Form 2901--General Information (Third Party Debt Collector Surety Bond) The attached form is designed to meet minimal statutory filing requirements pursuant to the relevant code provisions. This form and the information provided are not substitutes for the advice and services of an attorney. Commentary In accordance with Section 392.101 of the Finance Code, a third party debt collector or credit bureau may not engage in debt collection unless the entity has filed a $10,000 surety bond with the state. The bond must be issued by a surety company authorized to do business in Texas. Instructions for Form � � � � � � Principal/Third Party Debt Collector: Provide the name and address of the third party debt collector or credit bureau filing the surety bond. Bond: Provide the number used by the surety company to identify the bond. Surety: Provide the name of the surety company. The surety company must be authorized to do business as a surety company in Texas. Effective Date: Provide the date on which the bond will become effective. Execution: Persons who are authorized to sign on behalf of the third party debt collector or credit bureau, as principal, and the surety company must sign and date the bond. Delivery Instructions: The bond may be mailed to Registrations Unit, P.O. Box 13193, Austin, Texas 78711-3193 or delivered to the James Earl Rudder Office Building, 1019 Brazos, 1st Floor, Austin, Texas 78701. If evidence of filing is desired, two copies of the bond may be submitted. On filing the bond, the secretary of state will return a file-stamped copy of the bond, if a duplicate copy was provided. Revised 12/2014 Form 2901 1 American LegalNet, Inc. www.FormsWorkFlow.com Form #2901 Rev. 12/2014 This space reserved for office use Submit to: SECRETARY OF STATE Registrations Unit P O Box 13193 Austin, TX 78711-3193 512-475-0775 512-475-2815 - Fax Filing Fee: None. PRINCIPAL/ THIRD PARTY DEBT COLLECTOR BOND SURETY Name: Street Number: Name: THIRD PARTY DEBT COLLECTOR SURETY BOND City State Zip Amount : Ten thousand dollars ($10,000.00) We, PRINCIPAL AND SURETY identified above, our heirs, executors, successors and assigns, jointly and severally, are liable to the State of Texas, for the amount of the bond shown, in favor of the state for the benefit of a person damaged by PRINCIPAL's violation of Chapter 392, Finance Code, and in favor of a person damaged by PRINCIPAL's violation of Chapter 392, Finance Code. SURETY acknowledges that it is duly authorized and qualified to do business as a surety company in Texas. This agreement is subject to the following terms and conditions: This bond shall serve as the security required by Section 392.101, Finance Code, so that PRINCIPAL may engage in the business of debt collection. As a condition of SURETY's obligation, PRINCIPAL shall faithfully discharge all obligations, duties and responsibilities under Chapter 392, Finance Code, as that statute is presently worded, and as it may hereafter be amended to read. Any party injured by PRINCIPAL's failure to meet the conditions of the bond may bring an action based on the bond and recover against the bond. The aggregate liability of SURETY for all breaches of bond conditions may not exceed the amount of the bond. Regardless of the number of years the bond continues in force or the number of premiums paid or payable, the limit of SURETY's liability stated in the bond shall not be cumulative from year to year or period to period. The bond shall not be subject to cancellation by either PRINCIPAL or SURETY unless written notice of intent to cancel is forwarded to the Secretary of State, Statutory Documents Section, not later than the 60th day before the date of cancellation. If the cancellation is at the request of SURETY, SURETY shall also provide PRINCIPAL with written notification at least 60 days prior to the effective date of cancellation. It is agreed that the bond shall be in full force and effect as of the following date: Date: Signature of authorized person for PRINCIPAL Printed or typed name of authorized person for PRINCIPAL Date: Signature of authorized person for SURETY Printed or typed name of authorized person for SURETY Form 2901 2 American LegalNet, Inc. www.FormsWorkFlow.com