Form FIS 1041 Application for License as a Business and Industrial Development Company (Bidco) - Michigan

Form FIS1041 or the "Application For License As A Business And Industrial Development Company (bidco)" is a form issued by the Michigan Department of Insurance and Financial Services.

The form was last revised in June 1, 2016 and is available for digital filing. Download an up-to-date Form FIS1041 in PDF-format down below or look it up on the Michigan Department of Insurance and Financial Services Forms website.

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FIS 1041 (6/16) Department of Insurance and Financial Services Page 1 of 9
Business and Industrial Development Company (BIDCO)
License Application Procedures
The Director of the Department of Insurance and Financial Services has determined that this
application is available for public inspection or copying pursuant to the provisions of the Freedom of
Information Act, PA 442 of 1976, as amended, MCL 15.231 et seq., [and section 2109 of the Michigan
Banking Code of 1999, as amended, MCL 487.12109.] Accordingly, except as otherwise indicated in
this application, the contents of the application shall be disclosed to any person who properly requests
an opportunity for inspection, examination, or copying.
1.
The application must be submitted to the Department of Insurance and Financial Services
(DIFS) either on the attached forms or in a format and presentation consistent with the
application itself.
2.
The application must be filed with original signature(s).
3.
Include a copy of the BIDCO’s formal business plan with the application. The Director has
determined that the business plan is confidential and will not be subject to public disclosure.
4.
DIFS shall refuse to accept an incomplete application. Complete responses to all applicable
questions will expedite processing.
5.
DIFS may contact any directors, officers, managers, or controlling persons of the applicant
individually or collectively, for information regarding this application.
6.
A certified copy of the Board of Directors Resolution must be filed with this application. The
resolution should: 1) Authorize submission of the application to the Director on behalf of the
corporation/company, and 2) Authorize payment of all fees charged by DIFS in processing this
application and performing such investigations as required by this application. A sample board
resolution is enclosed.
7.
Applicant may provide additional information in support of the application as deemed
appropriate. However, any such unsolicited information will be accepted for filing with the
understanding that it will be made part of the public record.
8.
Each proposed director, officer, manager, and controlling person shall complete the
Biographical Information (pages 2-2c), Background Information form (FIS 1016) and a
personal financial statement with original signature and return it to DIFS. Information provided
on the Background Information form and personal financial statement shall not be available for
public dissemination.
9.
Schedules or inserts may be attached to this application.
FIS 1041 (6/16) Department of Insurance and Financial Services Page 1 of 9
Business and Industrial Development Company (BIDCO)
License Application Procedures
The Director of the Department of Insurance and Financial Services has determined that this
application is available for public inspection or copying pursuant to the provisions of the Freedom of
Information Act, PA 442 of 1976, as amended, MCL 15.231 et seq., [and section 2109 of the Michigan
Banking Code of 1999, as amended, MCL 487.12109.] Accordingly, except as otherwise indicated in
this application, the contents of the application shall be disclosed to any person who properly requests
an opportunity for inspection, examination, or copying.
1.
The application must be submitted to the Department of Insurance and Financial Services
(DIFS) either on the attached forms or in a format and presentation consistent with the
application itself.
2.
The application must be filed with original signature(s).
3.
Include a copy of the BIDCO’s formal business plan with the application. The Director has
determined that the business plan is confidential and will not be subject to public disclosure.
4.
DIFS shall refuse to accept an incomplete application. Complete responses to all applicable
questions will expedite processing.
5.
DIFS may contact any directors, officers, managers, or controlling persons of the applicant
individually or collectively, for information regarding this application.
6.
A certified copy of the Board of Directors Resolution must be filed with this application. The
resolution should: 1) Authorize submission of the application to the Director on behalf of the
corporation/company, and 2) Authorize payment of all fees charged by DIFS in processing this
application and performing such investigations as required by this application. A sample board
resolution is enclosed.
7.
Applicant may provide additional information in support of the application as deemed
appropriate. However, any such unsolicited information will be accepted for filing with the
understanding that it will be made part of the public record.
8.
Each proposed director, officer, manager, and controlling person shall complete the
Biographical Information (pages 2-2c), Background Information form (FIS 1016) and a
personal financial statement with original signature and return it to DIFS. Information provided
on the Background Information form and personal financial statement shall not be available for
public dissemination.
9.
Schedules or inserts may be attached to this application.
FIS 1041 (6/16) Department of Insurance and Financial Services Page 2 of 9
Business and Industrial Development Company (BIDCO)
License Application Procedures (Continued)
10.
Applications filed with the Director may be amended in writing. Each amendment must clearly
state the specific section, page, and item(s) being amended. Substantive amendments will be
formally acknowledged in writing by DIFS.
11.
Provide a copy of applicant’s articles of incorporation/organization.
12.
If the company operates under an assumed name status, the application must be
accompanied by a certificate executed by the Corporations, Securities & Commercial
Licensing Bureau, Corporations Division indicating compliance with the provisions of section
217 of Act No. 284, Public Acts of 1972, as amended.
13.
Applicant may apply for preliminary approval as provided for under section 305(1) of the
Michigan BIDCO Act. Such approval may be granted only to those applicants lacking a
complete roster of directors, officers, and managers and/or those that have not identified and
received commitments for the initial capitalization of the BIDCO. Final approval will be subject
to identification of all directors, officers, and managers, completion of DIFS background
investigation for each, submission of full documentation of all financing commitments, and
DIFS review of all subsequent changes to the applicant’s business plan and financial
projections.
14.
Questions pertaining to the completion of this application may be directed to DIFS at
517-284-8822.
15.
A completed application and the application fee of $3,500 made payable to the “State of
Michigan” should be mailed to:
DEPARTMENT OF INSURANCE AND FINANCIAL SERVICES
ATTENTION: CORPORATE REVIEW
P.O. BOX 30220
LANSING, MI 48909-7720
Authorized by PA 89 of 1986, as amended. Required to organize a Business and Industrial Development Company.
FIS 1041 (6/16) Department of Insurance and Financial Services Page 3 of 9
Statutory Criteria: BIDCO
(Source: Michigan BIDCO Act of 1986, as amended) MCL 487.1101 et seq.
LEGAL
BIDCO
CITE
SECTION #
[MCL #]
DESCRIPTION
209(1)
487.1209
Fee ($3,500)
Company Name
401
487.1401
The company name shall include the word BIDCO
Applicant
301
487.1301
A. A Michigan corporation (profit or nonprofit) or limited liability
company
315
487.1315
B. A Michigan corporation or LLC licensed under any law of the U.S.
403
487.1403
C. Directors: minimum of seven (7)
305
487.1305
D. Directors: at least three (3) must be identified at the time of filing of
the application
Application
203
487.1203
A. On forms prescribed by the Director
303(1)
487.1303
B. Business plan required
C. Preliminary Approval:
303(1)(a)
487.1303
1. Net worth requirement (minimum $1 million to $10 million);
303(2)
487.1303
$500,000 in certain circumstances
303(1)(b)
487.1303
2. Directors, officers, and controlling person(s) are of good
character and sound financial standing
303(1)(c)
487.1303
3. Applicant will comply with the Michigan BIDCO Act
303(1)(d)
487.1303
4. There is a likelihood that the BIDCO will be a viable, ongoing
entity able to satisfy the basic objectives of its business plan
D. Final Approval Conditioned Upon:
305
487.1305
1. Review of completed fund-raising
2. Review of completed roster of officers and directors (minimum
number of directors is 7)
3. Updated balance sheet
4. Other information considered relevant by the Director
FIS 1041 (6/16) Department of Insurance and Financial Services Page 4 of 9
Application for License as a Business and Industrial Development Company
(BIDCO)
Name of BIDCO, (Include DBA name(s), if applicable)
Date of Application
Street Address
City, Village, or Township
State
Zip Code
Michigan
County
Telephone Number
Facsimile Number
(
)
(
)
Date of Incorporation/Organization
Michigan Corporation, LLC, or Nonprofit Corporation Number
Name of Michigan Resident Agent*
Address of Michigan Resident Agent
Name of state(s) other than Michigan where the applicant or its affiliates plan to conduct business activities
* The resident agent and address shown above must agree with that filed with the Corporations,
Securities & Commercial Licensing Bureau, Corporations Division.
Designated representative responsible for responding to questions relating to this application.
Name and Title
Telephone Number
Facsimile Number
(
)
(
)
Street Address
City, Village, or Township
State
Zip Code
The information supplied in this application is correct to the best of applicant’s knowledge. Signature
of person(s) authorized to submit this application.
Signature
Date
Signature
Date
FIS 1041 (6/16) Department of Insurance and Financial Services Page 5 of 9
Biographical Information Concerning Proposed Directors, Officers, Managers,
and Controlling Persons of the BIDCO
Name
Principal Occupation
Residence Address (City/State/Zip Code)
Business Address (City/State/Zip Code)
Length of Residence in Community
U.S. Citizen?
Yes
No
Office to be Held
Proposed Annual Salary
List principal civic, professional, or other business organizations in which you have membership
Education

Download Form FIS 1041 Application for License as a Business and Industrial Development Company (Bidco) - Michigan

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