New York Codes, Rules and Regulations › Title 2 - DEPARTMENT OF AUDIT AND CONTROL › Chapter I - Audit Of Revenues And Accounts Payable From State Funds And Funds Under Its Control › Part 15 - Collateral Loan Brokers › Section 15.7 - Collateral loan broker's registration and supplemental registration statement

Current through Register Vol. 46, No. 28, July 10, 2024
Each and every collateral loan broker is required to file
				  with the State Comptroller the following registration and supplemental
				  registration statement. For filing each collateral loan broker's registration
				  statement, a fee of $5; and for filing each supplemental statement, a fee of
				  $2.50. Such fees are payable at the time of filing and no filing shall be
				  deemed effective within the meaning of this section until such fees have been
				  paid.
1. Fee..
$5.00
2. Date ____
COLLATERAL LOAN BROKER'S REGISTRATION
				  STATEMENT
Article 5 of the General Business Law provides:
Section 53. After September First, Nineteen Hundred Sixty, no
				  person, corporation, firm or association shall carry on the business of
				  collateral loan broker within the State of New York unless and until such
				  collateral loan broker shall have caused to be filed in the office of the State
				  Comptroller upon forms prescribed by him a statement, duly verified as
				  hereinafter provided, to be known as "Collateral Loan Broker's Registration
				  Statement."
3. (Print Full
				Name).. (Trade
				Name).........................................................................
4. (Street Address of Principal Office)..
				(P.O.
				Address)......................................................................
5. _(Address of Licensed
				Premises)__________________________
6. (Business Phone No.)
7. Check Type of Organization: Individual []
				Partnership [] Corporation []
8.
				Individual: Answer No. 16.
9.
				Partnership: Answer No. 16.
10.
				Corporation: Answer No. 17.
11.
				(Name and Location of Licensing Body)
12. Date Collateral Loan Broker's License was
				Issued __________________________
13. Collateral Loan Broker's License No.
				__________________________
14.
				State whether any other business will be carried on in said premises:
Yes [] No []
15. If "Yes," give details. _
				__________________________
16. The
				following to be filled in only by Individual or Partnership Registrant:
...........................................................................................................................................................................
NAME
...........................................................................................................................................................................
RESIDENCE
...........................................................................................................................................................................
(If Partnership, Name each Partner)
_____________________________________________________________________________________
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_____________________________________________________________________________________
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The undersigned, each for himself, certifies that he is the
				  Registrant above named; that he knows the contents of the above registration
				  and the statements contained therein and the same are true of his own
				  knowledge; that the Registrant will comply with the rules and regulations of
				  the Department of Audit and Control pertaining to collateral loan brokers that
				  are now in force or that may in the future be promulgated.
DATED ___________
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_____________________________________________________________________________________
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_____________________________________________________________________________________
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_____________________________________________________________________________________
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(Signature of Individual or Each Partner)
17. The following questions are to be
				answered only by a Corporation Registrant:
a)
				Name of Corporation ______________________________
b) Was Corporation Organized in New York
				State _ Date Inc. _
c) If Not, did
				Corporation obtain Certificate of Authority to do Business in this State Yes or
				No
d) Date of Certificate
				______________________________
e)
				State Principal Place of Business (Address-City and State)
f) The Names and Addresses of All Officers of
				Corporation:
Name
Residence
Business Address
Title
_____________________________________________________________________________________
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_____________________________________________________________________________________
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_____________________________________________________________________________________
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THIS CERTIFICATE TO BE SIGNED AND DATED BY A
				  CORPORATION
_ certifies that he is (Title) of the
				  above______________________________________________
named corporation; that he knows the contents of the above
				  registration and the statements and answers therein; that the same are true of
				  his own knowledge; that he has been authorized, by order of the Board of
				  Directors of said Corporation to make the statements and answers as contained
				  in this registration; that the registrant will comply with the rules and
				  regulations of the Department of Audit and Control pertaining to collateral
				  loan brokers that are now in force or that may in the future be
				  promulgated.
DATED
_____________________________________________________________________________________
(Signature of Authorized Officer)