Fee: $20.00 + DOJ Noncriminal Applicant Fingerprint Fee
(Fees should include the Department of Business Oversight's filing fee of [$20.00] and the fee charged by the Department of Justice [Penal Code Section 11105] for processing Noncriminal Applicant Fingerprints.)
Receipt No. ____________________
STATE OF CALIFORNIA DEPARTMENT OF BUSINESS OVERSIGHT
320 West 4th Street, Suite 750
Los Angeles, California 90013-1105
(213) 576-7690
NOTICE OF OFFICERS, DIRECTORS, PARTNERS, "CONTROL" PERSONS, MANAGERS, MEMBERS, TRUSTEES AND EMPLOYEES OF A RESIDENTIAL MORTGAGE LENDER, RESIDENTIAL MORTGAGE LENDER AND SERVICER OR RESIDENTIAL MORTGAGE LOAN SERVICER*
______________________________
Special Instruction: Read
Financial Code Section 50317
before completing this notice. OFFICIAL USE ONLY
LAST NAME _________________________
Date submitted CII: ____________________
Applicant I.D.# _________________________
PLEASE PRINT OR TYPE
NAME OF COMPANY: ________________________________________ FILE NO. _________________________
ADDRESS OF MAIN OFFICE: ____________________(Street)____________________(City)____________________(State)____________________(Zip Code)
EMPLOYING BRANCH OFFICE:
NAME OF OFFICER, DIRECTOR, PARTNER, "CONTROL" PERSON [Financial Code Section 50003(e)], MANAGER, MEMBER, TRUSTEE AND EMPLOYEE:
______________________________(Last)______________________________(First)______________________________(Middle)
___________________________
POSITION HELD OR TO BE HELD:
HOME ADDRESS: (Street)____________________(City)____________________(State)____________________(Zip Code) _______________
DATE OF BIRTH: __________(Month)__________(Day)__________(Year) PLACE OF BIRTH: __________
HEIGHT: _________________________ WEIGHT: _________________________ SEX: _________________________ COLOR OF EYES: ____________________
COLOR OF HAIR: ____________________
__________
* This document shall be treated by the Department of Business Oversight as being received in confidence pursuant to paragraph (4) of subdivision (d) of Section 6254 of the Government Code.
Cal. Code Regs. Tit. 10, § 1950.122.2
2. Change without regulatory effect amending form filed 5-24-99 pursuant to section 100, title 1, California Code of Regulations (Register 99, No. 22).
3. Amendment of subsection (a)(1), new subsection (a)(5) and amendment of subsection (b) and NOTE filed 4-1-2010 as an emergency; operative 4-1-2010 (Register 2010, No. 14). A Certificate of Compliance must be transmitted to OAL by 9-28-2010 or emergency language will be repealed by operation of law on the following day.
4. Amendment of subsection (a)(1), new subsection (a)(5) and amendment of subsection (b) and NOTE refiled 9-28-2010 as an emergency; operative 9-28-2010 (Register 2010, No. 40). A Certificate of Compliance must be transmitted to OAL by 12-27-2010 or emergency language will be repealed by operation of law on the following day.
5. Amendment of subsection (a)(1), new subsection (a)(5) and amendment of subsection (b) and NOTE refiled 12-23-2010 as an emergency; operative 12-23-2010 (Register 2010, No. 52). A Certificate of Compliance must be transmitted to OAL by 3-23-2011 or emergency language will be repealed by operation of law on the following day.
6. Certificate of Compliance as to 12-23-2010 order, including amendment of subsection (a)(5), transmitted to OAL 3-14-2011 and filed 4-25-2011; amendments operative 5-25-2011 (Register 2011, No. 17).
7. Change without regulatory effect amending form within subsection (c) filed 8-13-2014 pursuant to section 100, title 1, California Code of Regulations (Register 2014, No. 33).
Note: Authority cited: Section 50304, Financial Code. Reference: Sections 50121, 50122, 50130, 50140 and 50317, Financial Code.
2. Change without regulatory effect amending form filed 5-24-99 pursuant to section 100, title 1, California Code of Regulations (Register 99, No. 22).
3. Amendment of subsection (a)(1), new subsection (a)(5) and amendment of subsection (b) and Note filed 4-1-2010 as an emergency; operative 4-1-2010 (Register 2010, No. 14). A Certificate of Compliance must be transmitted to OAL by 9-28-2010 or emergency language will be repealed by operation of law on the following day.
4. Amendment of subsection (a)(1), new subsection (a)(5) and amendment of subsection (b) and Note refiled 9-28-2010 as an emergency; operative 9-28-2010 (Register 2010, No. 40). A Certificate of Compliance must be transmitted to OAL by 12-27-2010 or emergency language will be repealed by operation of law on the following day.
5. Amendment of subsection (a)(1), new subsection (a)(5) and amendment of subsection (b) and Note refiled 12-23-2010 as an emergency; operative 12-23-2010 (Register 2010, No. 52). A Certificate of Compliance must be transmitted to OAL by 3-23-2011 or emergency language will be repealed by operation of law on the following day.
6. Certificate of Compliance as to 12-23-2010 order, including amendment of subsection (a)(5), transmitted to OAL 3-14-2011 and filed 4-25-2011; amendments operative 5-25-2011 (Register 2011, No. 17).
2. Change without regulatory effect amending form filed 5-24-99 pursuant to section 100, title 1, California Code of Regulations (Register 99, No. 22).
3. Amendment of subsection (a)(1), new subsection (a)(5) and amendment of subsection (b) and Note filed 4-1-2010 as an emergency; operative 4-1-2010 (Register 2010, No. 14). A Certificate of Compliance must be transmitted to OAL by 9-28-2010 or emergency language will be repealed by operation of law on the following day.
4. Amendment of subsection (a)(1), new subsection (a)(5) and amendment of subsection (b) and Note refiled 9-28-2010 as an emergency; operative 9-28-2010 (Register 2010, No. 40). A Certificate of Compliance must be transmitted to OAL by 12-27-2010 or emergency language will be repealed by operation of law on the following day.
5. Amendment of subsection (a)(1), new subsection (a)(5) and amendment of subsection (b) and Note refiled 12-23-2010 as an emergency; operative 12-23-2010 (Register 2010, No. 52). A Certificate of Compliance must be transmitted to OAL by 3-23-2011 or emergency language will be repealed by operation of law on the following day.
6. Certificate of Compliance as to 12-23-2010 order, including amendment of subsection (a)(5), transmitted to OAL 3-14-2011 and filed 4-25-2011; amendments operative 5-25-2011 (Register 2011, No. 17).
7. Change without regulatory effect amending form within subsection (c) filed 8-13-2014 pursuant to section 100, title 1, California Code of Regulations (Register 2014, No. 33).
2. Change without regulatory effect amending form filed 5-24-99 pursuant to section 100, title 1, California Code of Regulations (Register 99, No. 22).
3. Amendment of subsection (a)(1), new subsection (a)(5) and amendment of subsection (b) and Note filed 4-1-2010 as an emergency; operative 4-1-2010 (Register 2010, No. 14). A Certificate of Compliance must be transmitted to OAL by 9-28-2010 or emergency language will be repealed by operation of law on the following day.
4. Amendment of subsection (a)(1), new subsection (a)(5) and amendment of subsection (b) and Note refiled 9-28-2010 as an emergency; operative 9-28-2010 (Register 2010, No. 40). A Certificate of Compliance must be transmitted to OAL by 12-27-2010 or emergency language will be repealed by operation of law on the following day.
5. Amendment of subsection (a)(1), new subsection (a)(5) and amendment of subsection (b) and Note refiled 12-23-2010 as an emergency; operative 12-23-2010 (Register 2010, No. 52). A Certificate of Compliance must be transmitted to OAL by 3-23-2011 or emergency language will be repealed by operation of law on the following day.
6. Certificate of Compliance as to 12-23-2010 order, including amendment of subsection (a)(5), transmitted to OAL 3-14-2011 and filed 4-25-2011; amendments operative 5-25-2011 (Register 2011, No. 17).
7. Change without regulatory effect amending form within subsection (c) filed 8-13-2014 pursuant to section 100, title 1, California Code of Regulations (Register 2014, No. 33).