Form SS-9401 "Application for Litigation Financier Sole Proprietor Registration" - Tennessee

What Is Form SS-9401?

This is a legal form that was released by the Tennessee Secretary of State - a government authority operating within Tennessee. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • The latest edition provided by the Tennessee Secretary of State;
  • Easy to use and ready to print;
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  • Fill out the form in our online filing application.

Download a printable version of Form SS-9401 by clicking the link below or browse more documents and templates provided by the Tennessee Secretary of State.

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Download Form SS-9401 "Application for Litigation Financier Sole Proprietor Registration" - Tennessee

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APPLICATION FOR LITIGATION FINANCIER SOLE PROPRIETOR REGISTRATION
(SS-9401)
Business Services Division
Tre Hargett, Secretary of State
State of Tennessee
312 Rosa L. Parks AVE., 6th FL.
Nashville, TN 37243
(615) 741-2286
Filing fee $100.00
Pursuant to the provisions of the T.C.A. § 47-16-103 of the Tennessee Litigation Financing Consumer Pro-
tection Act, the undersigned sole proprietor hereby applies for registration as a Litigation Financier in the
State of Tennessee, and for that purpose sets forth:
APPLICANT INFORMATION
1. List the applicant’s full legal name, business name of applicant, if any, and complete physical street address:
First:
MI:
Last:
Business Name, if any:
Physical Street Address:
City:
ST:
Zip
County:
/
/
Phone #: (
)
-
Date of Birth :
MM
DD
YYYY
MAILING ADDRESS (
if different from the physical street address)
2. The complete mailing address of the applicant (if different from the physical street address) is:
Mailing Address:
City:
ST:
Zip
County:
REGISTERED AGENT INFORMATION
3. The name of the registered agent and complete physical street address located in the State of Tennessee is:
First:
MI:
Last:
Business Name, if any:
Physical Street Address:
City:
ST:
Zip
County:
Phone #: (
)
-
MAILING ADDRESS FOR REGISTERED AGENT (
if different from the physical street address)
Mailing Address:
City:
ST:
Zip
County:
4. The applicant shall be designated as a litigation financier pursuant to the Tennessee Litigation Financing Consumer
Protection Act.
Applicant’s Signature
Signature Date
Applicant’s Name (printed or typed)
Note: Pursuant to T.C.A. § 10-7-503 all information on this form is public record.
SS-9401
RDA pending
APPLICATION FOR LITIGATION FINANCIER SOLE PROPRIETOR REGISTRATION
(SS-9401)
Business Services Division
Tre Hargett, Secretary of State
State of Tennessee
312 Rosa L. Parks AVE., 6th FL.
Nashville, TN 37243
(615) 741-2286
Filing fee $100.00
Pursuant to the provisions of the T.C.A. § 47-16-103 of the Tennessee Litigation Financing Consumer Pro-
tection Act, the undersigned sole proprietor hereby applies for registration as a Litigation Financier in the
State of Tennessee, and for that purpose sets forth:
APPLICANT INFORMATION
1. List the applicant’s full legal name, business name of applicant, if any, and complete physical street address:
First:
MI:
Last:
Business Name, if any:
Physical Street Address:
City:
ST:
Zip
County:
/
/
Phone #: (
)
-
Date of Birth :
MM
DD
YYYY
MAILING ADDRESS (
if different from the physical street address)
2. The complete mailing address of the applicant (if different from the physical street address) is:
Mailing Address:
City:
ST:
Zip
County:
REGISTERED AGENT INFORMATION
3. The name of the registered agent and complete physical street address located in the State of Tennessee is:
First:
MI:
Last:
Business Name, if any:
Physical Street Address:
City:
ST:
Zip
County:
Phone #: (
)
-
MAILING ADDRESS FOR REGISTERED AGENT (
if different from the physical street address)
Mailing Address:
City:
ST:
Zip
County:
4. The applicant shall be designated as a litigation financier pursuant to the Tennessee Litigation Financing Consumer
Protection Act.
Applicant’s Signature
Signature Date
Applicant’s Name (printed or typed)
Note: Pursuant to T.C.A. § 10-7-503 all information on this form is public record.
SS-9401
RDA pending