"Application Checklist for Arkansas Money Services Application Form" - Arkansas

Application Checklist for Arkansas Money Services Application Form is a legal document that was released by the Arkansas Securities Department - a government authority operating within Arkansas.

Form Details:

  • Released on November 1, 2011;
  • The latest edition currently provided by the Arkansas Securities Department;
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  • Fill out the form in our online filing application.

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Download "Application Checklist for Arkansas Money Services Application Form" - Arkansas

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APPLICATION CHECKLIST
ARKANSAS MONEY SERVICES APPLICATION
THE FOLLOWING ITEMS MUST BE INCLUDED WITH THE APPLICATION.
INCOMPLETE APPLICATIONS WILL RESULT IN INCREASED PROCESSING TIME AND
POSSIBLE DENIAL OF THE APPLICATION.
A. A check or money order for the application fee payable to the Arkansas Securities Department in the amount of $1,500.
All application fees are nonrefundable.
B. A check or money order for the license fee payable to the Arkansas Securities Department in the amount of $750.
C. Completed, signed, and notarized Arkansas Money Services Application. All questions must be answered (if N/A, so state).
D. Certificate of Resolution naming the individual authorized to sign official documents on behalf of the applicant (Attachment
A). The Certificate of Authority should be signed by an officer/director/owner/partner/member other than the person being
given authority to sign.
E.
Authority to Obtain Information From Outside Sources Form must be completed and notarized for each person listed on
question #15 of the Arkansas Money Services Application (Attachment B).
F.
List of authorized delegates and their physical locations, including limited service and mobile locations (Attachment C).
G. Completed Arkansas Money Services Information Form (Attachment D). All questions must be answered (if N/A, so state).
H. A surety bond in the amount of $50,000 plus $10,000 per location. Maximum amount of bond required is $300,000
(Attachment E). There is no bond requirement for a currency exchange license.
I.
1. A sample form of contract for authorized delegates, if applicable.
2. A sample form of payment instrument or instrument upon which stored-value is recorded, if applicable.
J.
Financial Statements - Money Transmission License
Note:
Ark. Code Ann. § 23-55-207 requires a licensee to maintain a net worth of at least $250,000 for a money
transmission license only.
A copy of the applicant s audited financial statements for the most recent fiscal year and, if available, for
the two-year period immediately preceding the submission of the application.
A copy of the applicant s balance sheet and profit and loss statement dated within thirty (30) days of the date of the
application and certified by a representative of the applicant.
If the applicant is publicly traded, a copy of the most recent report filed with the United States Securities
and Exchange Commission under section 13 of the Securities Exchange Act of 1934.
If the applicant is a wholly owned subsidiary of a corporation publicly traded in the United States, a copy
of the audited financial statements for the parent corporation for the most recent fiscal year or a copy of the
parent corporation s most recent report filed under section 13 of the Securities Exchange Act of 1934.
If the applicant is a wholly owned subsidiary of a corporation publicly traded outside the United States, a
copy of similar documentation filed with the regulator of the parent corporation s domicile outside the
United States.
Revised November 2011
APPLICATION CHECKLIST
ARKANSAS MONEY SERVICES APPLICATION
THE FOLLOWING ITEMS MUST BE INCLUDED WITH THE APPLICATION.
INCOMPLETE APPLICATIONS WILL RESULT IN INCREASED PROCESSING TIME AND
POSSIBLE DENIAL OF THE APPLICATION.
A. A check or money order for the application fee payable to the Arkansas Securities Department in the amount of $1,500.
All application fees are nonrefundable.
B. A check or money order for the license fee payable to the Arkansas Securities Department in the amount of $750.
C. Completed, signed, and notarized Arkansas Money Services Application. All questions must be answered (if N/A, so state).
D. Certificate of Resolution naming the individual authorized to sign official documents on behalf of the applicant (Attachment
A). The Certificate of Authority should be signed by an officer/director/owner/partner/member other than the person being
given authority to sign.
E.
Authority to Obtain Information From Outside Sources Form must be completed and notarized for each person listed on
question #15 of the Arkansas Money Services Application (Attachment B).
F.
List of authorized delegates and their physical locations, including limited service and mobile locations (Attachment C).
G. Completed Arkansas Money Services Information Form (Attachment D). All questions must be answered (if N/A, so state).
H. A surety bond in the amount of $50,000 plus $10,000 per location. Maximum amount of bond required is $300,000
(Attachment E). There is no bond requirement for a currency exchange license.
I.
1. A sample form of contract for authorized delegates, if applicable.
2. A sample form of payment instrument or instrument upon which stored-value is recorded, if applicable.
J.
Financial Statements - Money Transmission License
Note:
Ark. Code Ann. § 23-55-207 requires a licensee to maintain a net worth of at least $250,000 for a money
transmission license only.
A copy of the applicant s audited financial statements for the most recent fiscal year and, if available, for
the two-year period immediately preceding the submission of the application.
A copy of the applicant s balance sheet and profit and loss statement dated within thirty (30) days of the date of the
application and certified by a representative of the applicant.
If the applicant is publicly traded, a copy of the most recent report filed with the United States Securities
and Exchange Commission under section 13 of the Securities Exchange Act of 1934.
If the applicant is a wholly owned subsidiary of a corporation publicly traded in the United States, a copy
of the audited financial statements for the parent corporation for the most recent fiscal year or a copy of the
parent corporation s most recent report filed under section 13 of the Securities Exchange Act of 1934.
If the applicant is a wholly owned subsidiary of a corporation publicly traded outside the United States, a
copy of similar documentation filed with the regulator of the parent corporation s domicile outside the
United States.
Revised November 2011
Currency Exchange License
A copy of the applicant s financial statements for the most recent fiscal year and, if available, for
the two-year period immediately preceding the submission of the application.
A copy of the applicant s balance sheet and profit and loss statement dated within thirty (30) days of the date of the
application and certified by a representative of the applicant.
K. If applicant is a corporation, limited liability corporation, or other legal entity, provide the following:
Certificate of Good Standing from the secretary of state or other state authority in which the applicant was
originally incorporated or organized and dated within thirty (30) days of the application.
Articles of Incorporation including any amendments thereto or Articles of Organization and operating
agreement.
If a foreign corporation, evidence of filing as a foreign corporation with the Arkansas Secretary of State dated within
the previous thirty (30) days of the application. The Arkansas Secretary of State may be contacted at (501) 682-
1010 or www.sos.arkansas.gov.
If applicant is a partnership, provide a copy of the Partnership Agreement.
L. If applicant is a subsidiary, a copy of an organizational chart.
M. Description of the method used to screen delegates for criminal history.
Contact the Arkansas Securities Department at (501) 324-9260 if you have any questions pertaining to
this application.
MAILING ADDRESS
Arkansas Securities Department
Heritage West Building, Suite 300
201 East Markham
Little Rock, AR 72201
Revised November 2011
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