STATE OF CALIFORNIA ­ DEPARTMENT OF INSURANCE APPLICATION FOR LICENSE TO ACT AS AN UNDERWRITTEN TITLE COMPANY CDI-056 (Rev. 07/2016) Instructions: Please answer each question as thoroughly as possible. Do not leave questions blank. As you complete this application, place a check in the box next to the item number to indicate that the requested information has been attached or is otherwise included in the application. · · · If items are attached to this application, please number the attachment corresponding to the number of the item below, along with a separate list of attachments. If there is no answer or the question is not applicable, please state "not applicable" in the space provided. If information or documentation is requested but not provided, please explain in a separate attachment. Application is hereby made to the Insurance Commissioner of the State of California for a license to transact business as an underwritten title company pursuant to Section 12389 of the Insurance Code of the State of California, and in support thereof Applicant hereby declares as follows: 1. Name of the applicant: ___________________________________________________________________ Address of the applicant (Home Office): ___________________________________________________________________ The applicant intends to operate in the following county(ies) in the State of California. The applicant is applying for the authority to transact escrow business in the following county(ies) in the State of California. ___________________________________________________________________ If the applicant is applying to conduct escrow services, list all business location(s) where escrow services will be conducted (attach list of additional addresses if space below is insufficient): a) __________________________________________________________ (Number and Street) (City) (County) (State) (Zip) 2. 3. 4. 5. __________________________________________________________ (Number and Street) (City) (County) (State) (Zip) __________________________________________________________ (Number and Street) (City) (County) (State) (Zip) b) If not maintained at the addresses listed in 5 a) applicant identifies the following business location(s) for maintaining and preserving all escrow records (attach list of additional addresses if space below is insufficient): __________________________________________________________ (Number and Street) (City) (County) (State) (Zip) American LegalNet, Inc. www.FormsWorkFlow.com STATE OF CALIFORNIA ­ DEPARTMENT OF INSURANCE APPLICATION FOR LICENSE TO ACT AS AN UNDERWRITTEN TITLE COMPANY CDI-056 (Rev. 07/2016) c) Please indicate here if applicant is applying to conduct internet escrow services: Yes, Applicant will act as an internet escrow agent. 6. If the applicant is requesting escrow authority, attached is either a) a surety bond in the sum of $50,000 or $100,000 depending on the proposed counties of licensure; or b) one original and one copy of the Securities Transaction Request forms (A174), tendering deposit to the Insurance Commissioner in the sum of $50,000 or $100,000 depending on the proposed counties of licensure. The Department will forward the originals to the Securities Deposit Unit and will retain the copy for its files. i) The appropriate fee for this Securities Transaction Request has been enclosed, along with a copy of the check. 1 7. Attached are complete and duly executed copies of all existing (or unsigned copies of all proposed) underwriting agreements with any admitted title insurers under which the applicant intends to transact business. Please respond to the statements below and attach a marked-up copy of the underwriting agreements, using tabs or captions to indicate where the following required provisions are located within the agreements. a) The agreements cover all of the counties for which the applicant is requesting authority to operate. The agreements do not allow for the placement of any liens upon the applicant. If the applicant does escrow, the agreements provide for one or more of the following provisions. Please check the appropriate box below: i) A fidelity bond or insurance policy in conformity with the requirements of Section 12389.6; or, b) c) 1 See the enclosed Schedule of Fees & Charges for In-State Treasury Depository. American LegalNet, Inc. www.FormsWorkFlow.com STATE OF CALIFORNIA ­ DEPARTMENT OF INSURANCE APPLICATION FOR LICENSE TO ACT AS AN UNDERWRITTEN TITLE COMPANY CDI-056 (Rev. 07/2016) ii) A review of the escrow disbursements by a title insurer employee in compliance with the requirements of Section 12389.6; or, An account review process in compliance with the requirements of Section 12389.6 or utilization of either the American Land Title Association's (ALTA) Escrow Internal Control Guidelines for Title Insurance Companies, Agencies and Approved Attorneys or the California Land Title Association's (CLTA) Account Review Processes and Oversight and Internal Control Guidelines as approved by the Department on April 1, 1996; or, Utilization of written procedures approved by the Commissioner in compliance with the requirements of Section 12389.6. iii) iv.) d) If there is exposure to loss on the part of the applicant, the agreements provide that such loss shall not exceed $5,000 per policy. The agreements affirmatively state whether or not the applicant is authorized to handle policy claims on behalf of the title insurer. (California Insurance Code Section 790; California Code of Regulations, Title 10, Section 2695.2(m)) The agreements clearly indicate that the applicant is responsible for the maintenance of records regarding all escrow receipts and disbursements. (California Insurance Code Section 12389(b)) The agreements clearly indicate that the applicant is responsible for the maintenance of records of title orders sufficient to indicate their source. (California Insurance Code Section 12397.5(a)) The agreements clearly indicate that the applicant is responsible for the maintenance of adequate records regarding commissions paid. (California Insurance Code Section 12408.5) The agreements require the establishment of a separate deposit account for escrow funds. (California Insurance Code Section 12413.5) The agreements provide for notice to be given by the title insurer to the Commissioner in the event of termination of the underwriting agreement. (California Insurance Code Section 12408.1) e) f) g) h) i) j) 8. 9. Attached is the Schedule of Rates