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D.C. Municipal Regulations (Last Updated: September 13, 2017) |
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Title 26. INSURANCE, SECURITIES, AND BANKING |
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SubTilte 26-C. BANKING AND FINANCIAL INSTITUTONS |
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Chapter 26-C22. MONEY TRANSMITTERS |
Section 26-C2299. DEFINITIONS
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2299.1For the purpose of this chapter, the following terms have the meaning ascribed:
Act - The Money Transmitters Act of 2000, effective July 18, 2000 (D.C. Law 13-140; D.C. Official Code §§ 26-1001 et seq. (2001)).
Applicant - A person filing an application for a license, a renewal license, or a change in control under the Act.
Authorized Delegate - An entity designated by a licensee under the provisions of the Money Transmitters Act of 2000 to sell or issue payment instruments or engage in the business of transmitting money on behalf of the licensee.
Department - The Department of Insurance, Securities and Banking.
District - The District of Columbia.
Licensee - A person licensed pursuant to the Money Transmitters Act of 2000.
Person - An individual, corporation, partnership, association, limited liability company, joint venture, government, or any other legal or commercial entity or agent.
Shareholder with a controlling interest - A person who owns, directly or indirectly, more than ten percent of any class of stock of the applicant.
APPENDIX
ANNUAL RENEWAL REPORT FORM
RENEWAL APPLICATION FOR A MONEY TRANSMITTER LICENSE
Pursuant to the Money Transmitters Act of 2000
(D.C. Law 13-140; D.C. Official Code §§ 26-1001 et seq. (2001)) ("Act")
Answer All Questions. If not applicable, indicate with an N/A.
PART ONE - TO BE COMPLETED BY ALL APPLICANTS
1.Applicant's name:_______________________________
2.Fictitious or trade name: _______________________________
3.Applicant's Federal Employer Identification Number: _______________________________
4.Applicant's principal business office:
Street Address: _______________________________
City and State: _______________________________
Telephone number:___________________________Fax Number: ____________________________
E-Mail: _______________________________
5.Money Transmitter License number, if applicable_____________________________
6.Name and address of principal contact person: (license will be sent to this person)
Name: _______________________________
Street Address: _______________________________
City and State: _______________________________
Telephone number: __________________________ Fax Number: _____________________________
E-Mail: _______________________________
7.Address at which the applicant keeps its books and records (if different from answer to Question 4).
Street Address: _______________________________
City and State: _______________________________
8.Applicant is a(n): (Check appropriate classification)
□ Individual
□ Partnership
□ Association
□ Joint Stock Association
□ Corporation
□ Other (explain): __________
9.Type of money transmission activity to be conducted (mark all that apply):
□ Checks
□ Travelers Checks
□ Drafts
□ Wire Transfers
□ Money Orders
□ Other (explain): __________
□ Stored Value
10.Money transmission sales are conducted through (marked all that apply):
□ Company Owned Outlets
□ Independent Authorized Delegates
□ Subsidiaries or Affiliate; and/or
□ Other (explain): __________________________
11.Submit the following:
(a)Complete name and address of each authorized delegate and each of the applicant's locations in the District of Columbia from which it conducts money transmission sales. (use separate 8 1/2 × 11 sheet of paper)
State the total number of the applicant's locations in the District of Columbia:
_______________________________
PART TWO
INSTRUCTIONS: Please check either "yes" or "no" in response to the following questions regarding changes since the last application or renewal. IF THERE HAVE BEEN ANY CHANGES, PLEASE PROVIDE THE REQUESTED INFORMATION (Note that a response to the following questions does not constitute compliance with any separate statutory notice or reporting requirement):
1.Has there been any change in principal officers, directors, partners, or individuals with a 25% or more ownership interest in the applicant since the last application or renewal?
□ Yes □ No
If yes, please explain change(s) on a separate sheet, and include the name, title, business address and percentage ownership of each person who has acquired an ownership interest or become an officer or director of the applicant.
2.Has the applicant had its license suspended, revoked or renewal refused in any other state since the last application or renewal?
□ Yes □ No
If yes, please explain on a separate sheet.
3.Has the applicant been subject to any enforcement action by a licensing authority in any other state since the last application or renewal?
□ Yes □ No
If yes, please explain on a separate sheet.
4.Has there been any material litigation involving the applicant since the last application or renewal? Material litigation means litigation that, according to generally accepted accounting principles, is deemed significant to any licensee's financial health and would be required to be referenced in its annual audited financial statements, report to shareholders or similar documents.
□ Yes □ No
If yes, please explain on a separate sheet.
5.Has there been any felony indictment or criminal conviction of any principal officer or partner of the applicant, or any individual with a 25% or more ownership interest in the applicant since the last application or renewal?
□ Yes □ No
If yes, please explain on a separate sheet.
6.Has there been any substantive change to the form of instruments issued by the applicant since the last application or renewal, if not previously provided?
□ Yes □ No
If yes, please provide a specimen if not previously provided.
7.Has there been any change in the applicant's principal clearing banks, clearing bank address or account number since the last application or renewal?
□ Yes □ No
If yes, please list the name, address, contact name and account number on a separate sheet.
8.Has there been any material change to the applicant's authorized delegate contract since the last application or renewal?
□ Yes □ No
If yes, please provide a copy.
9.Has there been any change to the applicant's internal auditor(s) since the last application or renewal?
□ Yes □ No
If yes, please provide the new contact name and phone number on a separate sheet.
10.Has the applicant, or any principal officer, director, partner, or individual with a 25% or more ownership interest in the applicant, filed a petition in bankruptcy or reorganization since the last application or renewal?
□ Yes □ No
If yes, please describe the proceedings on a separate sheet, and provide a copy of the petition and a copy of the discharge if applicable.
PART THREE - TO BE COMPLETED BY NON-CORPORATE APPLICANTS (If you are a Corporate Applicant, please go to Part Four)
1.For each of the applicant's principals and any other person(s) who will manage or control the applicant's money transmission business, provide:
Name: _______________________________
Title: _______________________________
Business Address: _______________________________
Residence Address: _______________________________
Name: _______________________________
Title: _______________________________
Business Address: _______________________________
Residence Address: _______________________________
Name: _______________________________
Title: _______________________________
Business Address: _______________________________
Residence Address: _______________________________
Name: _______________________________
Title: _______________________________
Business Address: _______________________________
Residence Address: _______________________________
2.Submit a copy of applicant's registration or qualification to do business in the District of Columbia.
3.For each of applicant's principals, submit a Personal Financial Statement (attached).
4.Submit a copy of applicant's audited financial statements (including balance sheet, statement of income or loss, and statement of changes in financial position) for the current year and, if available, for the prior two (2) years.
PART FOUR - TO BE COMPLETED BY CORPORATE APPLICANTS
1.Submit the following:
A.The most recent audited financial statements of the applicant, including the balance sheet, statement of income, statement of stockholder's equity and statement of cash flow for the prior two (2) years, prepared by an independent certified public accountant, if not previously provided.
If the applicant is a wholly-owned subsidiary of another corporation, the applicant may submit either the parent's consolidated audited financial statements for the current year and prior two (2) years, or the parent's Form 10K reports filed with the United States Securities and Exchange Commission for the prior three (3) years in lieu of the financial statements.
B.The most recent unaudited interim financial statements prepared for the applicant, dated no more than 120 days from the date of this application, if not previously provided.
C.Submit the following:
1)The total dollar amount of the applicant's outstanding instruments and money transmissions in the District of Columbia.
(a)As of the date of the most recent audited financial statement, and
(b)As of the date of the interim financial statement filed in accordance with prior request 1(B).
2)The total dollar amount of the applicant's outstanding instruments and money transmissions in the United States.
(a)As of the date of the most recent audited financial statement, and
(b)As of the date of the unaudited interim financial statement filed in accordance with prior request 1(B).
2.Submit the number and dollar amount of payment instruments sold/issued and money transmissions conducted by the applicant from ___________________through the close of business ___________________ (12 month period):
3.Submit a list of the applicant's permissible investments, and the book or market value of the investments.
(a)As of the date of the most recent audited financial statement, and
(b)As of the date of the unaudited interim financial statement filed in accordance with prior request 1(B).
4.If audited financial statements are not provided, and if permissible investments are required, the following is required:
A certification by an independent certified public accountant that the applicant's permissible investments, at all times possess a book or market value calculated in accordance with generally accepted accounting principles, of not less than the aggregate dollar amount of all outstanding payment instruments issued or sold by the licensee in the United States.
5.Submit proof of the surety bond required and/or a list of deposits and other obligations maintained in lieu of all or part of the corporate surety bond, as authorized by the Act. For each deposit, please designate the amount of each deposit, the financial institution in the District of Columbia that is the depository, and the account number.
I certify that the foregoing responses are true, accurate and complete to the best of my knowledge and belief
6.For each executive officer, shareholder having a controlling interest, officer, manager or other person that will manage or direct the applicant's money transmission activities, provide the following:
Name: _______________________________
Title: _______________________________
Business Address: _______________________________
Residence Address: _______________________________
Name: _______________________________
Title: _______________________________
Business Address: _______________________________
Residence Address: _______________________________
Name: _______________________________
Title: _______________________________
Business Address: _______________________________
Residence Address: _______________________________
Name: _______________________________
Title: _______________________________
Business Address: _______________________________
Residence Address: _______________________________
Name: _______________________________
Title: _______________________________
Business Address: _______________________________
Residence Address: _______________________________
7.Copies of all filings made by the applicant with the United States Securities and Exchange Commission, or a similar regulator outside the United States, within the year preceding the date of this application.
PART FIVE - TO BE SUBMITTED BY ALL APPLICANTS
Applicants shall complete and attach to this application the following forms, as prescribed by the Commissioner:
(1)Money Transmitter License Bond Form;
(2)Clean Hands Before Receiving a License or Permit Act of 1996 Certification Form;
(3)Personal Financial Statement;
(4)Certified Resident Agent Appointment Form; and
(5)If applicable, Non-U.S. Citizen Supplemental Information Form
PART SIX - TO BE COMPLETED BY ALL APPLICANTS
CERTIFICATION
Having been duly sworn, and under the penalties of perjury, I hereby certify that the representations in this RENEWAL APPLICATION FOR MONEY TRANSMITTER LICENSE are true and correct to the best of my knowledge and belief. I understand that omissions or inaccuracies may result in denial of the APPLICATION.
________________________________
(Name of Licensee)
By: _______________________________
Title:
State of _______________________________
County of _______________________________
On this the __________day of_______________, 20__________, before me, a Notary Public, appeared____________________________________________________________, known to me to be the person(s) named in, and who executed the foregoing application and made oath that the statements and representations set forth are true to the best of his/her/their knowledge and belief.
_______________________
Notary Public
My Commission Expires: _______________________
Submit this renewal application along with the required documentation and fee, and direct inquiries concerning licensing, preparation or filing of this renewal application to:
Department of Insurance, Securities and Banking
810 First Street, N.E., Suite 701
Washington, DC 20002