California Code of Regulations
Title 10 - Investment
Chapter 3 - Commissioner of Financial Protection and Innovation
Subchapter 6 - California Financing Law
Article 14 - Pilot Program for Increased Access to Responsible Small Dollar Loans
Subarticle 2 - Application and Registration
Section 1603 - Finder Registration: Form

1. Name of Licensee:

___________________________

2. Licensee's Business Address:

___________________________

___________________________

3. CFL License Number: _______________

4. Name of Finder:

___________________________

5. List all Fictitious Business Names used by the Finder:

___________________________

___________________________

___________________________

6. Finder's Main Business Address:

___________________________

___________________________

___________________________

7. Is the Finder registered with the California Secretary of State? Yes [] No []

8. Finder's type of business entity (Corporation, Limited Liability Company, Limited Partnership, General Partnership, or Limited Liability Partnership):

9. List all types of business activities conducted by the finder outside the authority of the California Financing Law:

___________________________

___________________________

___________________________

___________________________

___________________________

10. In the table below, list all government entities that regulate the finder's business activities, including all corresponding license, permit, and registration numbers, status, and expiration dates:

11. In the table below, provide information for each instance where the finder has been subject to disciplinary action by a government entity:

12. Have you entered into a written agreement with the finder as required under Section 22376 of the Financial Code? Yes [] No []

13. Does the written agreement include a provision that the finder agrees to comply with all regulations established by the Commissioner concerning the activities of finders as required under Section 22376 of the Financial Code? Yes [] No []

14. Does the written agreement include a provision that the finder agrees to provide the Commissioner access to all of the finder's books and records pertaining to the finder's operations under the agreement with the licensee? Yes [] No []

15. Provide the following information for an employee of the finder who is knowledgeable about, and has the authority to execute, the contract governing the business relationship between the finder and the licensee:

Name:

___________________________

Address:

___________________________

Telephone Number:

___________________________

Email:

___________________________

16. Complete Exhibit A identifying the business addresses of all locations at which the finder will perform the services described in Section 22372, subdivisions (a) and (b), of the Financial Code. Any subsequent locations or changes to locations or other information contained in the finder registration form must be reported to the Commissioner in accordance with Title 10 of the California Code of Regulations, Section 1600.

17. Complete Exhibit B providing the name, title, physical business location, telephone number, and email of each employee of the finder who is responsible for that finder's finding activities on behalf of the licensee at each of its locations. If different employees are responsible for different locations, provide the name and contact information of the employee responsible for each location. If one employee is responsible for the finder's activities, provide the name and contact information of the employee for all locations.

18. Complete Exhibit C identifying the services and activities that the finder will perform for the licensee at the finder's physical location for business. Will any of the finders listed in Exhibit C perform additional services authorized under Section 22372, subdivision (b) of the Financial Code?

Yes [] (If yes, please provide the licensing details for finders performing additional services, as specified and where indicated in Exhibit C.)

No []

19. Attach a copy of the written agreement with the finder, marked as Exhibit D. The licensee has duly caused this registration to be signed on its behalf by the undersigned, thereunto duly authorized.

The undersigned, on behalf of the licensee, acknowledges that this registration and all exhibits thereto 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 that I have read the foregoing registration, including all exhibits attached thereto, or filed therewith, and know the contents thereof, and that the statements therein are true and correct.

EXHIBIT A

Business addresses of all locations at which the finder will perform the services described in Section 22372, subdivisions (a) and (b), of the Financial Code:

EXHIBIT B

Name and contact information of each employee of the finder who is responsible for that finder's finding activities on behalf of the licensee at each of the locations:

EXHIBIT C

Services that a finder may perform for the licensee at the finder's physical location for business in accordance with Section 22372, subdivision (a), of the Financial Code. Please check the box for the type of services that the finder will perform for the licensee:

[] Distributing, circulating, using, or publishing preprinted brochures, flyers, factsheets, or other written materials relating to loans that the licensee may make or negotiate and that have been reviewed and approved in writing by the licensee prior to their being distributed, circulated, or published.

[] Providing written factual information about loan terms, conditions, or qualification requirements to a prospective borrower that has been either prepared by the licensee or reviewed and approved in writing by the licensee. A finder may discuss that information with a prospective borrower in general terms, but may not provide counseling or advice to a prospective borrower.

[] Notifying a prospective borrower of the information needed in order to complete a loan application without providing counseling or advice to a prospective borrower.

[] Entering information provided by the prospective borrower on a preprinted or electronic application form or onto a preformatted computer database without providing counseling or advice to a prospective borrower.

[] Assembling credit applications and other materials obtained in the course of a credit application transaction for submission to the licensee.

[] Contacting the licensee to determine the status of a loan application.

[] Communicating a response that is returned by the licensee's automated underwriting system to a borrower or a prospective borrower.

[] Obtaining a borrower's signature on documents prepared by the licensee, delivering the final copies of the documents to the borrower, and returning the signed original documents to the licensee.

A licensed or regulated finder may provide additional services on behalf of the licensee, in accordance with Section 22372, subdivision (b), of the Financial Code, IF the finder is licensed or regulated under any one of the federal or state laws specified in Section 22372, subdivision (b). Please check the box for the type of additional services the finder will provide for the licensee.

[] Disbursing loan proceeds to a borrower, if this method of disbursement is acceptable to the borrower. A finder that disburses loan proceeds to a borrower shall deliver or cause to be delivered to the borrower at the time loan proceeds are disbursed a plain and complete receipt, in accordance with Section 22372, subdivision (b)(1)(B).

[] Receiving loan payment or payments from the borrower, if this method of payment is acceptable to the borrower. A finder that receives loan payments shall deliver or cause to be delivered to the borrower at the time that the payment is made by the borrower, a plain and complete receipt, in accordance with Section 22372, subdivision (b)(2)(B).

[] Providing any notice or disclosure required to be provided to the borrower by the licensee, other than the notice required to be provided by the licensee to the borrower pursuant to subdivision (d) of Section 22373. A licensee that uses a finder to provide notices or disclosures to borrowers shall maintain a record of which notices and disclosures each finder provides to borrowers on its behalf, for the purposes of facilitating the commissioner's examination of the licensee.

If the finder will provide the additional services in Section 22372, subdivision (b), please check the box next to the federal or state law under which the finder is licensed or regulated and also provide the information requested.

___________________________

[] Division 1.1 of the Financial Code, commencing with Section 1000, the "Banking Law." List the name and address of the bank or trust company and its charter number and issuance date: ___________________________

[] Division 1.2 of the Financial Code, commencing with Section 2000, the "Money Transmission Act." List the name and address of the licensee, license number, and effective date(s) of license: ___________________________

[] Division 3 of the Financial Code, commencing with Section 12000, the "Check Sellers, Bill Payers and Proraters Law." List the name and address of the licensee, license number, and effective date(s) of license: ___________________________

[] Division 5 of the Financial Code, commencing with Section 14000, the "California Credit Union Law." List the name and address of the credit union, charter number and issuance date: ___________________________

[] Division 6 of the Financial Code, commencing with Section 17000, the "Escrow Law." List the name and address of the licensee, license number, and effective date(s) of license: ___________________________

[] Division 7 of the Financial Code, commencing with Section 18000, the "Industrial Loan Law," List the name and address of the licensee, license number, and effective date(s) of license: ___________________________

[] Division 8 of the Financial Code, commencing with Section 21000, regarding those engaged in the pawnbroker business. List the name and address of the licensee, license number, issuing authority, and effective date(s) of license: ___________________________

[] Division 10 of the Financial Code, commencing with Section 23000, the "California Deferred Deposit Transaction Law." List the name and address of the licensee, license number, and effective date(s) of license: ___________________________

[] Division 20 of the Financial Code, commencing with Section 50000, the "California Residential Mortgage Lending Act." List the name and address of the licensee, type of license (mortgage lender and/or servicer), license number, and effective date(s) of license: ___________________________

[] Chapter 5 of Part 2 of Division 1 of the Insurance Code, commencing with Section 1621, regarding the licensure and regulation of those engaged in the insurance industry. List the name and address of the licensee, type of insurance license (agent, broker, etc.), license number, and effective date(s) of license: ___________________________

[] Chapter 1 (commencing with Section 5000) of Division 3 of the Business and Professions Code, regarding accountants. List the name and address of the licensee, license number, and effective date(s) of license: ___________________________

[] An approved agent of a person licensed pursuant to Division 1.2 of the Financial Code, commencing with Section 2000, the "Money Transmission Act." List the name, address and contact information of the approved agent, the date the agent was approved as an agent of a money transmitter, and the name, address and contact information of the licensed money transmitter: ___________________________

[] A federally regulated bank, thrift or credit union. List the name and address of the federally regulated bank, thrift or credit union, the chartering authority, charter number and issuance date: ___________________________

1. Providing counseling or advice to a borrower or prospective borrower.

2. Providing loan-related marketing material that has not previously been approved by the licensee to a borrower or a prospective borrower.

1. Negotiating the price, length, or any other loan term between a licensee and a prospective borrower.

2. Advising either a prospective borrower or a licensee as to any loan term.

3. Offering information pertaining to a single prospective borrower to more than one licensee, except that, if a licensee has declined to offer a loan to a prospective borrower and has so notified that prospective borrower in writing, the person may then offer information pertaining to a single prospective borrower to another licensee with which it has a finder's agreement.

4. Personally contacting or providing services to a borrower or prospective borrower at any place other than a finder's physical location for business.

CFL 1603 (8/21)