"Collection Agency Quarterly Notification of Agents Form" - Idaho

Collection Agency Quarterly Notification of Agents Form is a legal document that was released by the Idaho Department of Finance - a government authority operating within Idaho.

Form Details:

  • Released on July 1, 2016;
  • The latest edition currently provided by the Idaho Department of Finance;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of the form by clicking the link below or browse more documents and templates provided by the Idaho Department of Finance.

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BRAD LITTLE
Governor
PATRICIA R. PERKINS
Director
INSTRUCTIONS FOR THE ANNUAL/QUARTERLY REPORT
NOTE: If you are reporting 100 agents or more you MUST file electronically on Access Idaho
NEW APPLICATION INSTRUCTIONS:
Complete the entire top left portion of the report and mark the box on the right indicating it is a new application;
The list must be in last name alphabetical order and by location order;
Attach legal documents and explanations for any “Yes” checked felony or misdemeanor answers;
A fee of $20.00 (each) for all agents that conduct or plan to conduct Idaho activity, including the RPIC(s), must accompany this
report;
Attach ONE check payable to the Idaho Department of Finance for the total fees due ($20 for each agent you are registering)
QUARTERLY
REPORT INSTRUCTIONS:
Quarterly Notifications are DUE June 15, September 15, and December 15;
Send the Quarterly Report only once a quarter
on or near the due date or no earlier than 30 days prior to the due
date;
Complete the entire top left portion of the report and mark the box on the right indicating the quarter for which you are
reporting;
Mark the quarter being reported with the year (i.e. 2010, 2011, etc) on the top right portion of the report;
The list must be in last name alphabetical order and by location order;
If terminated employees—those no longer conducting Idaho activity—are being reported, mark the box on the top right hand
side and list at the end of the Quarterly Report in alphabetical order and location order;
Attach legal documents and explanations for any checked “Yes” felony or misdemeanor answers;
A fee of $20.00 for each newly activated agent conducting Idaho activity, including any newly approved and activated RPIC(s),
must accompany this report for filings on June 15
th
, September 15
th
and December 15
th
;
Attach ONE check payable to the Idaho Department of Finance for the total fees due ($20 for each newly activated agent you
are registering);
The Quarterly Report form may be copied or downloaded as needed. The form is required to be signed.
ANNUAL
REPORT INSTRUCTIONS:
Complete the entire top left portion of the report and mark the box on the right titled “Annual Report”;
List ALL ACTIVE agents that are or will be conducting Idaho activity, including the RPIC(s), in alphabetical order and by
location;
List all terminated or inactivated agents since the last filed report;
Attach legal documents and explanations for any checked “Yes” felony or misdemeanor answers;
Attach ONE check payable to the Idaho Department of Finance for the total fees due ($20 for ALL ACTIVE Agents including the
RPIC you are registering);
The Annual Report form may be copied or downloaded and reproduced as needed. The form is required to be signed.
IDAHO COLLECTION AGENCY ACT Idaho Code §26-2240: Each applicant for a license under this act, with its initial license application, and each
licensee at annual renewal, shall file with the director a list of all agents including the name of each agent and any other identifying information
the director may require. A fee of twenty dollars ($20.00) for each listed agent shall accompany the list. Each licensee shall notify the director
in writing of any additions to its agent list no less often than every calendar quarter. A fee of twenty dollars ($20.00) shall be paid to the
director for each additionally identified agent in the quarterly notification of additions to a licensee’s agent list. An agent is not required to be
listed, nor the fee paid therefore, unless the agent acted for the licensee for more than thirty (30) business days.
If you have any questions, please feel free to contact the Licensing Section at 208-332-8002 or collections@finance.idaho.gov.
CONSUMER FINANCE BUREAU
800 Park Blvd., Suite 200, Boise, ID 83712
Mail To: P.O. Box 83720, Boise ID 83720-0031
Phone: (208) 332-8002 Fax: (208) 332-8096
http://finance.idaho.gov
1905
PROTECTING THE INTEGRITY OF IDAHO FINANCIAL MARKETS SINCE
Rev 7/2016
BRAD LITTLE
Governor
PATRICIA R. PERKINS
Director
INSTRUCTIONS FOR THE ANNUAL/QUARTERLY REPORT
NOTE: If you are reporting 100 agents or more you MUST file electronically on Access Idaho
NEW APPLICATION INSTRUCTIONS:
Complete the entire top left portion of the report and mark the box on the right indicating it is a new application;
The list must be in last name alphabetical order and by location order;
Attach legal documents and explanations for any “Yes” checked felony or misdemeanor answers;
A fee of $20.00 (each) for all agents that conduct or plan to conduct Idaho activity, including the RPIC(s), must accompany this
report;
Attach ONE check payable to the Idaho Department of Finance for the total fees due ($20 for each agent you are registering)
QUARTERLY
REPORT INSTRUCTIONS:
Quarterly Notifications are DUE June 15, September 15, and December 15;
Send the Quarterly Report only once a quarter
on or near the due date or no earlier than 30 days prior to the due
date;
Complete the entire top left portion of the report and mark the box on the right indicating the quarter for which you are
reporting;
Mark the quarter being reported with the year (i.e. 2010, 2011, etc) on the top right portion of the report;
The list must be in last name alphabetical order and by location order;
If terminated employees—those no longer conducting Idaho activity—are being reported, mark the box on the top right hand
side and list at the end of the Quarterly Report in alphabetical order and location order;
Attach legal documents and explanations for any checked “Yes” felony or misdemeanor answers;
A fee of $20.00 for each newly activated agent conducting Idaho activity, including any newly approved and activated RPIC(s),
must accompany this report for filings on June 15
th
, September 15
th
and December 15
th
;
Attach ONE check payable to the Idaho Department of Finance for the total fees due ($20 for each newly activated agent you
are registering);
The Quarterly Report form may be copied or downloaded as needed. The form is required to be signed.
ANNUAL
REPORT INSTRUCTIONS:
Complete the entire top left portion of the report and mark the box on the right titled “Annual Report”;
List ALL ACTIVE agents that are or will be conducting Idaho activity, including the RPIC(s), in alphabetical order and by
location;
List all terminated or inactivated agents since the last filed report;
Attach legal documents and explanations for any checked “Yes” felony or misdemeanor answers;
Attach ONE check payable to the Idaho Department of Finance for the total fees due ($20 for ALL ACTIVE Agents including the
RPIC you are registering);
The Annual Report form may be copied or downloaded and reproduced as needed. The form is required to be signed.
IDAHO COLLECTION AGENCY ACT Idaho Code §26-2240: Each applicant for a license under this act, with its initial license application, and each
licensee at annual renewal, shall file with the director a list of all agents including the name of each agent and any other identifying information
the director may require. A fee of twenty dollars ($20.00) for each listed agent shall accompany the list. Each licensee shall notify the director
in writing of any additions to its agent list no less often than every calendar quarter. A fee of twenty dollars ($20.00) shall be paid to the
director for each additionally identified agent in the quarterly notification of additions to a licensee’s agent list. An agent is not required to be
listed, nor the fee paid therefore, unless the agent acted for the licensee for more than thirty (30) business days.
If you have any questions, please feel free to contact the Licensing Section at 208-332-8002 or collections@finance.idaho.gov.
CONSUMER FINANCE BUREAU
800 Park Blvd., Suite 200, Boise, ID 83712
Mail To: P.O. Box 83720, Boise ID 83720-0031
Phone: (208) 332-8002 Fax: (208) 332-8096
http://finance.idaho.gov
1905
PROTECTING THE INTEGRITY OF IDAHO FINANCIAL MARKETS SINCE
Rev 7/2016
BRAD LITTLE
STATE OF IDAHO
DEPARTMENT OF FINANCE
Governor
PATRICIA R. PERKINS
IDAHO COLLECTION AGENCY ACT
Director
ANNUAL/QUARTERLY NOTIFICATION OF AGENTS/COLLECTORS
If there are NO new agents or
terminated agents for the quarter
LICENSE NO.
DATE: ________________
QUARTERLY REPORT -
New Agents
YEAR
please check the box below
NMLS # (if applicable)
JUN 15
NAME OF LICENSEE
SEP 15
STREET
DEC 15
NEW APPLICATION
CITY, STATE, ZIP
NAME OF AUTHORIZED SIGNATURE (Print clearly)
ANNUAL REPORT
(All Active Agents)
MARCH 15, 20________
SIGNATURE
Applicant/Licensee agrees to be responsible, under Title 26, Chapter 22, Idaho Code, for acts of Agent(s) while said Agent(s) is employed by the Licensee. Licensee certifies that Agent(s) has been
instructed as to the requirements of the Idaho Collection Agency Act and the Fair Dept Collection Practices Act and that Agent(s) has a reasonable understanding and will comply with same.
DISCLOSURES:
IF YES, THE AGENT MUST SUPPLY A SIGNED DETAILED WRITTEN EXPLANATION ALONG WITH SUPPORTING COURT
DOCUMENTS.
COMPLETE COLUMN B - within the past ten (10) years have you been convicted of or plead guilty or nolo contendere ("no contest") in a domestic, foreign, or military court to any felony? COMPLETE
COLUMN C - within the past ten (10) years have you been convicted of or plead guilty or nolo contendere ("no contest") in a domestic, foreign or military court to a misdemeanor involving: Collection,
Credt Repair, Debt/Credit Counseling, Debt Buying, Debt Settlement, Financial Services or a Financial Services related business?
Listing Order: List Newly Hired Agents first, then list all newly terminated Agents on Quarterly Reports.
GROUP BY
PLEASE TYPE THE AGENT NAME Alphabetical Order by
LOCATION
DATE OF BIRTH
HIRE DATE
TERM DATE
DESK NAME
Location
LAST, FIRST, (M)
CITY & STATE OF
mm/dd/yy
mm/dd/yy
mm/dd/yy
IF USED
OFFICE
1
2
3
4
5
6
7
CONSUMER FINANCE BUREAU
800 PARK BLVD STE 200 BOISE ID 83712
P O BOX 83720 BOISE ID 83720-0031
COLLECTIONS@FINANCE.IDAHO.GOV
GROUP BY
PLEASE TYPE THE AGENT NAME Alphabetical Order by
LOCATION
DATE OF BIRTH
HIRE DATE
TERM DATE
DESK NAME
Location
LAST, FIRST, (M)
CITY & STATE OF
mm/dd/yy
mm/dd/yy
mm/dd/yy
IF USED
OFFICE
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
38
39
40
41
42
0
Total
CONSUMER FINANCE BUREAU
800 PARK BLVD STE 200 BOISE ID 83712
P O BOX 83720 BOISE ID 83720-0031
COLLECTIONS@FINANCE.IDAHO.GOV
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