Form ADM18 "Supporting Financial Information - Schedules 1-3" - Texas

What Is Form ADM18?

This is a legal form that was released by the Texas Office of Consumer Credit Commissioner - a government authority operating within Texas. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on July 1, 2016;
  • The latest edition provided by the Texas Office of Consumer Credit Commissioner;
  • 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 fillable version of Form ADM18 by clicking the link below or browse more documents and templates provided by the Texas Office of Consumer Credit Commissioner.

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Download Form ADM18 "Supporting Financial Information - Schedules 1-3" - Texas

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Supporting Financial Information
Schedules 1 - 3
To be submitted with "Financial Statement (ADM17)"
If additional space is needed, attach a document identifying all required information noted below.
Middle Name (Full)
First Name
Last Name
As of Date:
Entity Name or Name of Owner/Sole Proprietor
Must match "As of" date on ADM17
(
as identified in Application for LIcense)
Sched. 1: Cash on Deposit
Exact Name & Mailing Address
Account Name
Any Restrictions on
Account Type
Amount
of Bank or Other Depository
Account No.
Withdrawal
Sched. 2: Accounts, Loans, & Notes Receivable
Rate of
Delinquency
Description
Principal Amount
Security
Term
Acquisition Date
Fin. Charge
Rate
Form ADM18 ( Rev 7/16)
Office of Consumer Credit Commissioner Licensing-512-936-7605 or licensing@occc.texas.gov
Page 1 of 2
Print Form
Print Form
Supporting Financial Information
Schedules 1 - 3
To be submitted with "Financial Statement (ADM17)"
If additional space is needed, attach a document identifying all required information noted below.
Middle Name (Full)
First Name
Last Name
As of Date:
Entity Name or Name of Owner/Sole Proprietor
Must match "As of" date on ADM17
(
as identified in Application for LIcense)
Sched. 1: Cash on Deposit
Exact Name & Mailing Address
Account Name
Any Restrictions on
Account Type
Amount
of Bank or Other Depository
Account No.
Withdrawal
Sched. 2: Accounts, Loans, & Notes Receivable
Rate of
Delinquency
Description
Principal Amount
Security
Term
Acquisition Date
Fin. Charge
Rate
Form ADM18 ( Rev 7/16)
Office of Consumer Credit Commissioner Licensing-512-936-7605 or licensing@occc.texas.gov
Page 1 of 2
Schedules 1 - 3 (Continued)
Sched. 3: Life Insurance
Name of Insured
Policy Type
Name of Beneficiary
Face Amount
Name of Insurance Co.
Cash Surrender Value
Policy Assigned?
Yes
No. of Loans Against This Policy
Amt of Yearly Premium
No
Name of Insured
Policy Type
Name of Beneficiary
Face Amount
Name of Insurance Co.
Cash Surrender Value
Policy Assigned?
Yes
No. of Loans Against This Policy
Amt of Yearly Premium
No
Name of Insured
Policy Type
Name of Beneficiary
Face Amount
Name of Insurance Co.
Cash Surrender Value
Policy Assigned?
Yes
No. of Loans Against This Policy
Amt of Yearly Premium
No
Name of Insured
Policy Type
Name of Beneficiary
Face Amount
Name of Insurance Co.
Cash Surrender Value
Policy Assigned?
Yes
No. of Loans Against This Policy
Amt of Yearly Premium
No
Name of Insured
Policy Type
Name of Beneficiary
Face Amount
Name of Insurance Co.
Cash Surrender Value
Policy Assigned?
Yes
No. of Loans Against This Policy
Amt of Yearly Premium
No
The Office of Consumer Credit Commissioner obtains information from this form and certain third-party sources. With few exceptions, you
may review and correct the information we collect. To find out more about the information we collect or to make an open records
request, contact our Public Information Officer at 512-936-7622 or public.information@occc.texas.gov.
Form ADM18 ( Rev 7/16)
Office of Consumer Credit Commissioner Licensing-512-936-7605 or licensing@occc.texas.gov
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