Form 440-4990 "Annual Recertification of Bona Fide Nonprofit Organization" - Oregon

What Is Form 440-4990?

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 July 1, 2019;
  • 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 440-4990 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 440-4990 "Annual Recertification of Bona Fide Nonprofit Organization" - Oregon

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Oregon Department of Consumer and Business Services
Division of Financial Regulation
350 Winter St. NE, room 400, Salem, Oregon 97301-3881
Mailing address: P.O. Box 14480, Salem, OR 97309-0405
503-378-4140 • Fax: 503-947-7862
dfr.oregon.gov
ANNUAL RECERTIFICATION OF BONA FIDE NONPROFIT ORGANIZATION
(hereinafter “the nonprofit”)
1.
(Organization name):
has received confirmation that is it a bona fide nonprofit organization from the Division of Financial Regulation
(hereinafter “DFR”).
2.
Attached is the nonprofit’s most recent financial audit performed by an independent third-party auditor.
3.
All significant changes, if any, to the materials submitted to obtain the bona fide nonprofit organization status or to
the nonprofit’s operations that may affect the bona fide nonprofit organization status have been reported to DFR
previously or are attached to this form.
4.
The nonprofit continues to meet the criteria for a bona fide nonprofit organization, including, but not limited to:
a. The IRS continues to recognize the nonprofit as having 501(c)(3) status.
b. The nonprofit provides loans that are consistent with a public or charitable purpose.
c. The nonprofit charges no more in fees than is necessary to support the loan origination program activities.
d. The nonprofit compensates its employees in a manner that does not incentivize the employees to act in a manner
other than in the best interest of the borrower.
e. The nonprofit provides loans that contain terms that are in the best interest of the borrower.
f. The nonprofit obtains criminal records checks on loan originators.
g. The nonprofit has required loan originators to complete continuing education in ECOA, TILA, FCRA, HOEPA,
HMDA, RESPCA, FDCPA, GLB, or SAFE.
h. The nonprofit administers a process that provides for receiving and documenting complaints.
5. The undersigned person, under penalty of perjury, declares that he or she signs this certification on behalf of the
nonprofit indicated and that he or she occupies the official position indicated and is authorized to sign this document
on behalf of the nonprofit.
Nonprofit name:
Mailing address:
City:
State:
ZIP Code:
Email:
Phone number:
Signer’s name:
Title:
Signature:
Sworn and subscribed before me this
day of
, 20
Notary public for the state of
My commission expires
.
Notary public signature:
Notary public seal:
440-4990 (7/19/COM)
Annual Recertification of Bona Fide Nonprofit Organization
Oregon Department of Consumer and Business Services
Division of Financial Regulation
350 Winter St. NE, room 400, Salem, Oregon 97301-3881
Mailing address: P.O. Box 14480, Salem, OR 97309-0405
503-378-4140 • Fax: 503-947-7862
dfr.oregon.gov
ANNUAL RECERTIFICATION OF BONA FIDE NONPROFIT ORGANIZATION
(hereinafter “the nonprofit”)
1.
(Organization name):
has received confirmation that is it a bona fide nonprofit organization from the Division of Financial Regulation
(hereinafter “DFR”).
2.
Attached is the nonprofit’s most recent financial audit performed by an independent third-party auditor.
3.
All significant changes, if any, to the materials submitted to obtain the bona fide nonprofit organization status or to
the nonprofit’s operations that may affect the bona fide nonprofit organization status have been reported to DFR
previously or are attached to this form.
4.
The nonprofit continues to meet the criteria for a bona fide nonprofit organization, including, but not limited to:
a. The IRS continues to recognize the nonprofit as having 501(c)(3) status.
b. The nonprofit provides loans that are consistent with a public or charitable purpose.
c. The nonprofit charges no more in fees than is necessary to support the loan origination program activities.
d. The nonprofit compensates its employees in a manner that does not incentivize the employees to act in a manner
other than in the best interest of the borrower.
e. The nonprofit provides loans that contain terms that are in the best interest of the borrower.
f. The nonprofit obtains criminal records checks on loan originators.
g. The nonprofit has required loan originators to complete continuing education in ECOA, TILA, FCRA, HOEPA,
HMDA, RESPCA, FDCPA, GLB, or SAFE.
h. The nonprofit administers a process that provides for receiving and documenting complaints.
5. The undersigned person, under penalty of perjury, declares that he or she signs this certification on behalf of the
nonprofit indicated and that he or she occupies the official position indicated and is authorized to sign this document
on behalf of the nonprofit.
Nonprofit name:
Mailing address:
City:
State:
ZIP Code:
Email:
Phone number:
Signer’s name:
Title:
Signature:
Sworn and subscribed before me this
day of
, 20
Notary public for the state of
My commission expires
.
Notary public signature:
Notary public seal:
440-4990 (7/19/COM)
Annual Recertification of Bona Fide Nonprofit Organization