X X X 9. Bonding Agent X X X X X X X 10. Proposed Activities X X X X X X X 11. Qualification of Securities X X X X X X X A. Balance Sheet X X X X X X X B. Surety Bond X X X X X X X C. Statement of Identity D. Sole Proprietor Licensee Information E. Authorization for Disclosure F. Fictitious Business Name G. Corporation Licensee Information H. Foreign Corporation Licensee Information I. General Partnership Licensee Information X X X X X X X X X X X X X X X X X X X X X X X J. Limited Partnership & LLC Licensee Information K. Foreign Limited Partnership & LLC Licensee Information Execution Section 1422 – CFLL Instructions X X GP ONLY GP ONLY X X X X X X X LP ONLY LP ONLY X X X X X LP ONLY X X X 10 American LegalNet, Inc. www.FormsWorkflow.com (Department of Corporations Use Only) DEPARTMENT OF CORPORATIONS Fee Paid $ ___________________ File No.__________________________ Receipt No. __________________ STATE OF CALIFORNIA DEPARTMENT OF CORPORATIONS APPLICATION FOR A LICENSE UNDER THE CALIFORNIA FINANCE LENDERS LAW APPLICATION FOR A LICENSE AS A: [ ] LENDER [ ] BROKER [ ] BOTH The application must be accompanied by a non-refundable application fee of $200, a non-refundable investigation fee of $100, and non-refundable fingerprint processing fees (Departments of Corporations and Justice). The application (together with the fees payable to the Department of Corporations) must be filed in the Los Angeles office of the Department of Corporations, located at 320 West 4th Street, Suite 750, Los Angeles, CA 90013. 1. a. Name of Applicant: b. Fictitious Business Name: c. Fictitious Business Name filed in the County of: 2. Applicant is organized and will do business as (check as applicable): an individual (a sole proprietor) a general partnership a limited partnership a corporation a limited liability company other (please specify such as joint venture, association, joint stock company, trust, unincorporated organization, government, or political subdivision of a government): 3. Applicant’s proposed licensed place of business: (Number and Street) 1422 – CFLL Application Long Form (Rev. 9/07) (City) (County) (State) (Zip) 1 American LegalNet, Inc. www.FormsWorkflow.com 4. If the applicant is a sole proprietor, provide the following information: a. The FULL first, middle (if no middle name, so indicate) and last name of the sole proprietor. (Name) b. The FULL first, middle (if no middle name, so indicate) and last name, complete business address, telephone number, and e-mail address, if any, for each person(s) who will be in charge of the place of business. (Name) (Number and Street) c. (Telephone Number) (E-mail Address) (City) (State) (Zip ) If the applicant has listed a business location outside of California in Item Number 3, provide the FULL first, middle (if no middle name, so indicate) and last name, and complete address of an agent for service of process in California. If there is no authorized agent in California, so indicate. (Name) (Number and Street) 5. (City) (State) (Zip) If the applicant is a general partnership or a limited partnership, provide the following information: a. Applicant was organized on in the State of . (Date MM/DD/YYYY) b. The FULL first, middle (if no middle name, so indicate) and last name, and complete business address for each general partner. Indicate if a general partner is a managing general partner by checking the corresponding box. Check here if a Managing Partner (Name) (Number and Street) c. (State) (Zip) The FULL first, middle (if no middle name, so indicate) and last name, complete business address, telephone number, and e-mail address, if any, for each person(s) who will be in charge of the place of business. (Name) (Number and Street) d. (City) (Telephone Number) (City) (E-mail Address) (State) (Zip) The FULL first, middle (if no middle name, so indicate) and last name for any other person responsible for the conduct of applicant’s lending activity in this state. (Name) 1422 – CFLL Application Long Form (Rev. 9/07) (Name) 2 American LegalNet, Inc. www.FormsWorkflow.com e. The FULL first, middle (if no middle name, so indicate) and last name for any person (other than those persons listed above) that owns or controls, directly or indirectly, 10% or more of the applicant. (Name) f. (Name) If the applicant is a general partnership, provide the FULL first, middle (if no middle name, so indicate) and last name, and complete address of an agent for service of process in California. If there is no authorized agent in California, so indicate. (Name) (Number and Street) 6. (City) (State) (Zip) If the applicant is a corporation, limited liability company, joint venture, association, joint stock company, trust, unincorporated organization, government, or political subdivision of a government, provide the following information: a. Applicant was organized on in the State of . (Date MM/DD/YYYY) b. The FULL first, middle (if no middle name, so indicate) and last name, be given for each person named below. President/Chief Executive Officer: Executive Vice President/Vice President: (Name) (Name) Secretary: Treasurer/Chief Financial Officer: (Name) (Name) Directors: (Name) (Name) Manager(s) [i.e., a managing member of an association, or a manager appointed or elected by the members of a limited liability company]: (Name) (Name) Trustee(s) (Name) 1422 – CFLL Application Long Form (Rev. 9/07) (Name) 3 American LegalNet, Inc. www.FormsWorkflow.com c. The FULL first, middle (if no middle name, so indicate) and last name, complete business address, telephone number, and e-mail address, if any, for each person(s) who will be in charge of the place of business. (Name) (Telephone Number) (Number and Street) d. (City) (State) (Name) The FULL first, middle (if no middle name, so indicate) and last name for any person (other than those persons listed above) that owns or controls, directly or indirectly, 10% or more of the applicant. (Name) 7. (Zip ) The FULL first, middle (if no middle name, so indicate) and last name for any other person responsible for the conduct of applicant's lending activity in this state. (Name) e. (E-mail Address) (Name) Has the applicant been subject to any administrative action by any government agency, any criminal action, or any civil action involving an act of dishonesty, fraud, or deceit in California, any other state, or a foreign jurisdiction? Yes No If yes, provide copies of all pertinent court documents relating to the action and complete the following: Type of Action: Administrative Criminal Civil Name of Regulator, Agency or Plaintiff: Nature of Charges: Type of Resolution: Date of Resolution or Settlement: 8. Does the applicant conduct or intend to conduct any other business at the applicant's proposed licensed Yes No place of business (Item Number 3 above)? If yes, describe any business being conducted or planned to be conducted on the applicant’s premises. If the California Corporations Commissioner’s authorization is not required because the products or services are of a supervised financial institution affiliated with the applicant, indicate so. 1422 – CFLL Application Long Form (Rev. 9/07) 4 American LegalNet, Inc. www.FormsWorkflow.com 9. Provide the name, address, and telephone number of the bonding agent to whom the Department can direct questions regarding the surety bond required in Exhibit B below. (Name of Bonding Agent) (Telephone Number) (Number and Street) 10. (City) (State) (Zip ) Complete the following as it applies to your proposed operations: a. In the table below, mark the type of collateral and enter the corresponding minimum loan amount for commercial and consumer loans applicable to your proposed method of operation. COMMERCIAL LOANS Collateral Type (check Minimum Loan Amount  all that apply) Real Property $ Personal Property $ Unsecured $ CONSUMER LOANS Collateral Type (check Minimum Loan Amount  all that apply) Real Property $ Personal Property $ Unsecured $ Note: The minimum loan amount for a commercial purpose loan is $5,000.00. A consumer purpose loan collateralized by real property must be $5,000.00 or more. b. 11. Provide a short description of the applicant's business plan that includes any information necessary for the California Corporations Commissioner to have an understanding of the type of business that the applicant plans to conduct under this license. Has the applicant’s offer and sale of securities been qualified in California? Yes No If no, check as applicable: Applicant is exempt from qualification, and has filed any applicable notice of exemption with the Department. Applicant has never offered or sold its securities in California or to a California resident. 1422 – CFLL Application Long Form (Rev. 9/07) 5 American LegalNet, Inc. www.FormsWorkflow.com REQUIRED EXHIBITS: EXHIBIT A. Provide a balance sheet of the applicant prepared in accordance with generally accepted accounting principles and dated no more than 90 days prior to the date this application is filed. Label the balance sheet as Exhibit A. EXHIBIT B. Provide the original surety bond, including riders and endorsements in the amount of $25,000. The instructions and bond form are enclosed. EXHIBIT C. Provide for each individual (natural person) named in Items 4, 5, and 6, a Statement of Identity and Questionnaire, along with fingerprint information and the cost of fingerprint processing. The Statement of Identity and Questionnaire form is enclosed. EXHIBIT D. SOLE PROPRIETOR ONLY: Complete the enclosed form entitled "Statement of Citizenship, Alienage, and Immigration Status For Application of Department of Corporations License or Certificate." EXHIBIT E. Complete the enclosed form entitled "Customer Authorization for Disclosure of Financial Records." EXHIBIT F. Provide a copy of the current Fictitious Business Name Statement filed with the county clerk. Label the document as Exhibit F. EXHIBIT G. ALL CORPORATE APPLICANTS INCORPORATED IN ANY STATE: Submit an original certificate of good standing or qualification executed by the Secretary of State of your state of incorporation, or other proper authority showing that the applicant is authorized to transact business in that state. The certificate must indicate the original date of incorporation. Label the document as Exhibit G. EXHIBIT H. ADDITIONAL REQUIREMENT FOR APPLICANTS INCORPORATED IN STATES OTHER THAN CALIFORNIA (FOREIGN CORPORATION) ONLY: Submit an original certificate of good standing or qualification executed by the California Secretary of State showing that the applicant is qualified to do business in California. Label the document as Exhibit H. EXHIBIT I. GENERAL PARTNERSHIP APPLICANTS ONLY: Submit a copy of the original partnership agreement. Label the document as Exhibit I. EXHIBIT J. APPLICANTS ORGANIZED IN ANY STATE AS A LIMITED PARTNERSHIP OR LIMITED LIABILITY COMPANY: Submit an original certificate of good standing or qualification executed by the Secretary of State of your state of organization, or other proper authority showing that the applicant is authorized to transact business in that state. The certificate must indicate the original date of organization. Label the document as Exhibit J. 1422 – CFLL Application Long Form (Rev. 9/07) 6 American LegalNet, Inc. www.FormsWorkflow.com EXHIBIT K. ADDITIONAL REQUIREMENT FOR APPLICANTS ORGANIZED AS A LIMITED PARTNERSHIP OR LIMITED LIABILITY COMPANY IN STATES OTHER THAN CALIFORNIA (FOREIGN BUSINESS ENTITY) ONLY: Submit an original certificate of good standing or qualification executed by the California Secretary of State showing that the applicant is qualified to do business in California. Label the document as Exhibit K. EXECUTION SECTION. Complete and sign the enclosed declaration. 1422 – CFLL Application Long Form (Rev. 9/07) 7 American LegalNet, Inc. www.FormsWorkflow.com EXECUTION SECTION In the matter of the Application for a License under the California Finance Lenders Law, I, the undersigned, authorized to act on behalf of the applicant, declare that the following statements are true and correct: 1. That the applicant has obtained and read copies of the California Finance Lenders Law (Division 9 of the California Financial Code) and the Finance Company Rules (Chapter 3, Title 10, California Code of Regulations) and is familiar with their content. 2. That the applicant is not an operating subsidiary of a federally chartered bank or financial institution that is subject to oversight by the federal regulatory agency in accordance with federal law (12 U.S.C. § 1 et seq.). 3. That the applicant agrees to comply with the requirements of the California Finance Lenders Law, the rules adopted, and the orders issued by the California Corporations Commissioner. 4. That in the event of any change of its officers, directors, or any other persons named in this application, the applicant will file an amendment to the application containing the same information in relation to the new person(s) as is required in the application, within thirty days from the date of the change, with the California Corporations Commissioner. 5. That the applicant will file with the California Corporations Commissioner an amendment to this application prior to any material change in the information contained in the application for licensure, including, without limitation, the plan of operation. 6. That the applicant agrees to report any change of business location at least 10 days prior to the change. 7. That the applicant for a brokers license agrees that a license issued pursuant to the California Finance Lenders Law does not provide the authority to broker loans to lenders that are not licensed as finance lenders as defined in Financial Code Section 22009, that loans will only be brokered to lenders licensed pursuant to the California Finance Lenders Law, and that finance lenders may not pay compensation for brokerage services (i.e., brokerage commission, finders fee, referral fees, etc.) to anyone not licensed as a broker under this Division, except for those exempt persons as provided for in Section 1451 of the Rules (10 C.C.R. § 1451). 8. For purposes of Financial Code Sections 22340 and 22600, when selling loans secured by real property to institutional investors, the applicant agrees that the source of funds will be exclusive of any funding advances from an institutional investor committed to purchasing the note. The practice commonly known as “table funding” is not permitted under the California Finance Lenders Law. 9. That the applicant agrees that a license issued pursuant to the California Finance Lenders Law permits only employees to work under the license. Persons engaged in lending that are not employees may need to obtain a license under the California Finance Lenders Law. 10. That the applicant agrees that a license issued pursuant to the California Finance Lenders Law does not permit a licensee to authorize locations operated by persons other than employees of the licensee under some form of franchise or license agreement (e.g., net branching). 1422 – CFLL Application Long Form (Rev. 9/07) 8 American LegalNet, Inc. www.FormsWorkflow.com 11. That the applicant agrees to obtain a new license issued pursuant to the California Finance Lenders Law for each additional location. 12. That the applicant agrees to comply with limitations on rates and charges for loans under the California Finance Lenders Law. 13. That the applicant agrees to obtain the California Corporations Commissioner’s approval prior to engaging in other business at a licensed location, unless that other business is providing products or services of an affiliated supervised financial institution. 14. That the applicant agrees that real estate may not be taken as security for a consumer loan of less than $5,000. 15. That the applicant agrees that commercial loans of less than $5,000 are treated as consumer loans under the law. 16. For high interest rate loans secured by real estate, the applicant agrees to comply with the additional disclosure and consumer protection requirements of the Covered Loan Law. (Financial Code Section 4970 et seq.). 17. That the applicant agrees to not share borrower information with third parties without obtaining the express written consent of the borrower, as required by the California Financial Information Privacy Act (Financial Code Section 4050 et seq.). 18. That the applicant agrees to not charge interest on a loan secured by real estate for more than one day prior to the date the loan proceeds are disbursed from escrow. 19. That the applicant will maintain adequate staff to meet the requirements of the California Finance Lenders Law, as prescribed by rule or order of the California Corporations Commissioner. 20. That the applicant agrees to maintain accounting records that meet generally accepted accounting principles and demonstrate a net worth of at least $25,000 at all times. 21. That the applicant will file with the California Corporations Commissioner any report required by the Commissioner. 22. That the applicant agrees to maintain books and records sufficient to document compliance with the California Finance Lenders Law. 23. That the applicant will keep and maintain for 36 months from the date of final entry on any loan the business records and other information required by law or rules of the California Corporations Commissioner. 24. That the applicant will maintain a register of all loans made or brokered under this license that will be updated at least monthly, and that the information maintained in the register will include the name and address of the borrower, account number, amount of loan, date of loan, terms, total of payments and the annual percentage rate, and that the register will also show the account number, name of borrower and payoff date of all loans paid in full. 1422 – CFLL Application Long Form (Rev. 9/07) 9 American LegalNet, Inc. www.FormsWorkflow.com 25. That the applicant will submit to periodic examinations by the California Corporations Commissioner as required by the California Finance Lenders Law. 26. That the applicant agrees to pay for the costs of each examination. 27. That the applicant, if located outside of the State of California, agrees to make available to the California Corporations Commissioner or the Commissioner's representatives, at a location in this state designated by the California Corporations Commissioner, or the Commissioner's representatives, the books, accounts, papers, records and files within 10 calendar days of any request from the Commissioner; or to pay the reasonable expenses for travel, meals, and lodging of the California Corporations Commissioner or the Commissioner's representatives incurred during any investigation or examination made at the licensee's location outside this state. 28. That the applicant agrees to pay an annual assessment each year of a minimum of $250 per location. 29. That the applicant agrees to file an annual report by March 15 of each year. 30. That the applicant agrees to maintain a surety bond of $25,000 at all times. 31. That the applicant hereby attests that the applicant (including officers, directors, general partners, persons responsible for the applicant’s lending activities in California and persons owning or controlling directly or indirectly, 10% or more of the applicant) has not engaged in conduct that would be cause for denial of a license. (Only one declaration required for each applicant.) 32. That, if applicable, the applicant will comply with the rules governing the filing of a fictitious business name as set forth in the Business and Professions Code, beginning at Section 17900. 33. That the applicant will comply with the examination requirements concerning advertising pursuant to California Code of Regulations Section 1550. 34. By signing the application, the applicant hereby irrevocably appoints the California Corporations Commissioner of the State of California, or the Commissioner's successor in office, to be the undersigned's attorney to receive service of any lawful process in any noncriminal suit, action or proceeding against the undersigned, or the undersigned's successor, executor, or administrator which arises under the California Finance Lenders Law or any rule or order thereunder after this consent has been filed, with the same force and validity as if served personally on the undersigned. For the purpose of compliance with the California Finance Lenders Law of the State of California, notice of the service and a copy of process must be sent by registered or certified mail to the undersigned at the following address: (Name) (Number and Street) 1422 – CFLL Application Long Form (Rev. 9/07) (City) (State) (Zip Code) 10 American LegalNet, Inc. www.FormsWorkflow.com Indicate the name, title, address, telephone number, and e-mail address of the person who should be contacted for information regarding this application. The license will also be mailed to this person unless otherwise instructed. Attention: (Name) (Number and Street) (Title) (Telephone Number) (City) (State) (Zip Code) (Email Address) WHEREFORE, applicant requests that a license be issued by the California Corporations Commissioner authorizing applicant to engage in business under the California Finance Lenders Law within the State of California. The applicant has duly caused this application to be signed on its behalf by the undersigned, thereunto duly authorized. The undersigned, on behalf of the applicant, acknowledges that this application and all exhibits thereto which are not designated as confidential are subject to public inspection pursuant to Section 250.9.1, Chapter 3, Title 10, California Code of Regulations. A request for confidentiality of certain documents may be requested pursuant to Section 250.10. If a request for confidential treatment is granted (or denied), the person making such request will be notified in writing. I declare under penalty of perjury under the laws of the State of California that I have read the foregoing application, including all Exhibits attached thereto, or filed therewith, and know the contents thereof, and that the statements therein are true and correct. The signor of this declaration must be named in either Section 4, 5, or 6 of this application. (Applicant) Executed at (City, County, and State) (Signature of Declarant) Date (Typed Name of Declarant) (Title) 1422 – CFLL Application Long Form (Rev. 9/07) 11 American LegalNet, Inc. www.FormsWorkflow.com STATE OF CALIFORNIA DEPARTMENT OF CORPORATIONS INSTRUCTIONS FOR FILING OF SURETY BOND EXHIBIT B This exhibit contains the approved format for the Surety Bond as required by Financial Code Section 22112. Every licensee is required to obtain and maintain a surety bond. The original surety bond must be filed with an application and must include all of the following: 1. The signature of the attorney-in-fact for the surety company. 2. A notarized signature of the attorney-in-fact. 3. A power of attorney from the surety company. 4. Legal name of the licensee. Business name(s), if applicable, may also be included. 5. The signature of the licensee. 6. A notarized signature of the licensee. EXHIBIT B 1 American LegalNet, Inc. www.FormsWorkflow.com BEFORE THE DEPARTMENT OF CORPORATIONS OF THE STATE OF CALIFORNIA EXHIBIT B BOND OF FINANCE LENDER AND/OR BROKER FINANCIAL CODE SECTION 22112 Bond No. ______________ KNOW ALL MEN BY THESE PRESENTS: That we _________________________________________________, as Principal, whose address for service is ______________________________________________________________, (Street Address, City, State and ZIP Code) and _____________________________________, a corporation, created, organized and existing under and by virtue of the laws of the State of ________________________ and an admitted Surety insurer authorized to transact a general Surety business in the State of California, as Surety whose address for service is _________________________________________________________, (Street Address, City, State and ZIP Code) are held and firmly bound unto the Commissioner of Corporations of the State of California, for the use thereof and for the use of any person or persons who may have a cause of action against the Principal under the provisions of the California Finance Lenders Law and all laws amendatory thereof and supplementary thereto now and hereafter enacted, in the total aggregate penal sum of ____________________ Dollars ($____________) (see Financial Code Section 22112), lawful money of the United States of America, to be paid to the Commissioner of Corporations of the State of California, or to any person or persons, for the use and benefit aforesaid, for which payment well and truly to be made, we bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally firmly by these presents. The condition of the above obligation is such that – WHEREAS, The above-named Principal has made application to the Commissioner of Corporations of the State of California for a license to engage in business under and pursuant to the provisions of the California Finance Lenders Law, and is required under the provisions of the California Finance Lenders Law to furnish a bond in the sum above named, conditioned as herein set forth: NOW, THEREFORE, The Principal, and any and all agents and employees representing the Principal, shall faithfully conform to and abide by the provisions of the California Finance Lenders Law and all laws amendatory thereof and supplementary thereto now and hereafter enacted, and of all rules and regulations lawfully made by the Commissioner of Corporations of the State of California under the California Finance Lenders Law and shall honestly and faithfully apply all funds received and shall faithfully and honestly perform all obligations and undertakings under the California Finance Lenders Law, and shall pay to the Commissioner of Corporations of the State of California and to any person or persons, for the use and benefit aforesaid, any and all moneys which become due or owing the State or to any such person or persons from the Principal under and by virtue of the provisions of the California Finance Lenders Law. EXHIBIT B 2 American LegalNet, Inc. www.FormsWorkflow.com This bond is subject to the following provisions: 1. That any person who sustains an injury covered by this bond may, in addition to any other remedy that he or she may have, bring an action in his or her own name upon this bond for the recovery of any damages sustained by him or her. 2. That the total aggregate liability of the Surety or sureties herein shall be limited to the payment of _______________________ Dollars ($____________) (insert amount of the bond). 3. This bond may be canceled by the Surety in accordance with the provisions of Sections 996.320 and 996.330 of the Code of Civil Procedure of the State of California. 4. That, in the event either the Principal and/or the Surety under this bond are served with notice of any action commenced against the Principal or the Surety under the bond, the Principal and Surety as each is served with notice of action shall respectively and, within 10 days, give written notice of the filing of such action to the Commissioner of Corporations of the State of California, at the Los Angeles office of the Department of Corporations. 5. That, in the event the Surety under this bond makes full or partial payment on this bond the Surety shall immediately give written notice of such full or partial payment to the Commissioner of Corporations of the State of California, at the Los Angeles office of the Department of Corporations. 6. . That the effective date of this bond shall be Signature of Principal Typed or Printed Name of Principal Executed at (City and State) I certify (or declare) under penalty of perjury under the laws of the State of California that I have executed the foregoing bond under an unrevoked power of Attorney. Executed in _______________________________ on _________________ (City and State) (Date) Signature of Attorney-in-Fact for Surety Printed or typed name of Attorney-in-Fact for Surety ALL OF THE ABOVE SIGNATURES MUST BE NOTARIZED EXHIBIT B 3 American LegalNet, Inc. www.FormsWorkflow.com NOTICE REQUIRED BY THE INFORMATION PRACTICES ACT (Cal. Civ. Code Sec. 1798.17) (a) The Department of Corporations of the State of California, Financial Services Division, requests the information solicited by the forms attached to this notice. (b) The Assistant Commissioner, Administration, 1515 K Street, Sacramento, CA 95814, telephone (916) 445-5541, shall inform individuals regarding the location of the Department's records and the categories of persons who use the information in the Department's records. (c) The Department's records are maintained pursuant to one or more of the following statutes: Financial Code Sections 12201, 12204, 12216, 12220, 17201, 17209, 17209.1, 17213.5, 22101 and 50301. (d) Except for individual Social Security Account Numbers submission of all items of information requested by the attached form is mandatory. (e) Failure to provide all or any part of the information requested by the attached form may result in the denial of the license application or other authorization sought from the Department. (f) Information supplied by individuals will be used to determine ability to conduct business consistent with the statutory requirements for the license or other authorization applied for. Information will be used as follows: (1) initial processing of an application to make necessary findings for granting or denying the license or other authority applied for; (2) assuring compliance through continuing regulatory processes including references and comparisons of the information with regard to other laws administered by the Department, various regulatory and special investigatory examination reports, and other data; and (3) undertaking enforcement proceedings seeking appropriate administrative or civil remedies or to refer matters to appropriate federal, state or local law enforcement officers. (g) In furtherance of the purposes identified above information may be transferred to other federal, state or local regulatory or law enforcement agencies. Transfers may also be made to licensees or other persons subject to the jurisdiction of the Department in order to perform statutory duties. (h) Subject to certain exceptions or exemptions, the Information Practices Act grants individuals the right to access to personal information concerning the individual which is maintained by the Department of Corporations. 1 FS 512 SIQ (09/07) American LegalNet, Inc. www.FormsWorkflow.com DEPARTMENT OF CORPORATIONS STATE OF CALIFORNIA EXHIBIT C File Number, if any Licensee (Company Name) Insert Department of Corporations file number, if any, and the name of the licensee (company) to which this Statement of Identity and Questionnaire relates. STATEMENT OF IDENTITY AND QUESTIONNAIRE Exact Full Name First Name Middle Name (Do not use initials or nicknames) Last Name Position to be filled in connection with the preparation of this questionnaire (e.g., Officer, Director, Manager, etc.). Sex Hair Eyes Birthdate See Commissioner’s Release 2-G regarding whether furnishing the social security number is mandatory or voluntary and for a description of the use made of that information. Residence Phone Number California Driver's License Number (if none, so state) Business Phone Number Email Address From Weight Birthplace Social Security Number 1. Height Hours of Employment (e.g., 8:00 a.m. to 5:00 p.m.) Residence addresses for the last 10 years: To Street City State Zip Code Present Attach separate schedule if space is not adequate. EXHIBIT C (FS 512 SIQ) 1 American LegalNet, Inc. www.FormsWorkflow.com Insert Full Name of Individual: _______________________ 2. Insert Licensee (Company Name): Employment for the last 10 years: From To Present Employer Name and Address Occupation and Duties Attach separate schedule if space is not adequate. 3. a. Have you ever been named in any order, judgment or decree of any court or any governmental agency or administrator, temporarily or permanently restraining or enjoining you from engaging in or continuing any conduct, practice or employment? Yes No If the answer is "Yes", give details: Attach a copy of any order, judgment or decree. b. Are you currently, or have you been within the last ten years, under federal, state or local investigation for possible violation of any law, ordinance, or licensing or regulatory scheme? Yes If the answer is "Yes", give details: 4. No a. Are you currently licensed to engage in financial business in this state or any other state? Yes No Financial business means securities broker-dealer or agent, investment adviser or investment adviser representative, financial planner, insurance agent, escrow agent, finance lender or broker, mortgage lender or servicer, real estate broker, payday lender, financial institution, bill payer or prorater, commodity sales person, certified public accountant, or any other business involving investment or financial transactions. If the answer is "Yes", describe in the chart next page the following for each license: EXHIBIT C 2 American LegalNet, Inc. www.FormsWorkflow.com Insert Full Name of Individual: _______________________ License Period From: To: License Number Insert Licensee (Company Name): Type of License/Business Name and Address of Licensing Entity Attach separate schedule if space is not adequate. b. Have you ever been refused a license to engage in any business in this state or any other state, or has any such license ever been suspended, revoked, or surrendered subject to a settlement, or any other similar action? Yes No If the answer is "Yes", give details: Attach a copy of any settlement. 5. Have you ever been convicted of or pleaded nolo contendere to a misdemeanor or felony other than minor traffic citations that do not constitute a misdemeanor or felony offense? "Convicted" includes a verdict of guilty by judge or jury, a plea of guilty or of nolo contendere or a forfeiture of bail. All convictions must be disclosed even if the plea or verdict was thereafter set aside and the charges against you dismissed or expunged or if you have been pardoned. Convictions occurring while you were a minor must be disclosed unless the record of conviction has been sealed under Section 1203.45 of the California Penal Code or Section 781 of the California Welfare and Institution Code. Yes No If the answer is "Yes", give details: Attach a copy of any order, judgment or decree. If a conviction was entered under Section 23152(a) of the Vehicle Code, attach a written declaration stating whether drugs were involved. 6. Have you ever been a defendant in a civil court action other than divorce, condemnation or personal injury? Yes No If the answer is "Yes", please complete the following: Date of suit Location of court Nature of suit Attach a copy of any order, judgment or decree. EXHIBIT C 3 American LegalNet, Inc. www.FormsWorkflow.com Insert Full Name of Individual: _______________________ 7. Insert Licensee (Company Name): Have you ever been a subject of a bankruptcy or a petition in bankruptcy? Yes No Yes No If the answer is "Yes", give date, title of case, location of bankruptcy filing: 8. Have you ever been refused a bond, or have you ever had a bond revoked or canceled? If the answer is "Yes", give details: 9. Have you ever changed your name including a woman’s maiden name or ever been known by any name other than that herein listed? Yes No If so, explain. Change in name through marriage or court order and exact date of each name change must be listed. 10. Have you ever done business under a fictitious firm name either as an individual or in any form of business, e.g. partnership, limited liability company, corporation or other? Yes No If the answer is "Yes", give details: The following questions must be answered by all persons submitting this questionnaire in connection with an ESCROW AGENT’S LICENSE. 11. In what capacity will you be employed? (e.g., Clerk, Escrow Officer, Manager, Officer, Director, etc.) 12. Do you expect to be a party to, or broker or salesman in connection with