Form DBO-2118 "Application for Approval to Acquire Control of Money Transmitter" - California

What Is Form DBO-2118?

This is a legal form that was released by the California Department of Financial Protection and Innovation - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on January 1, 2019;
  • The latest edition provided by the California Department of Financial Protection and Innovation;
  • 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 DBO-2118 by clicking the link below or browse more documents and templates provided by the California Department of Financial Protection and Innovation.

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Download Form DBO-2118 "Application for Approval to Acquire Control of Money Transmitter" - California

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STATE OF CALIFORNIA – DEPARTMENT OF BUSINESS OVERSIGHT
APPLICATION FOR APPROVAL TO ACQUIRE CONTROL OF
DBO-2118 (Rev. 1-19)
MONEY TRANSMITTER
TO:
COMMISSIONER OF BUSINESS OVERSIGHT
, who maintains its principal place
(Name of Applicant)
of business at
(Street Address)
(City, State, Zip Code)
hereby applies for approval to acquire control of
(Name of Licensee)
which maintains its Head Office at
(Street Address)
(City, State, Zip Code)
pursuant to Division 1.2 (commencing with Section 2000) of the Financial Code.
The documents and information attached hereto are hereby referred to and by this
reference incorporated herein.
(Name of Applicant)
(Signature) (Name)
(Title)
(Telephone)
VERIFICATION
I declare under penalty of perjury under the laws of the State of California that the
information contained in this application, including the attached information and
documents, is true and correct and that this declaration is executed at
on
, 20
.
(Signature)
(Name)
(Title)
(Note: This is a sample format of an application for approval to acquire control of a person licensed to transmit
money under Financial Code Section 2035. This sample is provided only as an illustration of the format of an
application. Refer to the requirements of Financial Code Sections 2000, et seq.)
STATE OF CALIFORNIA – DEPARTMENT OF BUSINESS OVERSIGHT
APPLICATION FOR APPROVAL TO ACQUIRE CONTROL OF
DBO-2118 (Rev. 1-19)
MONEY TRANSMITTER
TO:
COMMISSIONER OF BUSINESS OVERSIGHT
, who maintains its principal place
(Name of Applicant)
of business at
(Street Address)
(City, State, Zip Code)
hereby applies for approval to acquire control of
(Name of Licensee)
which maintains its Head Office at
(Street Address)
(City, State, Zip Code)
pursuant to Division 1.2 (commencing with Section 2000) of the Financial Code.
The documents and information attached hereto are hereby referred to and by this
reference incorporated herein.
(Name of Applicant)
(Signature) (Name)
(Title)
(Telephone)
VERIFICATION
I declare under penalty of perjury under the laws of the State of California that the
information contained in this application, including the attached information and
documents, is true and correct and that this declaration is executed at
on
, 20
.
(Signature)
(Name)
(Title)
(Note: This is a sample format of an application for approval to acquire control of a person licensed to transmit
money under Financial Code Section 2035. This sample is provided only as an illustration of the format of an
application. Refer to the requirements of Financial Code Sections 2000, et seq.)
STATE OF CALIFORNIA – DEPARTMENT OF BUSINESS OVERSIGHT
APPLICATION FOR APPROVAL TO ACQUIRE CONTROL OF
DBO-2118 (Rev. 1-19) Page 2 of 5
MONEY TRANSMITTER
INSTRUCTIONS
An application to acquire control of a money transmitter should include the following:
1. Form DBO 2118.
2. Percentage of outstanding shares of the money transmitter which the applicant presently owns
and percentage or number of shares proposed to be purchased.
3. Applicant should respond in reference to the factors set forth in California Financial Code
Section 2035, subsection (b) (the "Financial Code").
4. Application fee as required by Financial Code Section 2038(b).
In reference to 2035(b) (1), personal financial statements should be submitted for individual
applicants and for each member of an applicant group. In addition, audited financial s t a t e m e n t s
s h o u l d be submitted for any companies or corporation which an applicant controls, or in which an
applicant has a substantial ownership interest. If audited financial statements are not available,
unaudited financial statements as of the most recent date should be submitted including balance
sheets, statement of income, statements of changes in capital accounts and statements of changes
in financial position.
Additionally, applicant should describe the manner and terms of financing of the purchase and the
source of financing. If any portion of the purchase price is proposed to be borrowed, applicant should
describe in detail the manner and terms of financing of the purchase. Copies of all loan commitments
(including financing terms) should also be submitted.
In reference to Section 2035(b)(4), applicant should explain the purpose for the acquisition, describe
any proposed change in the business, management of corporate structure of the transmitter of money
and describe how applicant proposes to manage and operate the transmitter of money once control
is acquired.
In reference to Section 2035(b)(1), a Confidential Resume, a current Personal Financial Statement and
fingerprint cards should be submitted for each applicant where the applicant is a natural person and
each person who controls the applicant or is an executive officer and director of the applicant where
the applicant is not a natural person.
Provide a Confidential Resume and a current Personal Financial Statement each completed and
signed as of a date within 90 days before the filing of the application by each director, executive
officer, or 10% equity security owner of applicant. (Use Interagency Biographical and Financial Report
or Department of Business Oversight Forms 2 and 3.)
The fingerprint cards or Live Scan receipt must be submitted with the application. Each person
fingerprinted should complete the appropriate boxes requesting personal information.
Fingerprints must be taken at a law enforcement agency or a Live Scan Service Center. A list of Live
Scan Service Centers is available at https://oag.ca.gov/fingerprints/locations. It may be necessary
to arrange an appointment for fingerprinting, and the applicant is responsible for any fee charged. In
addition, for FD-258s, a processing fee at the current rate charged by the California Department of
Justice, must accompany each form submitted.
We also reserve the right to request additional information, if necessary. If you have any further
.
questions, please contact t h e Mo n e y T ra n sm it t er D i vi s i o n at (415) 263-8555
STATE OF CALIFORNIA – DEPARTMENT OF BUSINESS OVERSIGHT
APPLICATION FOR APPROVAL TO ACQUIRE CONTROL OF
DBO-2118 (Rev. 1-19) Page 3 of 5
MONEY TRANSMITTER
Notice to Individuals – Use of Information
The Commissioner of Business Oversight (the "Commissioner") is authorized by the Financial Code to
gather and maintain certain information regarding individuals in certain applications and other matters.
If the attached form is submitted in connection with any application or other matter before the
Commissioner, the requested information is deemed necessary to process that application other matter
pursuant to the Financial Code. You may use the form, or provide the information in another written
format. If the information is not accurately and completely provided, the application may be denied, or the
other matter may be resolved against your interests.
If the form requests you to provide your social security account number, please be advised that providing
your social security account number is voluntary. Your social security account number will be used as
an identifier and may be used to verify information provided to the Department of Business Oversight
(the "Department"). Failure to provide your social security number may require the Department to use
other methods to verify information, which may cause delays in processing this information and any
related application or other matter. If the information you have provided to the Department cannot be
verified, the Department may reject your filing and deny any related application or cause any other matter
to be resolved against your interests. In addition, the Commissioner may request additional information
or clarification of submitted information.
You may be required to provide your fingerprints in conjunction with submitting your personal
information. If your fingerprints are required, the Department will provide you with the necessary
instructions and, if applicable, the forms upon which your fingerprints may be submitted.
For Non USA Residence Applicant
If any control person does not or has not resided in the US for at least 10 years, an investigative
background report must be prepared by an acceptable search firm and submitted directly to the
Department in addition to other background information required in the application. The cost of the
report must be borne by the applicant or the individual. We have not yet assembled a list of
“acceptable” search firms. At a minimum, the firm must demonstrate that they have sufficient
resources and are properly licensed to conduct the search of the background and that the firm is not
affiliated with or an interest of any of the individuals under investigation. The background
investigation report must be in English and provided directly to the Department.
At a minimum, the report must contain the following:
1. A comprehensive credit report/history including the actual credit report as well as a summary.
2. Civil court and bankruptcy court records for the past 10 years, including a search of the court data in
the country (ies), states, towns, where the individual resided and worked and in contiguous areas.
3. Criminal records including felonies, misdemeanors and violations including a search of court data in
the country (ies), states, towns, where the individual resided and worked and in contiguous areas.
4. Education records.
5. Employment history.
STATE OF CALIFORNIA – DEPARTMENT OF BUSINESS OVERSIGHT
APPLICATION FOR APPROVAL TO ACQUIRE CONTROL OF
DBO-2118 (Rev. 1-19) Page 4 of 5
MONEY TRANSMITTER
6. Media history including an electronic search of national and local publications, wire services and
business publications.
7. Regulatory history, particularly securities, insurance, mortgage-related, real estate, etc., if
applicable.
The report must be accompanied by a search summary letter which identifies the scope of the search,
indicate the independence of each firm from the individuals and the applicant, and identifies a
person and provides contact information if questions should arise.
If an individual has had such a report, which meets the specifications listed above, prepared for another
licensing agency within the past 12 months, the individual may have the investigating agency submit a
copy of that report to us. In addition to the documentation generally required, the individual would need
to submit a statement of no material change.
In processing the information you provide, the Department may cause a consumer credit report to be
prepared in accordance with the provisions of Title 1.6, Part 4, Division Third of the Civil Code
(commencing at Section 1785.1), or an investigative consumer report to be prepared in accordance with
the provisions of Title 1.6A, Part 4, Division Third of the Civil Code (commencing at Section 1786), or
the respective successor statutes.
The information you provide the Department will be held in confidence as required by the Information
Practices Act (Civil Code Section 1798, et seq.). The Information Practices Act provides that the
Department may share the information you provide with the Department of Insurance, the Department of
Business Oversight, other federal and state financial institution regulators, law enforcement agencies, or
any other governmental entity if the disclosure is required under state or federal law. In addition, the
Department may share the information you provide with any such agency if the disclosure assists the
agency in discharging its duties.
STATE OF CALIFORNIA – DEPARTMENT OF BUSINESS OVERSIGHT
APPLICATION FOR APPROVAL TO ACQUIRE CONTROL OF
DBO-2118 (Rev. 1-19) Page 5 of 5
MONEY TRANSMITTER
DBO’s Privacy Notice on Collection
DBO Collects and Uses Personal Information:
The DBO collects the information
requested on this form as authorized by Financial Code section 2035. The DBO uses this
information to evaluate a person’s application to acquire control of a licensed money
transmitter. Use of the personal Information DBO collects is subject to limitations contained
in the Information Practices Act of 1977 and other applicable state and federal laws.
Providing Personal Information Is Mandatory:
When providing information or
documents, please do not include unrequested personal information such as a Social
Security number, driver’s license number, or financial information.
DBO May Disclose Your Personal Information: We may share your personal
information with other state departments, the federal government or law enforcement.
Your personal information may also be disclosed:
• In response to a Public Records Act request, as allowed by the Information
Practices Act.
• To another governmental agency as required by state or federal law.
• In response to a court order or administrative order, a subpoena or a search
warrant.
Your Access to Your Personal Information: You may review the records maintained by
DBO that contain your personal information. To request access, contact: DBO Privacy
Officer, 1515 K Street, Sacramento, CA 95814, (866) 275-2677.
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