Form DFPI-CFL22066(D)(4) "Notice of Partnering Organization Pursuant to Section 22066 (D)(4) of the Financial Code" - California

What Is Form DFPI-CFL22066(D)(4)?

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 November 1, 2020;
  • 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 DFPI-CFL22066(D)(4) 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 DFPI-CFL22066(D)(4) "Notice of Partnering Organization Pursuant to Section 22066 (D)(4) of the Financial Code" - California

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STATE OF CALIFORNIA –DEPARTMENT OF FINANCIAL PROTECTION AND INNOVATION
NOTICE OF PARTNERING ORGANIZATION PURSUANT TO SECTION 22066(d)
DFPI-CFL 22066 (d)(4) (Rev. 11-20)
(4) OF THE FINANCIAL CODE
Department of Financial Protection and Innovation
Fee: None
File Number
DEPARTMENT OF FINANCIAL PROTECTION AND INNOVATION STATE OF CALIFORNIA
FINANCIAL CODE SECTION 22066 PARTNERING
ORGANIZATION NOTICE
SECTION 22066(d)(4) of the CALIFORNIA FINANCING LAW
(Financial Code section 22066(d)(4))
A. DATE
:
B. Check one
:
( )
Original Notice
( )
Amended Notice
C. Information about the Exempt Organization
1. Name of Exempt Organization
:
File Number (if known)
:
:
2. Contact Person
Name and title
(
)
a. Business Phone:
b. Email Address:
c. Mailing Address:
( )
Same as Exempt Organization
Number and Street
City
State
Zip Code
STATE OF CALIFORNIA –DEPARTMENT OF FINANCIAL PROTECTION AND INNOVATION
NOTICE OF PARTNERING ORGANIZATION PURSUANT TO SECTION 22066(d)
DFPI-CFL 22066 (d)(4) (Rev. 11-20)
(4) OF THE FINANCIAL CODE
Department of Financial Protection and Innovation
Fee: None
File Number
DEPARTMENT OF FINANCIAL PROTECTION AND INNOVATION STATE OF CALIFORNIA
FINANCIAL CODE SECTION 22066 PARTNERING
ORGANIZATION NOTICE
SECTION 22066(d)(4) of the CALIFORNIA FINANCING LAW
(Financial Code section 22066(d)(4))
A. DATE
:
B. Check one
:
( )
Original Notice
( )
Amended Notice
C. Information about the Exempt Organization
1. Name of Exempt Organization
:
File Number (if known)
:
:
2. Contact Person
Name and title
(
)
a. Business Phone:
b. Email Address:
c. Mailing Address:
( )
Same as Exempt Organization
Number and Street
City
State
Zip Code
STATE OF CALIFORNIA –DEPARTMENT OF FINANCIAL PROTECTION AND INNOVATION
NOTICE FOR PARTNERING ORGANIZATION PURSUANT TO
DFPI-CFL 22066(d)(4) (Rev. 11-20) Page 2 of 3
SECTION 22066(d)(4) OF THE FINANCIAL CODE
D. Information about the Partnering Organization
1. Name of Partnering Organization:
:
2. Address of Partnering Organization
Number and Street
City
State
Zip Code
Mailing Address:
( )
Same as above
Number and Street
City
State
Zip Code
3. Area Code and Telephone Number:
(
)
4. Website Address
:
5. Contact Person:
Name and title
a. Business Phone
: (
)
b. Email Address:
( )
c. Mailing Address:
Same as Partnering Organization
Number and Street
City
State
Zip Code
STATE OF CALIFORNIA –DEPARTMENT OF FINANCIAL PROTECTION AND INNOVATION
NOTICE FOR PARTNERING ORGANIZATION PURSUANT TO
DFPI-CFL 22066(d)(4) (Rev. 11-20) Page 3 of 3
SECTION 22066(d)(4) OF THE FINANCIAL CODE
E. Attach the following documentation to this application:
1.
Documentation of Partnering Organization’s status as a tax-exempt organization under
Section 501(c)(3) of the Internal Revenue Code of 1986, including the most recent
Form 990.
2.
Written agreement between Exempt Organization and Partnering Organization.
3.
All additional addresses at which the Partnering Organization facilitates lending activities.
F. Certification, Acknowledgement and Signature
1.
Exempt Organization certifies that the representations, documentation and information
submitted in this application for exemption are true and correct
.
Date
Name of Exempt Organization
Print Name of Individual Signing on Behalf of Exempt Organization
Signature
Title
Page of 3