Get Application For License As A Premium Finance Company (before Filling Out This Form Read The

Filling out the application for a license as a premium finance company is a crucial step in establishing a legal business entity in New York. This guide provides clear and supportive instructions to ensure all required fields and sections are adequately completed.

Follow the steps to successfully complete your application.

1. Click ‘Get Form’ button to obtain the form and open it for editing.
2. Begin by stating the name of the applicant along with any relevant trade names or assumed names. This should include the full legal name and any names under which you intend to conduct business.
3. Indicate the type of application by checking the appropriate box: De Novo (new licensee), Change of Control, or Additional Branch.
4. Select the form of organization by checking the corresponding entity type, such as Individual, Partnership, Corporation, or Limited Liability Company.
5. Provide the address where the business will be conducted, including street number, city, county, and zip code, in the specified fields.
6. List the principal place of business, ensuring to provide complete address details.
7. Fill in the address where the relevant business records will be maintained for department examination.
8. Complete the section indicating the date of formation and the state under which the applicant was formed.
9. Attach the necessary incorporation documents specific to your organization type, such as the Certificate of Incorporation, Articles of Organization, or Partnership Certificate.
10. Submit a detailed business plan along with the application.
11. Provide the required information about the applicant and principals, including contact details and company website.
12. Prepare a pro forma balance sheet as of the start of business, including sections for assets and liabilities.
13. Create an income and expense statement projected for the first year of operation.
14. If applicable, provide information regarding capital structure, including details of authorized and outstanding shares.
15. List names and addresses of officers, directors, shareholders, and key employees, along with their respective titles and positions.
16. Address questions on prior licenses, and if any officer has been arrested or convicted, provide detailed statements.
17. Prepare and submit notarized statements regarding local zoning compliance and compliance with the privacy provisions of the Gramm-Leach-Bliley Act.
18. Ensure you enclose a check for the application investigation fee as stated, noting that this amount is nonrefundable.
19. Complete the application by affixing the signature of the applicant’s president and secretary, and include notarization.
20. Lastly, ensure all required attachments and documents are included before submission, and save the completed form for your records.

Complete your application online to start your premium finance business today.