Cal. Code Regs. tit. 10 § 280.153

Current through Register 2024 Notice Reg. No. 50, December 13, 2024

Section 280.153 - Notice of Officers, Directors, Partners, "Control" Persons, Managers, Members, Trustees and Employees

(a) The notice to accompany the filing of an individual's fingerprints required in the following circumstances shall be made on the form set forth in subsection (b) of this rule:

(1) In compliance with the requirements of Exhibit C to Item 10 of the application for license (Rule 280.151);

(2) In compliance with the requirements for filing an application for change of control (Rule 280.250);

(b) The notice shall be made on the following form:

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

NOTICE OF OFFICERS, DIRECTORS, PARTNERS, "CONTROL" PERSONS, MANAGERS, MEMBERS, TRUSTEES AND EMPLOYEES OF A CAPITAL ACCESS COMPANY^*

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, MANAGER, MEMBER, TRUSTEE AND EMPLOYEE:

___________________________
	(Last)	(First)	(Middle)

POSITION HELD OR TO BE HELD: __________

*HOME ADDRESS:*___________________________
	(Street)	(City)	(State)	(Zip Code)

*DATE OF BIRTH:*___________________________				*PLACE OF BIRTH:*___________________________
	(Month)	(Day)	(Year)

*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, § 280.153

1. New section filed 6-24-99; operative 7-1-99 pursuant to Government Code section 11343.4(d) (Register 99, No. 26).
2. Change without regulatory effect amending form within subsection (b) filed 8-13-2014 pursuant to section 100, title 1, California Code of Regulations (Register 2014, No. 33).

Note: Authority cited: Section 28951, Corporations Code. Reference: Sections 28104(a)(1), 28152(d), 28152(e) and (f), 28153 and 28552, Corporations Code.

1. New section filed 6-24-99; operative 7-1-99 pursuant to Government Code section 11343.4(d) (Register 99, No. 26).