PP Account T&C Rev. 10/01/2018 Colorado Department of State Prepaid Accounts : Policies, Terms and Conditions The Department of State (Department) offers Prepaid Accounts for those businesses / e ntities that conduct frequent transactions with the Department, i.e., those filers who have mul tiple transactions occurring at least each business day of the month. Effective October 1, 2018 , the Department is implementing the following T erms and C onditions that outline the requirements for opening and maintaining a Prepaid Account. Businesses / e ntitie s that wish to apply for and use the Prepaid Account option for their transactions are required to agree to these T erms and C onditions. The Department expects that from time to time changes to these T erms and C onditions may be required. The most current version will be www.sos.state.co.us . Terms and Conditions for Prepaid Accounts with the Department of State 1. All Prepaid Accounts must be opened via a su bmitted to the Department of State . (T hese accounts will not be available to open on - line via the Department of State website . ) The application must be completed entirely, including the physical address of the business /entity and the email address for th e point of contact for the account. 2. All P repaid A ccounts must be opened in the Only one account number will 3. An initial deposit of a minimum of $500, submitted with the paper application, is required to open a Prepaid Account. Thereafter, future deposits to maintain the Prepaid Account must be a minimum of $500 each . 4. The Point of Contact named on the application fo r the entity will be notified via email when the account balance drops below $250. 5. All deposits made via check will be available for transactions 14 calendar days after receipt and processing by the Department. If a check is returned because of insufficient funds or a closed bank account, the Prepaid Account balance in the account is suff icient to process transactions. 6. Beginning with the first month upon opening a Prepaid Account , and for each month thereafter, the Department will assess a monthly service fee of $25 to cover costs associated with managing the account activity. This fee will be deducted by the Department from the balance in the Prepaid Account. 7. At least monthly, t he Department will send a statement of the account via email to the Point of Contact of the Prepaid Account holder. 8. Any Prepaid Account that has no activity within a 12 - month period will be closed and a refund of any funds remaining in the account will be sent to the b usiness or e ntity under whose name the account was opened. 9. A b usiness or e ntity that wishes to close a Prepaid Account must submit such request to the Department of State in writing , signed by an authorized individual and stating the date the account should be closed . No transactions may be made against the account after that date. Within 30 days of the closure of the account, the Department will refund any remaining funds in the account to the b usiness or e ntity under whose name the account was opened. 10. The Prepaid Account holder is responsible for notifying the Department of State, in writing , of any changes in the address, contact information (including email address) , or authorized account users of the b usiness or e ntity under whose name th e account was opened. 11. Unless otherwise indicated in writing by the b usiness or e ntity, all fees for transactions submitted by the b usiness or e ntity will be deducted from the Prepaid Account of the named b usiness or e ntity under whose name the account was opened. By signing the Prepaid Account Application, the a pplicant agree s and to hold a Prepaid Account with the Department of State. American LegalNet, Inc. www.FormsWorkFlow.com x-none$x-noneCR Number x-noneDate Account Opened: x-noneSTATE OF COLORADO x-noneDepartment of State x-noneJena Griswold x-none1700 Broadway, Suite 200 x-noneSecretary of State x-noneDenver, CO 80290 Prepaid Account Application x-noneAll information on this application is required to establish a Prepaid Account. x-noneBusiness/Entity Name x-noneBusiness/Entity Address x-none(Number and Street Name) x-none(City) x-none(State) x-none(Zip Code) x-none(Province and Country, if applicable) x-noneMailing Address x-none(If different than street address) x-none(Number and Street Name, or P.O. Box) x-none(City) x-none(State) x-none(Zip Code) x-nonePoint of Contact for this account x-none x-none(Name) x-none(Title) x-none(Telephone Number, with Area Code) x-none(Fax Number, with Area Code) x-noneE-mail Address of Contact x-noneIndividuals authorized to use account x-none(Name) x-none(Telephone Number) x-none(Name) x-none(Telephone Number) x-none(Name) x-none(Telephone Number) x-noneIndividual authorized to open account x-none(Print Name) x-none(Title) x-noneDate Application Received: x-noneAccount Number Assigned: x-none(Telephone Number) x-none(E-mail Address) x-noneAmount of Initial Deposit: x-noneDate Account Processed: x-noneDate Account Closed: x-noneComments: x-none(Signature of Authorized Individual) x-none(Date) x-noneThe person signing for the Business/Entity named on this application hereby affirms that she/he is authorized to act on behalf of such Business/Entity with regard to use of a Prepaid Account with the Department of State, agrees to the terms and conditions of having a Prepaid Account, and acknowledges that the Department of State is relying on her/his representations to that effect. x-noneFor Office Use Only PP Acct App Rev. 1/8/2019 American LegalNet, Inc. www.FormsWorkFlow.com