Form 440-4803 "Check Cashing Annual Report" - Oregon

What Is Form 440-4803?

This is a legal form that was released by the Oregon Department of Consumer and Business Services - a government authority operating within Oregon. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on November 1, 2012;
  • The latest edition provided by the Oregon Department of Consumer and Business Services;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form 440-4803 by clicking the link below or browse more documents and templates provided by the Oregon Department of Consumer and Business Services.

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Download Form 440-4803 "Check Cashing Annual Report" - Oregon

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Oregon Department of Consumer and Business Services
Division of Financial Regulation
350 Winter St. NE, Rm. 410, Salem, Oregon 97301-3881
Mailing address: P.O. Box 14480, Salem, OR 97309-0405
503-378-4140  Fax: 503-947-7862
http://dfcs.oregon.gov
CHECK CASHING ANNUAL REPORT
ORS ch. 697/OAR 441-755
As of Dec. 31, 20 .
Note: This report is due by April 1 for the prior calendar year (January through December).
Name of licensee:
License no.:
License location:
Street
City
State
ZIP
Complete the following information for checks cashed in the past calendar year:
The total number of payment instruments cashed:
The total dollar amount of all payment instruments cashed:
$
$
The total amount of fees charged for all payment instruments cashed:
This report was completed by:
Date:
Phone number:
E-mail address:
440-4803 (11/12/COM)
Oregon Department of Consumer and Business Services
Division of Financial Regulation
350 Winter St. NE, Rm. 410, Salem, Oregon 97301-3881
Mailing address: P.O. Box 14480, Salem, OR 97309-0405
503-378-4140  Fax: 503-947-7862
http://dfcs.oregon.gov
CHECK CASHING ANNUAL REPORT
ORS ch. 697/OAR 441-755
As of Dec. 31, 20 .
Note: This report is due by April 1 for the prior calendar year (January through December).
Name of licensee:
License no.:
License location:
Street
City
State
ZIP
Complete the following information for checks cashed in the past calendar year:
The total number of payment instruments cashed:
The total dollar amount of all payment instruments cashed:
$
$
The total amount of fees charged for all payment instruments cashed:
This report was completed by:
Date:
Phone number:
E-mail address:
440-4803 (11/12/COM)