California Code of Regulations
Title 10 - Investment
Chapter 3 - Commissioner of Financial Protection and Innovation
Subchapter 6 - California Financing Law
Article 3 - Books, Records and Examinations
Section 1430 - Annual Report

Universal Citation: 10 CA Code of Regs 1430

Current through Register 2024 Notice Reg. No. 38, September 20, 2024

STATE OF CALIFORNIA -- BUSINESS, CONSUMER SERVICES AND HOUSING AGENCY

DEPARTMENT OF BUSINESS OVERSIGHT

INSTRUCTIONS FOR COMPLETING THE 20XX ANNUAL REPORT FOR LENDERS AND BROKERS LICENSED UNDER THE CALIFORNIA FINANCE LENDERS LAW

WHO MUST FILE THE REPORT: Every licensee under the California Finance Lenders Law as of December 31, 20XX must file the annual report. The report must include information on all businesses conducted under the California Finance Lenders license by licensees located in or outside the State of California.

NO BUSINESS OR INACTIVE LICENSES: An annual report must be filed even if no business was conducted under the license(s) in 20XX. If no business was conducted under the license(s) during the calendar year 20XX, complete Schedules A through C-3, Schedule K and Verification section only. Include a statement at the bottom of the Verification section "No business was conducted under the license(s) during the calendar year 20XX." "No business" means no loans were made, refinanced, or brokered in 20XX, and no loan payments or broker fees were received in 20XX.

WHEN IS THE REPORT DUE/PENALTY FOR FAILURE TO FILE THE ANNUAL REPORT: The annual report is due on or before March 15, 20XX. No extension of the filing date shall be granted. Failure to file the report will result in summary revocation of your license(s). Under Government Code Section 11522, a licensee whose license has been revoked may have to wait a period of not less than one year from the date of revocation before applying for a license.

WHAT IS THE PURPOSE OF THE ANNUAL REPORT: The information reported in the annual report is used to publish the Department of Business Oversight's Annual Report -- Operation of Finance Companies. In addition, each licensee's annual assessment is based on income reported by the licensee as earned from activities conducted under the California Finance Lenders license. The information reported is also used to determine the licensee's compliance with the statutory net worth requirement.

WHERE TO FILE THE REPORT:	DEPARTMENT OF BUSINESS OVERSIGHT
	FINANCIAL SERVICES DIVISION
	320 WEST FOURTH STREET, SUITE 750
	LOS ANGELES, CA 90013

THE ANNUAL REPORT FORM: The information must be prepared in the annual report form prescribed by the Department of Business Oversight in Form CFL 812A (Rev. 11/13)), including Schedule B-1 Balance Sheet and Schedule C-1 Statement of Income and Expenses. Financial statements attached to the report will not be accepted in place of Schedule B-1 and Schedule C-1. ALL AMOUNTS MUST BE ROUNDED TO THE NEAREST WHOLE DOLLAR. Do not add ".00" to represent rounding to the nearest dollar. In addition, do not round items to the nearest thousand or million dollars, or round intermediate calculations. The annual report is electronically scanned and therefore the information must be TYPED in the annual report form, and the ORIGINAL signed copy of the annual report must be filed with the Department of Business Oversight.

COMPLETENESS & ACCURACY: The annual report will be rejected by the Department of Business Oversight and returned to the licensee if the information provided is incomplete or incorrect. All questions and schedules must be completed. If any schedule is inapplicable, indicate "Not Applicable" at the top of the page. Attach a supplemental page(s) if more space is needed. All information provided in the report is subject to verification. Accordingly, due care should be exercised in the completion of the report. The annual assessment is calculated from the information provided in the annual report. If the annual report filed contains incorrect information, it may result in an incorrect annual assessment. Assessment notices will be distributed to licensees on or before September 30, 20XX.

HOW TO READ THE MAILING LABEL: If you received an annual report form from the Department of Business Oversight in the mail, a mailing label is attached at line 1 of Schedule A of the form. The mailing label provides information on your license. Your license number or the mailing number assigned if you possess multiple licenses, and the number of licenses held by you as of December 31, 20XX is shown on the top line of the label.

PERIOD COVERED BY THE REPORT: The reporting period is either (1) January 1, 20XX to December 31, 20XX, or (2) the effective date of licensure in 20XX to December 31, 20XX.

WHICH SCHEDULES MUST BE COMPLETED: The Table of Schedules To Be Completed in the annual report identifies the schedules that must be completed by the type of license(s) held. If your business consists of more than one location, a single consolidated annual report must be submitted. Do not submit a separate annual report for each location.

FAILURE TO COMPLETE THE REQUIRED SCHEDULES WILL RESULT IN THE REJECTION AND RETURN OF THE ANNUAL REPORT TO THE LICENSEE.

SCHEDULE A (GENERAL INFORMATION):

Item 1.	If the Department of Business Oversight's mailing label is attached to the annual report form, item 1 (name and main office address of the licensee) does not need to be completed.
Item 5.	If the annual report includes more than one licensed location, the license number and address of each licensed location must be listed on a separate attachment, marked as Schedule A, Item Number 5.

SCHEDULE B-1 (BALANCE SHEET): This schedule must be prepared on a basis consistent with generally accepted accounting principles. Licensees are required to maintain a net worth of at least $25,000. A licensed lender employing one or more mortgage loan originators must maintain a minimum net worth of at least $250,000, and a licensed broker employing one or more mortgage loan originators must maintain a minimum net worth of at least $50,000. Failure to maintain the required net worth is grounds for administrative action.

SCHEDULE B-2 (ANALYSIS OF LOANS AND RECEIVABLES OUTSTANDING): Record all receivables not subject to the California Finance Lenders license as Other Receivables on lines 7 through 14. Exercise care in classifying the receivables because certain sales contracts, leases, and other receivables may be subject to the California Finance Lenders Law. Flooring and accounts receivable financing are examples of transactions subject to the California Finance Lenders Law. In addition, certain types of leases such as dollar buy out, direct financing, abandonment, and purchase leases may be subject to the California Finance Lenders Law. If so, the receivables must be classified under California Finance Lenders Loan Receivables on lines 1 through 6.

SCHEDULE C-1 (STATEMENT OF INCOME AND EXPENSES) AND SCHEDULE C-2 (INCOME RECEIVED FROM CFLL LENDERS AND BROKERS LOANS): These schedules must be prepared on a basis consistent with generally accepted accounting principles. For reporting purposes, treat 20XX income earned from loans originated under the Personal Property Brokers, Consumer Finance Lenders, and Commercial Finance Lenders laws as Gross Income from CFLL Loans and CFLL Brokered Loans on line 1 of Schedule C-1. Also report only the amount of income earned during the year under the California Finance Lenders license. Loss on loan receivables must be shown as a separate line item on line 4 of Schedule C-1. Do not deduct any loss on loans receivables from the gross income on line 1 of Schedule C-1.

The income reported on lines 1 through 16 of Schedule C-2 is income received under your California Finance Lender license and may include income from loans made under the Personal Property Broker, Consumer Finance Lender, and Commercial Finance Lender Laws. Double-check your calculations. The income received must be accurately reported in the schedules because the amount you report is used to determine the amount of your annual assessment under the California Finance Lenders Law to renew your license(s) for the next year. Your annual assessment is based on the gross income you report on activities conducted under your California Finance Lenders Law license. Income earned under other state or federal lending licenses, activities not requiring a license, or activities conducted under licenses of other government agencies should not be reported on line 1 of Schedule C-1 or on lines 1 through 16 of Schedule C-2.

SCHEDULE C-3 (INCOME FROM OTHER BUSINESS AND SOURCES): Report under All Other Business and Sources, lines 1 through 7, only those revenues not subject to the California Finance Lenders Law. See instructions for Schedule B-2 above for classification of receivables under the California Finance Lenders Law. Any income received from your California Finance Lender license must be reported in Schedule C-2.

SCHEDULE D (SCHEDULE OF BROKERED LOANS): All loans brokered in 20XX under your California Finance Lenders license must be scheduled. Schedule A. Schedule of CFLL Brokered Loans must be completed by a licensee that brokered loans to any lender licensed under the California Finance Lenders Law. For a definition of consumer loans and commercial loans, refer to the instructions for Schedules E, F, and G (Loan Statistics) below.

Line 8(a) -- Residential Mortgage Loans Brokered. From the "Total Consumer Loans Brokered" reported on line 8, indicate on line 8(a) the number of loans brokered, the principal amount of loans and the amount of commissions received on residential mortgage loans.

Section B. Schedule of Other Brokered Loans must be completed by licensees that have brokered loans to any lender not licensed under the California Finance Lenders Law, such as mortgage loans made under a Department of Real Estate license. The name of the regulatory agency and license number that authorizes you to broker these loans must be provided.

SCHEDULES E, F, & G (LOAN STATISTICS): If any loans were made under your California Finance Lenders license during the year 20XX, Schedules E, F, and G must be completed. The loans made in 20XX must be categorized in Schedules E, F and G as either consumer loans or commercial loans as follows:

(1) Consumer Loan -- a loan, whether secured by real or personal property, or both, or unsecured, the proceeds of which are intended by the borrower for use primarily for personal, family, or household purposes.

Consumer loan also includes a loan of a principal amount of less than $5,000, the proceeds of which are intended by the borrower for use primarily for other than personal, family, or household purposes. An example is a loan of $4,000 used for your rental business.

For the purpose of completing "Auto Title Loans" in Schedule F, an auto title loan has the characteristics of a short-term loan (typically 12 to 36 months) in which a borrower with clear title to his or her vehicle may immediately receive a loan secured by the borrower's vehicle. These loans typically are more than $2,500 and have a higher interest rate. The loans differ from traditional auto loans, which are financed and secured by a lien on the vehicle in the purchase or refinance of a car.

(2) Commercial Loan -- means a loan principal amount of $5,000 or more, or any loan under an open-end credit program, whether secured by real or personal property, or both, or unsecured, the proceeds of which are intended by the borrower for use primarily for other than personal, family, or household purposes.

(3) Open-End Credit Loans (Revolving Credit Loans): For the purposes of completing Schedules E, F, and G for open-end credit loans, the following guidelines must be followed:

(a) Total all advances made during the year under the same open-end credit loan agreement. This total constitutes the "Principal Amount" of the loan and counts as one loan made in Schedules E, F and G.

(b) Classify the loans by size, by the total advances made during the year. As an example, if five advances were made in 20XX amounting to $15,000 under the same line of credit agreement of $5,000, it should be reported as one loan made under "Number of Loans", $15,000 under "Principal Amount", and under the column "Loans $10,000 or More" in Schedules E, F and G.

SCHEDULE I (SALE OF LOANS TO INSTITUTIONAL INVESTORS AND LOANS SERVICED): Item 2 -- Loans Serviced Under the California Finance Lenders License must include all loans originated, purchased or sold.

SCHEDULED K (DIRECTORY OF DIRECTORS, OFFICERS, ETC.): All licensees must provide information on all directors, officers, members, managing members, branch managers and any person (as defined in Section 22008 of the Financial Code) owning or controlling directly or indirectly 10 percent or more of the outstanding interests or equity securities. If an individual was required to be included in the initial application for a license under the California Finance Lenders Law or in a subsequent report of changes in personnel, the individual must be included in Schedule K.

A self-designed form may be substituted in place of Schedule K if a licensee has more than 21 directors, officers, members, managing members, branch managers or persons holding 10 percent or more of the outstanding interests. The self-designed form must contain at a minimum the information required in Schedule K.

For any individual listed in Schedule K who has not submitted a Statement of Identity and Questionnaire (FS 512 SIQ), submit the Statement of Identity and Questionnaire for the individual when filing the completed annual report. The Statement of Identity and Questionnaire is available on the Department of Business Oversight's website at www.dbo.ca.gov.

The information in Schedule K will be considered confidential information, and will be filed and maintained as part of the confidential records not subject to public inspection.

SCHEDULE L (CFLL REPORT ON NON-TRADITIONAL, ADJUSTABLE RATE AND MORTGAGE LOAN PRODUCTS, AND LOAN SURVEY): All licensees are required to complete Schedule L by indicating whether they made or arranged nontraditional mortgage products and adjustable rate mortgage products as defined by the Guidance. The Guidance is available on the Department's website at www.dbo.ca.gov. If any loans subject to the Guidance were made or arranged, the licensee must also submit information regarding those loan products in the Loan Survey under Schedule L.

SCHEDULE M (ADDITIONAL LOAN INFORMATION): All licensees must complete Schedule M by answering the mortgage related questions in items 1 and 3, and indicating in item 2 the type of loan programs that were provided to applicants during the calendar year. Information regarding the Secure and Fair Enforcement for Mortgage Licensing Act of 2008 (SAFE Act) can be found on the Department's website at www.dbo.ca.gov.

SCHEDULE N (LOAN ACTIVITY): All licensees must report activity concerning consumer loans they serviced during the year by type of security in item A, and provide the total number of loans and the total principal amount of loans that were not made under the California Finance Lenders Law license for both consumer and commercial loans in items B and C.

SCHEDULE O (CONFIDENTIAL -- DEFAULT RATES BY TYPE OF LOAN): Provide information on default rates for the year by type of loan. The information provided in Schedule O shall remain confidential and not subject to public inspection.

LICENSEES OPERATING IN MULTIPLE STATES: If you conducted business in California and in other states, the additional guidelines must be followed:

(1) SCHEDULE B-1 (BALANCE SHEET) -- Complete the balance sheet in the name of the entity listed on the license. Do not complete the schedule for the California operation only. Complete line 3, CFLL Loan Receivables, in Schedule B-1 only for those loans that were made under the California Finance Lenders license. All other loans and receivables not under the California Finance Lenders license should be reported on line 4, Other Receivables.

(2) SCHEDULE C-1 (STATEMENT OF INCOME AND EXPENSES) -- Complete the Statement of Income and Expenses in the name of the entity listed on the license. Do not complete the schedule for the California operation only. Include on line 1, Gross Income from CFLL Loans and CFLL Brokered Loans, only income generated under the California Finance Lenders license. All other income earned, whether in California or out of state, must be reported on line 2, Gross Income from All Other Business and Sources.

ANNUAL REPORT FORM AVAILABLE ON THE INTERNET: The annual report form is available in Adobe Acrobat format on the Department's website at "www.dbo.ca.gov".

The form may be completed online; however, THE ANNUAL REPORT CANNOT BE FILED ELECTRONICALLY. If the report is completed online, it must be printed in the Adobe Acrobat format and submitted to the Department of Business Oversight in paper form. Please be sure to include your license number on the annual report to prevent any delays in processing your annual report. If you receive an annual report form from the Department of Business Oversight in the mail, include the information on the mailing label on the annual report you file with the Department of Business Oversight. It is important to include your seven-digit license number. It is the Department of Business Oversight primary means of linking your annual report to your company.

VERIFICATION: The Verification section must be completed in accordance with the instructions by the licensed individual, a general partner if the licensee is a partnership, a manager if the licensee is a limited liability company, or a corporate officer if the licensee is a corporation. The Verification must be signed on the original copy of the report filed with the Department of Business Oversight. An incomplete or unsigned Verification will result in rejection and return of the annual report to the licensee.

FEE: No fee is required to file the annual report.

PUBLIC INSPECTION: The individual annual reports filed pursuant to Financial Code Section 22159 shall be made available to the public for inspection, except for Schedule O which includes information of a proprietary business nature and shall remain confidential and not subject to public inspection, and upon request, the balance sheet contained in the annual report of a sole proprietor or any other nonpublicly traded persons. "Nonpublicly traded persons" for purposes of this section mean persons with securities owned by 35 or fewer individuals.

If a sole proprietor or licensee meeting the definition of nonpublicly traded persons is requesting confidential treatment of the balance sheet, the Request for Confidential Treatment in Schedule B-1 must be completed.

FOR ASSISTANCE AND INFORMATION REGARDING THE ANNUAL REPORT: Contact the Department of Business Oversight at telephone 1-866-275-2677.

DEPARTMENT OF BUSINESS OVERSIGHT

PLEASE READ THE ATTACHED INSTRUCTIONS CAREFULLY BEFORE COMPLETING THE ANNUAL REPORT.

To: COMMISSIONER OF BUSINESS OVERSIGHT, STATE OF CALIFORNIA

ANNUAL REPORT

LICENSEES ENGAGED IN BUSINESS UNDER THE CALIFORNIA FINANCE LENDERS LAW (CFLL)

(Finance Lender and Broker)

For the Year Ended December 31, 20XX

SCHEDULE A

GENERAL INFORMATION

1. Name of Licensee (as shown on the license) and Address of Main Office: __________

2. Business Phone No.: (__________) ______________________________ Fax No.: (__________) ______________________________

___________________________

Website Address:

___________________________

E-mail Address:

3. Address Change: If you wish to change the address of your place of business, you must submit a Change of Address Form (1/2014), hereby incorporated by reference, to the Department of Business Oversight. The Change of Address form must be received by the Department of Business Oversight ten (10) days prior to the date of your move, or the Department of Business Oversight may assess an administrative penalty of $500. The Change of Address form is available on the Department's website at www.dbo.ca.gov.

___________________________

4. Office Hours:

5.	a) License Number for Main Office:	___________________________
	b) NMLS Number (if applicable):	___________________________

6.	Licensed Authority:	A. [] Lender Only
		B. [] Empty Checkbox? Lender and Broker
		C. [] Empty Checkbox? Broker Only

7. Total Number of Licenses Held at December 31, 20XX: ______________________________

8.	Type of Organization:	[] Corporation
		[] Partnership
		[] Individual
		[] Limited Liability Company
		[] Other (specify)____________________

9. Person Preparing the Annual Report:

___________________________		___________________________
Signature		Name and Title (Typed)
___________________________Phone No.: (_____)
___________________________Phone No.: (_____)	___________________________Email Address:

VERIFICATION

___________________________STATE OF	)
	) SS.
___________________________COUNTY OF	)

I, the undersigned, state: That I am an officer, a general partner or the sole proprietor, or have a position of similar proprietary interest of (insert name of licensee as shown on the license)

___________________________

and I have read and signed the report and the documents filed herewith and know the contents thereof. I certify that the financial statements contained therein were prepared in conformity with generally accepted accounting principles consistently applied, and the statistical information supplied is to the best of my knowledge true and exact.

Additional certification of licensees with two or more licensed locations:

By signing this report I hereby authorize the Commissioner to contact our main office regarding issues and concerns for all branches of the company.

Complete Section (A) OR Section (B) as appropriate.

___________________________

(A) IF LOCATED IN CALIFORNIA OR IN A STATE WHICH PERMITS A DECLARATION UNDER PENALTY OF PERJURY, COMPLETE THIS SECTION. NOTARIZATION IS NOT NECESSARY.

Date_________	___________________________-____________, ____________,
(Month/Day)	(Year)		(City)	(State)

I certify (or declare) under the penalty of perjury that the foregoing is true and correct.

______________________________

Signature of Declarant

______________________________

Name and Title (Typed)

(B) IF LOCATED OUTSIDE OF CALIFORNIA IN A STATE WHICH DOES NOT PERMIT A DECLARATION UNDER PENALTY OF PERJURY, COMPLETE THIS SECTION. NOTARIZATION IS REQUIRED.

___________________________Date ,		___________________________	___________________________
	(Month/Day)	(Year)		Signature of Affiant

___________________________at				___________________________
(City)				Name and Title (Typed)

___________________________				Subscribed and sworn to before me on
(State)
				___________________________,	___________________________
				Month/Date)	(Year)
(Seal)				___________________________
				Notary Public in and for said County and State

TABLE OF SCHEDULES TO BE COMPLETED

The following schedules in the annual report must be completed:

A. If you are licensed as a CFLL LENDER, complete:

SCHEDULE	SCHEDULE
A	G
VERIFICATION	H
B-1	I
B-1(a)	J
B-2	K
C-1	L
C-2	M
C-3	N
E	O
F

B. If you are licensed as a CFLL BROKER, complete:

SCHEDULE	SCHEDULE
A	C-2
VERIFICATION	C-3
B-1	D
B-1(a)	J
B-2	K
C-1	L and M

C. If you are licensed as both a CFLL LENDER and CFLL BROKER, complete all schedules.

D. If any schedule is inapplicable, indicate "Not Applicable" at the top of the schedule.

E. The Verification section must be completed. AN UNSIGNED OR INCOMPLETE VERIFICATION WILL NOT BE ACCEPTED, AND WILL RESULT IN REJECTION AND RETURN OF THE ANNUAL REPORT TO THE LICENSEE.

F. If no business was conducted under the license(s) during the year, complete Schedules A through C-3, Schedule K and Verification section only. The remaining pages need not be submitted. "No business" means no loans were made, refinanced, or brokered in the calendar year, and no loan payment or broker fee was received during the year. Include the following statement at the bottom of the Verification section, "No business was conducted under the license(s) during the calendar year 20XX."

G. Your annual assessment is based on the gross income you report on activities conducted under your California Finance Lenders Law license (Schedule C-1, Statement of Income and Expense, Line 1). Income earned under other state or federal lending licenses, activities not requiring a license, or activities conducted under licenses of other government agencies should be reported on Schedule C-1, Line 2.

H. For purposes of completing the annual report, all income derived from loans originated under the Personal Property Broker, Consumer Finance Lender, and /or Commercial Finance Lender Laws should be treated as income earned under the California Finance Lenders Law.SCHEDULE B-1 BALANCE SHEET AS OF DECEMBER 31, 20XX

___________________________Name of Licensee:			___________________________CFLL License No.

ASSETS

1.	..........................Cash	$	___________________________
2.	Investments
3.	..........................CFLL Loan Receivables (must equal Schedule B-2, line 6)		___________________________
4.	..........................Other Receivables (must equal Schedule B-2, line 14)		___________________________
5.	..........................Reserves and Withholds by Banks and Finance Companies		___________________________
6.	Fixed Assets (Less: Accumulated Depreciation $	)	___________________________
	(Fixed assets include land, buildings, equipment, furniture and fixtures, automobiles, and leasehold improvements, less accumulated depreciation.)

7.	..........................Prepaid Expenses and Deferred Charges		___________________________
8.	..........................Commissions Receivables		___________________________
9.	..........................Other Assets		___________________________
10.	..........................Total Assets (sum of lines 1 thru 9 and must equal line 22)	$	___________________________
LIABILITIES AND NET WORTH

11.	..........................Loans and Notes Payable from Third Parties	$	___________________________
12.	..........................Loans and Notes Payable from Parents and Affiliates		___________________________
13.	..........................Bonds, Debentures, and Certificates of Indebtedness		___________________________
14.	..........................Accounts Payable		___________________________
15.	..........................Dealers Reserves and Withholds		___________________________
16.	..........................Accrued Taxes Other Than Income Tax		___________________________
17.	..........................Reserve for Income Taxes		___________________________
18.	..........................Credit Insurance Premiums Due Insurer		___________________________
19.	..........................Other Liabilities and Accruals		___________________________
20.	..........................Total Liabilities (sum of lines 11 thru 19)	$	___________________________
21.	..........................Net Worth (line 10 less line 20 and must equal Schedule B-1(a), line 10, 13, 14 or 19)	$	___________________________
22.	..........................Total Liabilities and Net Worth (add lines 20 & 21 and must equal line 10)	$	___________________________

SCHEDULE B-1REQUEST FOR CONFIDENTIAL TREATMENT

Name of Licensee (as shown on the license):

___________________________

CFLL License Number:

PURSUANT TO SECTION 22159(a) OF THE FINANCIAL CODE, I REQUEST CONFIDENTIAL TREATMENT OF THE BALANCE SHEET. THE LICENSEE QUALIFIES FOR CONFIDENTIAL TREATMENT OF THE BALANCE SHEET AS A:

(CHECK ONE)

SOLE PROPRIETOR		[]

NONPUBLICLY TRADED PERSON" (persons with securities owned by 35 or fewer individuals)		[]

By:__________________________________________________________________

Signature of Authorized Person

Name(typed): _______________________________________________

Position: ______________________________________________________________

Name of Licensee: ____________________________________________________________ CFLL License No. ____________________

FOR CORPORATIONS:

1. Common Stock..........................			$	___________________________

2. Preferred Stock..........................				___________________________

3. Paid In Capital in Excess of Par..........................				___________________________

4. Less: Treasury Stock, Donated Stock, etc..........................				___________________________()

5. Total Capital (sum of lines 1 thru 4)..........................			$	___________________________

6. Retained Earnings at 01/01/XX..........................	$	___________________________
7. Adjustments to Retained Earnings..........................		___________________________
8. Net Income or Loss (from Schedule C-1, line 23)..........................		___________________________
9. Retained Earnings at 12/31/XX (sum of lines 6 thru 8)..........................				___________________________

10. Total Net Worth (sum of lines 5 and 9, and must equal Schedule B-1, line 21)..........................			$	___________________________

FOR PARTNERSHIPS:

11. Partnership Capital Accounts:

Name (General Partners)_______	Percentage		Amount
___________________________	___________________________	$	___________________________
___________________________	___________________________		___________________________
___________________________	___________________________		___________________________
___________________________	___________________________		___________________________
___________________________	___________________________		___________________________

12. Limited Partners (in total)..........................

___________________________

13. Total Net Worth (sum of lines 11 and 12, and must equal Schedule B-1, line 21)..........................

___________________________

FOR INDIVIDUALS, TRUSTEES, AND OTHERS:

14. Net Worth of Individuals, Trustees, and Others (enter amount from Schedule B-1, line 21)..........................	$	___________________________
FOR LIMITED LIABILITY COMPANIES:
15. Members' Contributions..........................		___________________________
16. Members' Draws..........................		___________________________
17. Members' Equity..........................		___________________________
18. Net Income (Loss) (from Schedule C-1, line 23)..........................		___________________________
19. Total Members' Equity (sum of lines 15-18, and must equal Schedule B-1, line 21)	$	___________________________

SCHEDULE B-2 ANALYSIS OF LOANS AND RECEIVABLES OUTSTANDING AS OF DECEMBER 31, 20XX

CALIFORNIA FINANCE LENDERS LOAN RECEVABLES:

___Aggregate Balance

(may include outstanding receivables originated under the Personal Property Broker, Consumer Finance Lender, and Commercial Finance Lender laws)

1.	..........................Consumer Loans	$	___________________________
2.	..........................Commercial Loans		___________________________
3.	..........................Subtotal (sum of lines 1 and 2)	$	___________________________
4.	..........................Less: Unearned Pre-computed Charges		___________________________()
5.	..........................Less: Allowance for Bad Debts		___________________________()
6.	..........................Net California Finance Lenders Loan Receivables (sum of lines 3 thru 5 and must equal Schedule B-1, line 3)	$	___________________________
OTHER RECEIVABLES NOT SUBJECT TO THE CFLL:
(See instructions for Schedule B-2 for classification of receivables)

		___Aggregate Balance

7.	..........................Sales Contracts	$	___________________________
8.	..........................Leases (True leases)		___________________________
9.	..........................Factoring		___________________________
10.	..........................Others		___________________________
11.	..........................Subtotal (sum of lines 7 and 10)	$	___________________________
12.	..........................Less: Unearned Pre-computed Charges		___________________________()
13.	..........................Less: Allowance for Bad Debts		___________________________()
14.	..........................Net Other Receivables (sum of lines 11 thru 12, and must equal Schedule B-1, line 4)	$	___________________________

SCHEDULE C-1

STATEMENT OF INCOME AND EXPENSES FOR CALENDAR YEAR 20XX

INCOME

1.	..........................Gross Income from CFLL Loans and CFLL Brokered Loans (from Schedule C-2, line 16). REPORT ONLY CFLL GROSS INCOME ON THIS LINE	$	___________________________
2.	..........................Gross Income from All Other Business and Sources (from Schedule C-3, line 7)		___________________________
3.	..........................Total Gross Income (sum of lines 1 and 2)	$	___________________________
EXPENSES

4.	..........................Loss on Loan Receivables	$	___________________________
5.	..........................Professional Audit and Accounting Services		___________________________
6.	..........................Insurance and Bond Premiums		___________________________
7.	..........................Legal Services and Expenses		___________________________
8.	..........................Occupancy Expenses		___________________________
9.	..........................Provision for Bad Debt Allowance		___________________________
10.	..........................Salaries and Bonuses: Employees		___________________________
11.	..........................Salaries and Bonuses: Owners, Partners, Executives		___________________________
12.	..........................Depreciation		___________________________
13.	..........................License Fees and Taxes		___________________________
14.	..........................Telephone and Utilities		___________________________
15.	..........................Advertising and Promotions		___________________________
16.	..........................Other Expenses		___________________________
17.	..........................Total Expenses Before Interest and Income Taxes (sum of lines 4 thru 16)	$	___________________________
18.	..........................Income or (loss) Before Interest and Income Taxes (line 3 less line 17)	$	___________________________
19.	..........................Interest Paid to Bona Fide Third Parties		___________________________
20.	..........................Interest Paid to Parent Company and Affiliates		___________________________
21.	..........................Income or (Loss) Before Income Taxes (subtract lines 19 and 20 from line 18)	$	___________________________
22.	..........................Provisions for Income Taxes		___________________________
23.	..........................Net Income or (Loss) (line 21 less line 22)	$	___________________________

(If the licensee is incorporated, the Net Income or Loss amount in line 23 must agree with Schedule B-1(a), line 8.)SCHEDULE C-2

ANALYSIS OF INCOME RECEIVED FROM CFLL LENDERS AND BROKERS LOANS FOR CALENDAR YEAR 20XX

			Loans Under $2,500 (Column 1)		Loans of $2,500 or More (Column 2)		Total (Column 3)
CFLL LENDERS AND BROKERS LOANS:

CONSUMER LOANS:
1.	..........................Charges Earned or Collected from Loans	$	___________________________	$	___________________________	$	___________________________
2.	..........................Collection from Charged Off Accounts		___________________________		___________________________		___________________________
3.	..........................Income from Credit Insurance		___________________________		___________________________		___________________________
4.	..........................Other Insurance Commissions		___________________________		___________________________		___________________________
5.	..........................Administrative and Loan Fees		___________________________		___________________________		___________________________
6.	..........................Commissions from Brokering CFLL Consumer Loans (from Schedule D, line 8)		___________________________		___________________________		___________________________
7.	..........................Other Income		___________________________		___________________________		___________________________
8.	..........................Total Consumer Loans Income (sum of lines 1 thru 7)	$	___________________________	$	___________________________	$	___________________________
COMMERCIAL LOANS:

9.	..........................Charges Earned or Collected from Loans					$	___________________________

10.	..........................Collection from Charged Off Accounts						___________________________

11.	..........................Income from Credit Insurance						___________________________

12.	..........................Other Insurance Commissions						___________________________

13.	..........................Commissions from Brokering CFLL Commercial Loans (from Schedule D, line 13)						___________________________

14.	..........................Other Income						___________________________

15.	..........................Total Commercial Loan Income (sum of lines 9 thru 14)					$	___________________________

16.	..........................Total Gross Income from CFLL Loans and Brokered Loans (sum of line 8, column 3 and line 15, and must equal Schedule C-1, line 1)					$	___________________________

SCHEDULE C-3 ANALYSIS OF INCOME RECEIVED FROM OTHER BUSINESS AND SOURCES FOR CALENDAR YEAR 20XX

ALL OTHER BUSINESS AND SOURCES:

1.	..........................Charges Earned or Collected	$	___________________________
2.	..........................Other Interest or Return on Investment		___________________________
3.	..........................Collection from Charged Off Accounts		___________________________
4.	..........................Income from Credit Insurance		___________________________
5.	..........................Other Insurance Commissions		___________________________
6.	..........................Other Income (describe below)		___________________________
7.	..........................Total Income from All Other Business and Sources (sum of lines 1 through 6, and must equal Schedule C-1, line 2)	$	___________________________

Describe source(s) of other income reported on lines 1 through 6:

___________________________

SCHEDULE D SCHEDULE OF BROKERED LOANS FOR CALENDAR YEAR 20XX

A. SCHEDULE OF CFLL BROKERED LOANS (e.g., to any lender licensed under the CFLL)

Name of Lender	Lender's License Number	Number of Loans Brokered		Principal Amount of Loans		Amount of Commissions Received
LIST CONSUMER LOANS BROKERED:

___________________________1.	___________________________	___________________________	$	___________________________	$	___________________________
___________________________2.	___________________________	___________________________		___________________________		___________________________
___________________________3.	___________________________	___________________________		___________________________		___________________________
___________________________4.	___________________________	___________________________		___________________________		___________________________
___________________________5.	___________________________	___________________________		___________________________		___________________________
___________________________6.	___________________________	___________________________		___________________________		___________________________
___________________________7.	___________________________	___________________________		___________________________		___________________________
8. Total Consumer Loans Brokered (sum of lines 1 through 7, and must equal Schedule C-2, line 6, column 3)..........................		___________________________	$	___________________________	$	___________________________

8a. Residential Mortgage Loans Brokered (see Schedule D instructions to complete this section)..........................		___________________________		___________________________		___________________________

LIST COMMERCIAL LOANS BROKERED:

___________________________9.	___________________________	___________________________	$	___________________________	$	___________________________
___________________________10.	___________________________	___________________________		___________________________		___________________________
___________________________11.	___________________________	___________________________		___________________________		___________________________
___________________________12.	___________________________	___________________________		___________________________		___________________________
13. Total Commercial Loans Brokered (sum of lines 9 through 12, and must equal Schedule C-2, line 13)..........................		___________________________	$	___________________________	$	___________________________

14. Total Loans Brokered (sum of lines 8 and 13)..........................		___________________________	$	___________________________	$	___________________________

Describe the method of computing commissions and how commissions are paid (i.e., in advance, from loan proceeds, etc.). If commissions are prepaid, describe the method of refunding commissions in the event a loan is not funded.

___________________________

B. SCHEDULE OF OTHER BROKERED LOANS (e.g., to any lender not licensed under the CFLL)

	Total Number of Loans Brokered		Total Principal Amount of Loans Brokered		Total Amount of Commissions Received
TOTALS	___________________________	$	___________________________	$	___________________________

Provide the name of the government agency and your broker license number authorizing you to broker other loans identified Section B:____________________

SCHEDULE E CALIFORNIA FINANCE LENDERS LOANS MADE OR REFINANCED DURING THE YEAR BY SIZE OF LOAN FOR CALENDAR YEAR 20XX

CONSUMER LOANS

Loans of:			Number of Loans		Principal Amount

1.	$	.......................... 499 or Less	___________________________	$	___________________________
2.		.......................... 500 to 1,999	___________________________		___________________________
3.		.......................... 2,000 to 2,499	___________________________		___________________________
4.		.......................... 2,500 to 4,999	___________________________		___________________________
5.		.......................... 5,000 to 9,999	___________________________		___________________________
6.		..........................10,000 or More	___________________________		___________________________
7.	..........................Total Consumer Loans Made (Sum of lines 1 through 6. Totals must equal Schedule F, line 27 and Schedule G, line 40.)		___________________________	$	___________________________

COMMERCIAL LOANS

8.	..........................$ 5,000 or More		___________________________	$	___________________________

9.	..........................Total Commercial Loans Made (Totals must equal Schedule F, line 34 and Schedule G, line 49.)		___________________________	$	___________________________

10.	..........................Total Loans Made - All Categories (Sum of lines 7 and 9. Totals must equal Schedule F, line 35 and Schedule G, line 50)		___________________________	$	___________________________

SCHEDULE F

CALIFORNIA FINANCE LENDERS LOANS MADE OR REFINANCED DURING THE YEAR BY TYPE OF SECURITY FOR CALENDAR YEAR 20XX

CONSUMER LOANS

Type of Security		Number of Loans		Principal Amount

Loans Under $2,500

1.	..........................Unsecured	___________________________	$	___________________________
2.	..........................Personal Property (Household Items)	___________________________		___________________________
3.1	..........................Automobiles and Other Motor Vehicles	___________________________		___________________________
3.2	..........................Auto Title Loans	___________________________		___________________________
4.	..........................Wage Assignment	___________________________		___________________________
5.	..........................Other Security	___________________________		___________________________
6.	..........................Total Loans Made (sum of lines 1 through 5)	___________________________	$	___________________________
Loans $2,500 to $4,999

7.	..........................Unsecured	___________________________	$	___________________________
8.	..........................Personal Property (Household Items)	___________________________		___________________________
9.1	..........................Automobiles and Other Motor Vehicles	___________________________		___________________________
9.2	..........................Auto Title Loans	___________________________		___________________________
10.	..........................Wage Assignment	___________________________		___________________________
11.	..........................Other Security	___________________________		___________________________
12.	..........................Total Loans Made (sum of lines 7 through 11)	___________________________	$	___________________________
Loans $5,000 to $9,999

13.	..........................Unsecured	___________________________	$	___________________________
14.	..........................Personal Property (household items)	___________________________		___________________________
15.1	..........................Automobiles and Other Motor Vehicles	___________________________		___________________________
15.2	..........................Auto Title Loans	___________________________		___________________________
16.	..........................Wage Assignment	___________________________		___________________________
17.	..........................Real Property	___________________________		___________________________
18.	..........................Other Security	___________________________		___________________________
19.	..........................Total Loans Made (sum of lines 13 through 18)	___________________________	$	___________________________
Loans $10,000 or More

20.	..........................Unsecured	___________________________	$	___________________________
21.	..........................Personal Property (Household Items)	___________________________		___________________________
22.1	..........................Automobiles and Other Motor Vehicles	___________________________		___________________________
22.2	..........................Auto Title Loans	___________________________		___________________________
23.	..........................Wage Assignment	___________________________		___________________________
24.	..........................Real Property	___________________________		___________________________
25.	..........................Other Security	___________________________		___________________________
26.	..........................Total Loans Made (sum of lines 20 through 25)	___________________________	$	___________________________
27.	..........................Total Consumer Loans Made (sum of lines 6, 12, 19, and 26). Totals must equal Schedule E, line 7 and Schedule G, line 40)	___________________________	$	___________________________
COMMERCIAL LOANS ONLY

28.	..........................Unsecured	___________________________	$	___________________________
29.	..........................Personal Property	___________________________		___________________________
30.	..........................Automobiles and Other Motor Vehicles	___________________________		___________________________
31.	..........................Business Equipment	___________________________		___________________________
32.	..........................Real Property	___________________________		___________________________
33.	..........................Other Security	___________________________		___________________________
34.	..........................Total Commercial Loans Made (Sum of lines 28 through 33. Totals must equal Schedule E, line 9 and Schedule G, line 49.)	___________________________	$	___________________________
35.	..........................Total Loans Made - All Categories (sum of lines 27 and 34). Totals must equal Schedule E, line 10 and Schedule G, line 50.)	___________________________	$	___________________________

SCHEDULE G

CALIFORNIA FINANCE LENDERS LOANS MADE OR REFINANCED DURING THE YEAR BY RATES CHARGED FOR CALENDAR YEAR 20XX

CONSUMER LOANS ONLY

Unsecured Loans

Personal Property (household items)

Automobiles and Other Motor Vehicles

Auto Title Loans

Wage Assignment

Other Security

Annualized Rate of Charge

No. of Loans

Princ. Amount

No. of Loans

Princ. Amount

No. of Loans

Princ. Amount

No. of Loans

Princ. Amount

No. of Loans

Princ. Amount

No. of Loans

Princ. Amount

Loans Under $2,500

Step Rate: 2.5%, 2%, 1.5%, & 1% Per Month

___________________________

Alternate Rates: 1.6% Per Month

___________________________

Federal Reserve Bank Rate plus 10%

___________________________

Up to 14.999 APR

___________________________

15.000 to 19.999 APR

___________________________

20.000 to 24.999 APR

___________________________

25.000 to 29.999 APR

___________________________

30.000 to 34.999 APR

___________________________

35.000 to 39.999 APR

___________________________

10.1.

40.000 to 69.999 APR

___________________________

10.2.

70.000 to 99.999 APR

___________________________

10.3.

100.000 or More APR

___________________________

11.

Intentionally Left Blank

___________________________

12.

Total Loans Made (sum of lines 1thru11)

___________________________

Loan $2,500 to $4,999

13.

Up to 14.999 APR

___________________________

14.

15.000 to 19.999 APR

___________________________

15.

20.000 to 24.999 APR

___________________________

16.

25.000 to 29.999 APR

___________________________

17.

30.000 to 34.999 APR

___________________________

18.

35.000 to 39.999 APR

___________________________

19.1.

40.000 to 69.999 APR

___________________________

19.2

70.000 to 99.999 APR

___________________________

19.3

100.000 or More APR

___________________________

20.

Intentionally Left Blank

___________________________

21.

Total Loans Made (sum of lines 13thru 20)

___________________________

Loan $5,000 to $9,999

22.

Up to 14.999 APR

___________________________

23.

15.000 to 19.999 APR

___________________________

24.

20.000 to 24.999 APR

___________________________

25.

25.000 to 29.999 APR

___________________________

26.

30.000 to 34.999 APR

___________________________

27.

35.000 to 39.999 APR

___________________________

28.1.

40.000 to 69.999 APR

___________________________

28.2.

70.000 to 99.999 APR

___________________________

28.3.

100.000 or More APR

___________________________

29.

Intentionally Left Blank

___________________________

30.

Total Loans Made (sum of lines 22 thru 29)

___________________________

Loan $10,000 or Over

31.

Up to 14.999 APR

___________________________

32.

15.000 to 19.999 APR

___________________________

33.

20.000 to 24.999 APR

___________________________

34.

25.000 to 29.999 APR

___________________________

35.

30.000 to 34.999 APR

___________________________

36.

25.000 to 29.999 APR

___________________________

37.1.

35.000 to 39.999 APR

___________________________

37.2.

70.000 to 99.999 APR

___________________________

37.3.

100.000 or More APR

___________________________

38.

Intentionally Left Blank

___________________________

39.

Total Loans Made (sum of lines 31 thru 38)

40.

Total Consumer Loans Made (sum of lines 12, 21, 30 & 39). Totals must equal Schedule E, Line 7 and Schedule F, Line 27.

___________________________

COMMERCIAL LOANS ONLY

Note Rate or Contract Rate		Number of Loans		Principal Amount

41.	..........................Up to 14.999	___________________________	$	___________________________
42.	..........................15.000 to 19.999	___________________________		___________________________
43.	..........................20.000 to 24.999	___________________________		___________________________
44.	..........................25.000 to 29.999	___________________________		___________________________
45.	..........................30.000 to 34.999	___________________________		___________________________
46.	..........................35.000 to 39.999	___________________________		___________________________
47.1	..........................40.000 to 69.999	___________________________		___________________________
47.2	..........................70.000 to 99.999	___________________________		___________________________
47.3	..........................100.000 or More	___________________________		___________________________
48.	..........................Variable Rates Based on Index	___________________________		___________________________
49.	..........................Total Commercial Loans Made (Sum of lines 41 through 48. Totals must equal Schedule E, line 9 and Schedule F, line 34.)	___________________________	$	___________________________
50.	..........................Totals Loans Made - All Categories (Sum of lines 40 and 49. Totals must equal Schedule E, line 10 and Schedule F, line 35.)	___________________________	$	___________________________

SCHEDULE H

CREDIT INSURANCE GENERAL INFORMATION

1. Provide the name(s) and address(s) of insurance company(s) underwriting your credit insurance.

___________________________

Name:

___________________________

Address:

2. Is the insurance company(s) named in item 1 above a parent corporation, affiliated company, or in any other manner connected with you: Yes [] No []

If the answer to item 2 is "yes", explain the relationship:

___________________________

3. Credit insurance premiums charged per year per hundred dollars of initial indebtedness:

Single Premium	Credit Life	Joint Coverage

___________________________$	Personal Property	___________________________$
___________________________$	Real Property	___________________________$

Credit Disability

___________________________$	Personal Property	___________________________$
___________________________$	Real Property	___________________________$
Credit Loss-of-Income

___________________________$	Personal Property	___________________________$
___________________________$	Real Property	___________________________$

4. Is the credit insurance premium deducted from loan proceeds? Yes [] No []

If the answer is "no", explain how the credit insurance proceeds are paid:

___________________________

5. Are the credit insurance premiums that have been collected from borrowers remitted in total to the carrier?

Yes [] No []

If the answer is "no", provide an explanation:

___________________________

6. What is the age limit to qualify for credit insurance?

	Minimum	Maximum

Credit Life	___________________________	___________________________
Credit Disability	___________________________	___________________________
Credit Loss-of-Income	___________________________	___________________________

7. Does the credit disability policy contain a "14-day" non-retroactive provision? Yes [] No []

If the answer is "No", provide an explanation:

___________________________

8. List exclusions from coverage, if any:

___________________________

SCHEDULE I SALE OF LOANS TO INSTITUTIONAL INVESTORS AND LOANS SERVICED FOR CALENDAR YEAR 20XX

1. Loans Sold Pursuant to Financial Code Sections 22340, 22340.1, 22600 or 22600.1:

A. Report only those loans originated under your California Finance Lenders license(s), or purchased from an institutional lender or from another licensee pursuant to Division 9 of the Financial Code, and subsequently sold to institutional investors.

No. of Loans Sold	Dollar Value of Loans Sold		Dollar Amount of Loans Sold Retained for Servicing			Servicing Fees Earned

___________________________	$	___________________________	$	___________________________	$	___________________________

	Are these loans sold to institutional investors?	Yes [] No []
	Did you sell any of those loans to affiliated companies?	Yes [] No []
	Are trust accounts established for those loans serviced?	Yes [] No []

B. Loans Sold Under Other Authority

Report only those loans originated under your California Finance Lenders license(s), or purchased from an institutional lender or from another licensee pursuant to Division 9 of the Financial Code that were sold, but not sold under the authority of the California Finance Lenders Law.

No. of Loans Sold	Dollar Value of Loans Sold
		(License Number)
Please state under which authority the loans were sold:
		___________________________

2. Loans Serviced Under the California Finance Lenders License (includes all loans originated, purchased or sold):

Report all loans you serviced as of December 31, 20XX.

Loan Type	Number of Loans		Balance		Servicing Fees Earned
Residential Real Estate Secured	___________________________	$	___________________________	$	___________________________
All Other Loans	___________________________	$	___________________________	$	___________________________

SCHEDULE J OTHER BUSINESS ACTIVITIES AND COVERED LOANS

A. OTHER BUSINESS ACTIVITIES:

Schedule J must be completed for any other activities conducted at the licensed locations(s), in addition to making and/or brokering loans under your California Finance Lender license(s).

1.	SALE OF INSURANCE PRODUCTS	Insurer		20XX Revenue

	Credit Life Insurance	___________________________	$	___________________________
	Credit Disability Insurance	___________________________		___________________________
	Accidental Death & Dismemberment	___________________________		___________________________
	Personal Property Insurance	___________________________		___________________________
	Real Estate Loan Insurance	___________________________		___________________________
	Others (auto, whole life, etc.)	___________________________		___________________________

2. OTHER SERVICES PROVIDED (Examples: loan servicing, leasing, automobile contracts, etc.)

Description of Services Provided	20XX Revenue	License Authority (If Applicable)

___________________________	___________________________$	___________________________
___________________________	___________________________	___________________________
___________________________	___________________________	___________________________

3. BUSINESS CONDUCTED PURSUANT TO THE COMMODITY BROKERS LAW OF 1990

(Example: Sale and/or financing of precious metals or other commodities)

Describe Activity

20XX Revenue

License Authority (If Applicable)

4. OTHER BUSINESS ACTIVITY CONDUCTED AT LICENSED LOCATION (not already included in items 1, 2, or 3 above.)

Describe Activity

20XX Revenue

License Authority (If Applicable)

5. LIST ANY OTHER LICENSES ISSUED BY STATE OF CALIFORNIA GOVERNMENT AGENCIES AND HELD BY THE LICENSEE:

Name of License

Name of Agency

License Number

B. COVERED LOANS:

This section must be completed by a licensee that made "covered loans" as defined in Financial Code Section 4970(b)(1).

	Number of Covered Loans			Principal Amount
	___________________________		$	___________________________

SCHEDULE K DIRECTORY OF DIRECTORS, OFFICERS, MEMBERS, MANAGING MEMBERS, BRANCH MANAGERS AND ANY PERSON OWNING OR CONTROLLING (DIRECTLY OR INDIRECTLY) 10% OR MORE OF INTEREST OR EQUITY SECURITIES

Name of Licensee: ________________________________________________________________________________ CFLL License No. __________

Complete the following directory for ALL directors, officers, members, managing members, branch managers and any person (as defined in Section 22008 of the Financial Code) owning or controlling directly or indirectly 10 percent or more of the outstanding interest or equity securities. If an individual was required to be included in the initial application for a license under the California Finance Lenders Law or in a subsequent report of changes in personnel, the individual must be included in this directory.

A self-designed form may be substituted in place of Schedule K if a licensee has more than 21 directors, officers, members, managing members, branch managers and persons holding 10 percent or more of the outstanding interests. The self designed form must contain at a minimum the following information.

In addition to this directory, submit a Statement of Identity and Questionnaire (SIQ), for those individuals who did not submit the SIQ to the Department previously. The SIQ form is available on the Department of Business Oversight's website at www.dbo.ca.gov.

FULL NAME			POSITION HELD	% OF	BUSINESS ADDRESS (Street, City,
FIRST	MIDDLE	LAST	OR TO BE HELD	OWNERSHIP	State & Zip Code)

SCHEDULE L

CFLL REPORT ON NON-TRADITIONAL, ADJUSTABLE RATE AND MORTGAGE LOAN PRODUCTS

___________________________

COMPANY NAME:

___________________________

LICENSE NUMBER:

___________________________

NMLS NUMBER:

CONTACT PERSON:

___________________________

TELEPHONE NUMBER:

___________________________

1. During calendar year 20XX, did you make or arrange non-traditional mortgage products or adjustable rate mortgage products as defined by the Guidance?

	a. Made non-traditional mortgage products?	Yes [] No []
	b. Arranged non-traditional mortgage products?	Yes [] No []
	c. Made adjustable rate mortgage products?	Yes [] No []
	d. Arranged adjustable rate mortgage products?	Yes [] No []

If the answer is "yes" to any of the above, complete items 1 through 4 of the Non-Traditional, Adjustable Rate and Mortgage Loan Survey below.

If the answer is "no" to all of the above, complete item 1 of the Non-Traditional, Adjustable Rate and Mortgage Loan Survey below.NON-TRADITIONAL, ADJUSTABLE RATE AND MORTGAGE LOAN SURVEY

1. License Information (to be completed by all licensees)
CFLL License Number:
Licensee Name:
Name of Person Who Prepared this Survey:
Preparer's Title:
Telephone Number:
Email Address:

2. Does your company offer non-traditional mortgage products?	Yes
(Place an "x" in the appropriate category.)	No
(If "yes", complete remaining survey)
3. If "yes", are they retained on the books or sold?	Retained
(Place an "x" in one or both categories.)	Sold

4. Provide the dollar volume in thousands and number of loans retained as of December 31, 20XX, and the dollar volume in thousands and number of loans sold over the 12-month period ending December 20XX. For loans with multiple non-traditional characteristics, include them in each applicable category.	Retained (Number of Loans)	Retained (Dollar Amount)	Sold (Number of Loans)	Sold (Dollar Amount)
a. Interest-only Mortgage Loan
b. Payment Option ARM
c. Reduced Documentation
d. Simultaneous Second-lien Loan
e. Home Equity Line of Credit
f. Covered Loans
g. Adjustable Rate Mortgage Loans
5. All Loans (Non-Traditional and Traditional)

NON-TRADITIONAL, ADJUSTABLE RATE AND MORTGAGE LOAN SURVEY DEFINITIONS

Definitions
a.	Interest-only Mortgage Loan	A nontraditional mortgage in which, for a specified number of years (e.g., three or five years), the borrower is required to pay only the interest due on the loan, during which time the interest rate may fluctuate or may be fixed. After the interest-only period, the rate may be fixed or fluctuate based on the prescribed index and payments include both principal and interest.
b.	Payment Option ARM	A nontraditional mortgage that allows the borrower to choose from a number of different payment options. For example, each month, the borrower may choose a minimum payment option based on a "start" or introductory interest rate, an interest-only payment option based on the fully indexed interest rate, or a fully amortizing principal and interest payment option based on a 15-year or 30-year loan term, plus any required escrow payments. The minimum payment option can be less than the interest accruing on the loan, resulting in negative amortization. The interest-only option avoids negative amortization but does not provide for principal amortization. After a specified number of years, or if the loan reaches a certain negative amortization cap, the required monthly payment amount is recast to require payments that will fully amortize the outstanding balance over the remaining loan term.
c.	Reduced Documentation	A loan feature that is commonly referred to as "low doc/no doc", "no income/no asset", "stated income" or "stated assets." For mortgage loans with this feature, an institution sets reduced minimal documentation standards to substantiate the borrower's income and assets.
d.	Simultaneous Second-lien Loan	A lending arrangement where either a closed-end second-lien or a home equity line of credit (HELOC) is originated simultaneously with the first lien mortgage loan, typically in lieu of a higher down payment.
e.	Home Equity Line of Credit	An open-end loan, usually recorded as a second mortgage, that permits borrowers to obtain cash advances based on an approved line of credit.
f.	Covered Loans	Covered loan (under Section 4970 of the Financial Code) - a consumer loan in which the original principal balance of the loan does not exceed the most current conforming loan limit for a single-family first mortgage loan established by Fannie Mae and where one of the following conditions are met:
		a) the APR at consummation will exceed by more than 8 percentage points the yield on Treasury securities having comparable maturity periods on the 15th day of the month immediately preceding the month in which the loan application is received, or
		b) the total points and fees payable by the consumer at or before closing will exceed 6% of the total loan amount.
g.	Adjustable Rate Mortgage Loans (ARMS)	An adjustable rate mortgage loan that has one or more of the following characteristics: (1) low initial payments based on a fixed introductory rate that expires after a short period and then adjusts to a variable index rate plus a margin for the remaining term of the loan; (2) very high or no limits on how much the payment amount or the interest rate may increase ("payment or rate caps") on reset dates; (3) limited or no documentation of borrower's income; (4) product features likely to result in frequent refinancing to maintain an affordable monthly payment; and/or (5) substantial prepayment penalties and/or prepayment penalties that extend beyond the initial fixed interest rate period. As an example of item (1) above, ARMs known as "2/28" loans feature a fixed rate for two years and then adjust to a variable rate for the remaining 28 years, and the spread between the initial fixed interest rate and the fully indexed interest rate in effect at loan origination typically ranges from 300 to 600 basis points.

SCHEDULE M ADDITIONAL LOAN INFORMATION

1. Please answer the following questions in connection with the Secure and Fair Enforcement for Mortgage Licensing Act of 2008 (SAFE Act): (Information regarding the SAFE Act can be found on our website at www.dbo.ca.gov).

A. Did you make, arrange or service any residential mortgage loans as defined by the SAFE Act? Yes [] No []

B. How many mortgage loan originators did you employ as of 12/31/XX for this activity? __________

C. Indicate the NMLS Unique Identifier Number: __________

2. Under the authority of your California Finance Lenders license, please indicate which of the following type(s) of loan programs were provided to applicants during the calendar year:

	A. Consumer first mortgage loans (1-4 units)	Yes [] No []
	B. Consumer unsecured loans	Yes [] No []
	C. Consumer personal property loans	Yes [] No []
	D. Automobiles and other motor vehicles	Yes [] No []
	E. Auto title loans	Yes [] No []
	F. Affordable Credit-Building Opportunity loans	Yes [] No []
	G. Commercial real estate loans	Yes [] No []
	H. Commercial unsecured loans	Yes [] No []
	I. Commercial business equipment	Yes [] No []
	J. Commercial automobiles and other motor vehicles	Yes [] No []
	K. Accounts receivable financing	Yes [] No []
	L. Other CFLL activity (describe below)	Yes [] No []

___________________________

3. The following questions are in connection with the California Foreclosure Reduction Act and the single point of contact requirement in Civil Code Section 2923.7.

A. During the calendar year, did you foreclose on 175 or fewer residential real properties containing no more than four dwelling units that are located in California? Yes [] No []

B. Provide your total number of foreclosures initiated during the calendar year 20XX on residential real properties located in California, containing no more than four dwelling units. __________

C. Provide your total number of foreclosures that resulted in the sale of residential real properties located in California, containing no more than four dwelling units, during the calendar year. __________SCHEDULE N SCHEDULE OF LOAN ACTIVITY AS OF DECEMBER 31, 20XX

Unsecured

Personal Property Loans

Automobiles and Other Motor Vehicles

Auto Title Loans

Other Security

No.

Amount

No.

Amount

No.

Amount

No.

Amount

No.

Amount

A. Consumer Loans Serviced:

1. Loans outstanding prior year at 12/31/XX

___________________________

2. Loans outstanding at year end 12/31/XX

___________________________

3. Loans with one or more past due payments, which are past due 30 or more days at 12/31/XX

___________________________

4. For calendar year 20XX provide the following:

___________________________

a. Total loans made

___________________________

b. Number of loans charged one or more late fees

___________________________

c. Total late fees collected

___________________________

d. Total number of repossessions conducted

___________________________

e. Total number of loans reinstated

___________________________

f. Total number of loans collateral redeemed

___________________________

g. Total collateral sales resulting in a deficiency balance

___________________________

h. Total collateral sales resulting in a surplus balance

___________________________

i. Total charge-offs

___________________________

5. Average contracted term of loan ( in months)

___________________________

B. Schedule of Other Consumer Loans Made (must be completed by any licensee who originated consumer loans not under the California Finance Lenders Law.)

Total Number of Loans Made		Total Principal Amount of Other Loans Made

	___________________________	$	___________________________

Provide the name of the agency and your license number that authorizes you to originate other consumer loans:

______________________________

C. Schedule of Other Commercial Loans Made (must be completed by any licensee who originated commercial loans not under the California Finance Lenders Law.)

Total Number of Loans Made		Total Principal Amount of Other Loans Made

	___________________________	$	___________________________

SCHEDULE O (CONFIDENTIAL)

DEFAULT RATES BY TYPE OF LOAN AS OF DECEMBER 31, 20XX

		Total	Total	NUMBER OF LOANS PAST DUE				PERCENTAGE OF LOANS PAST DUE
Security Type		Number of Charge-Offs	Number of Loans Outstanding	Current Loan	1 Payment Past Due	2 Payments Past Due	3 or More Payments Past Due	Current Loan	1 Payment Past Due	2 Payments Past Due	3 or More Payments Past Due
Consumer Loans Under $2,500
1.	Unsecured Loans Personal Property	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________
2.	(Household items) Automobiles And	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________
3.	Other Vehicles	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________
4.	Auto Title Loans	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________
5.	Wage Assignment	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________
6.	Other Security	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________
7.	Totals	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________
Consumer Loans $2,500 to $4,999
8.	Unsecured Loans Personal Property	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________
9.	(Household items) Automobiles And	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________
10.	Other Vehicles	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________
11.	Auto Title Loans	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________
12.	Wage Assignment	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________
13.	Other Security	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________
14.	Totals	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________
Consumer Loans $5,000 to $9,999
15.	Unsecured Loans Personal Property	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________
16.	(Household items) Automobiles And	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________
17.	Other Vehicles	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________
18.	Auto Title Loans	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________
19.	Wage Assignment	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________
20.	Other Security	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________
21.	Totals	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________
		___________________________
Consumer Loans $10,000 or More
22.	Unsecured Loans Personal Property	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________
23.	(Household items)	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________
24.	Automobiles And Other Vehicles	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________
25.	Auto Title Loans	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________
26.	Wage Assignment	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________
27.	Other Security	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________
28.	Totals	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________	___________________________

CFL 812

1. New section filed 1-7-2014; operative 1-7-2014 pursuant to Government Code section 11343.4(b)(3) (Register 2014, No. 2). For prior history, see Register 83, No. 16.

Note: Authority cited: Sections 22150 and 22159, Financial Code. Reference: Sections 22159, 22160 and 22715, Financial Code.

Disclaimer: These regulations may not be the most recent version. California may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

California Code of RegulationsTitle 10 - InvestmentChapter 3 - Commissioner of Financial Protection and InnovationSubchapter 6 - California Financing LawArticle 3 - Books, Records and ExaminationsSection 1430 - Annual Report

California Code of Regulations
Title 10 - Investment
Chapter 3 - Commissioner of Financial Protection and Innovation
Subchapter 6 - California Financing Law
Article 3 - Books, Records and Examinations
Section 1430 - Annual Report