APPLICATION FOR LICENSURE AS AN INSTALLMENT SELLER

PART 1

The Pennsylvania Department of Banking and Securities (“the Department”) welcomes your request for this Installment Seller application. This portion of the application provides general information that will be useful when completing the written portion of the application.

The Department issues Installment Seller licenses under the provisions of the Consumer Credit Code relating to Motor Vehicles which sets forth the requirements to obtain a license, maintain a license, the authority of the Department, among other critical information.

It is imperative that you become familiar with and operate in compliance with the Consumer Credit Code. You may wish to consult with an attorney to ensure that your operations are compliant. The Consumer Credit Code can be found at 12 Pa. C.S. § 6101 et. seq. and is available on the Department's website at www.dobs.pa.gov.

License Required

§ 6211(a). The following persons may engage or continue to engage in this Commonwealth as aprincipal, employee, agent or broker only as authorized in this chapter and under a license issued bythe department: (1) An installment seller.

Where § 6202 provides the following definition of an “Installment seller.” A person engaged in the business of selling, hiring or leasing a motor vehicle under an installment sale contract or a legal successor in interest to the person.

§ 6211(b)(1). Unless revoked or suspended under section 6218 (relating to revocation or suspensionof license) or otherwise surrendered, a license shall be valid for one year.

§ 6211(b)(2). A license shall expire on October 1 annually, after the license is initially approved orrenewed.

§ 6211(c). A license may not be transferred or assigned.

Installment Seller Application Page | 1 Revised 4/2019

Records Required

§ 6204(a). A licensee shall maintain, at the place of business designated in the license certificate,records of the business conducted under the license issued for the place of business so as to enablethe department to determine whether the licensee's business contemplated by this chapter is beingoperated in accordance with the provisions of this chapter.

§ 6204(c). Records of a licensee shall be maintained in the English language.

§ 6204(d). Records of a licensee shall be preserved and available for examination by the departmentfor at least two years after making the final entry therein.

Examinations and Investigations

§ 6203(a). The department has the authority to do any of the following:

(1) Investigate the business activities of a licensee and person engaged in a business contemplatedby this chapter by the following means:

(i) Examining the records of the licensee and person.(ii) Accessing the offices and places of business of the licensee and person and the records of thelicensee and person.

(2) Examine the records, safes and vaults of a person described under subsection (b)(2) for the purposeof discovering violations of this chapter.

§ 6203(d). The expenses incurred by the department in connection with an examinationor investigation, including a proportionate part of the salary of an examiner or other employee of thedepartment and counsel assigned by the department, may be assessed by the department upon theparticular person examined or investigated.

Penalty for violation of Consumer Credit Code

§ 6274. A person required to be licensed under this chapter that violates this chapter, directs a violationof this chapter or engages in an activity for which a license could be suspended or revoked undersection 6218 (relating to revocation or suspension of license) shall be subject to a civil penalty leviedby the department of not more than $2,000 for each offense.

Refusal to issue license or license renewal

§ 6217(a). The department may refuse to issue a license or renew a license because of any of thefollowing:

(1) The applicant has made a material misstatement in the application for license or license renewal.(2) The existence of any of the grounds under section 6218(a) (relating to revocation or suspension oflicense).

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(3) The department is not satisfied that the financial responsibility, character, reputation, integrity andgeneral fitness of the applicant command the confidence of the public and warrant the belief that thebusiness for which the license application is filed will be operated lawfully, honestly, fairly and inaccordance with this chapter and the general laws of this Commonwealth. In so determining, thedepartment shall consider the applicant's:

(i) owners, partners or members and any managers, if the applicant is a partnership, association orlimited liability company; and

(ii) officers and directors, if the applicant is a corporation.

Initial license and license renewal fees

An initial licensing fee of $250 for the official place of business must accompany the Installment Seller application for licensure. Checks or money orders should be made payable to the Pennsylvania Department of Banking and Securities.

§ 6214(b). No abatement in the amount of the license fee shall be made if the license is:(1) Issued for less than one year; or(2) Surrendered, cancelled or revoked prior to the expiration of the license period for which the

license was issued.

Installment Seller licenses must be renewed annually by October 1. An annual renewal fee of $250 must accompany the renewal application for each licensed place of business. The annual renewal fee of $250 will be due on or before September 15.

Entire Consumer Credit Code along with other laws and regulations apply

The above is a representation of a few provisions of the Consumer Credit Code, however the entire Consumer Credit Code applies. As such, it is paramount that you read and understand the entire Consumer Credit Code as you must comply with all provisions when conducting business. In addition, there are several PA and Federal Laws and regulations which may apply to your business.

It is recommended that you contact an attorney, industry trade group or association, consultant, etc. so that you fully recognize and comprehend the many laws and regulations which impact your operations.

Information about corporate and business registration can be obtained by contacting the Corporation Bureau of the Pennsylvania Department of State, 3rd Floor, North Office Building, Harrisburg, Pennsylvania, 17120-0029. The telephone number is (717) 787-1057 or visit their website at www.dos.pa.gov.

An attorney may advise you about federal laws that may apply to installment sales.

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INSTALLMENT SELLER APPLICATION

Part 2

For Official Use Only License #

1. Please indicate name of business and how it is structured.

How is business organized?

Name of entity:

D/B/A [if applicable]:

Federal ID Number ( Sole Prop Use Social Security Number):

Dealer Identification Number:

Attach Articles of Incorporation, if a foreign corporation, Foreign Registration Statement to do business in Pennsylvania, or a copy of the Operating Agreement, By-Laws, etc., evidence of registry with the Pennsylvania Department of State, if required [if not required, state reason below] and, if applicable, a copy of the fictitious name registration. Please provide legal opinion if claiming exemption

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Web address must be registered with the Pennsylvania Department of State if it is significantly different from the licensed name or the licensed name is not prominently displayed on the home page.

List all types of business offered on your website:

Explain how business will be conducted via the internet (if applicable):

2. List complete address(es) where business will be conducted. As per Section 6219(d)(2) of theConsumer Credit Code, only one license is required if: (i) every place of business is conductedunder one name, and (ii) all business records are kept in one place.

OFFICIAL LOCATIONS ($250 LICENSING FEE MUST ACCOMPANY APPLICATION):

Street Address:

Zip:

Suite or Room #

State:

Branch Manager:

Fax Number:

City:

County:

Telephone Number:

If any of the following are not applicable, please indicate N/A

Company email address:Company web address:

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A. List full name, corporate or official title in the business, date of birth, social security number, residence address, residencetelephone number, cell phone number and email address of each officer, direct owner, director, partner or members andany managers of the proposed licensed business.. Attach additional sheets if necessary.

Attach additional sheets if necessary

Full Name: Title:

Social Security Number: Date of Birth:

Home Address:

3. Information about officers, directors, owners, partners or members and any managers of the entity.

Home Phone: Cell Phone: Email Address:

Full Name: Title:

Social Security Number: Date of Birth:

Home Address:

Home Phone: Cell Phone: Email Address:

Full Name: Title:

Social Security Number: Date of Birth:

Home Address:

Home Phone: Cell Phone: Email Address:

Full Name: Title:

Social Security Number: Date of Birth:

Home Address:

Home Phone: Cell Phone: Email Address:

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B. Have any of the officers, directors, and/or direct owners ever been involved with an entity that has been licensed or is currentlylicensed by the Department:

List the individual's name, the type of license(s), license number, and the name, city and county of the licensed business(es). If none, please place a check mark in designated location.

License Number:

County:

License Number:

County:

License Number:

County:

License Number:

None

Individual Name:

Type of License:

Business Name:

City:

Individual Name:

Type of License:

Business Name:

City:

Individual Name:

Type of License:

Business Name:

City:

Individual Name:

Type of License:

Business Name:

City:

Individual Name:

Type of License:

Business Name:

City:

County:

License Number:

County:

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4. Please complete the following information to identify the person(s) the Department should contact to addresslicensing, consumer complaint, billing, compliance and examination concerns.

A. Licensing Contact:

Title:

State: Zip:

Office Fax:

Full Name:

Address:

City:

Office Phone:

B. Consumer Complaint Contact:

Title:

State: Zip:

Office Fax:

Full Name:

Address:

City:

Office Phone:

C. Billing Contact:

Title:

State: Zip:

Office Fax:

Full Name:

Address:

City:

Office Phone:

D. Compliance Contact:

Title:

State: Zip:

Office Fax:

Full Name:

Address:

City:

Office Phone:

E. Examination Contact:

Full Name: Title:

Address:

City: State: Zip:

Office Phone: Office Fax:

Email Address:

Email Address:

Email Address:

Email Address:

Email Address:

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5. Have any officers, directors, owners, partners or members and any managers identified on this application ever beenconvicted of, pled guilty to, or pled nolo contendere (no contest) or given a diversionary sentence in lieu of conviction toany felony in this Commonwealth or anywhere else? Section 6217(a)(3) of the Consumer Credit Code.

No Yes

If yes, please provide a detailed explanation of the circumstances.

6. The Department of Banking and Securities requires all applicants to provide both National Criminal History RecordInformation (fingerprint cards) and Pennsylvania Criminal Record Checks for all officers, directors, owners, partners ormembers and any managers as per Section 6217(a)(3) of the Consumer Credit Code. Instructions for completing allrequired criminal history checks (PATCH and IdentoGo) and can be found at the end of the application.

7. Within the past ten (10) years, has the applicant or applicant’s affiliate, owner, partner, member, officer, director,employee or agent pleaded guilty to, entered a plea of nolo contender (no contest) to or been convicted of a violation underSection 6271 {relating to operating without a license} or subsection A of section 37 of the former act known as the MotorVehicle Sales Finance Act? Section 6217(b)(2) of the Consumer Credit Code.

No Yes

If yes, please provide a detailed explanation of the circumstances:

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8. Do you provide or arrange financing for Manufactured Homes?

9. If you answered “YES” to Question #8

Do you currently maintain a mortgage company license or a partially exempt registration and is your sales staff licensed as Mortgage Originators?

No Yes

No Yes

10. Has the applicant, as shown in Question #1, entered into any installment sale contracts prior to applying for anInstallment Seller license?

No Yes

11. Designate Pennsylvania agent for service of process [for foreign entities only]

The applicant corporation, in pursuance of action taken at a regular meeting of the Board of Directors of said corporation does hereby appoint:

Full Name:

Address:

Telephone Number:

its true and lawful attorney and authorized agent upon whom all lawful process in any proceeding against it may be served and agrees that service of process on its attorney or agent herein named shall be of the same legal force and validity as if served upon it, the said corporation, and the authority for such service of process shall continue in force as long as any liability remains outstanding against it in the Commonwealth of Pennsylvania.

In the case of death, removal from the Commonwealth of Pennsylvania, or any legal disability or disqualification of its attorney or agent herein named, the said corporation does hereby appoint the Secretary of Banking and Securities of the Commonwealth of Pennsylvania, and successor in office, to be its true and lawful attorney and authorized agent upon whom all lawful process in any proceeding against it may be served and agrees that service of process on the Secretary of Banking and Securities shall be of the same legal force and validity as if served upon it, the said corporation, and the authority for such service of process shall continue in force as long as any liability remains outstanding against it in the Commonwealth of Pennsylvania.

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I understand by submitting this Installment Seller Application:

I am agreeing to be bound by the following declaration: "I declare that all of my answers on this License Application are complete, true and correct. I make this declaration subject to the penalties of 18 PA.C.S. § 4904 relating to unsworn falsification to authorities."

I attest that I have read and understand the following (click each for link):

1.) Consumer Credit Code

2.) Motor Vehicle FAQs

3.) Motor Vehicle Sales Finance Examination Guide

Authorization/Affirmation

Owner, Officer or Partner

Name: Title:Signature:

Name: Title:Signature:

Name: Title:Signature:

Name: Title:Signature:

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Have you….

Answered all questions or indicated N/A? Checked answers for accuracy? Authorized/Affirmed the application? Attached a copy of the Articles of Incorporation, Operating Agreement and/or Foreign Registration Statement? Attached a copy of the approved fictitious name registration if applicable? Completed all criminal record checks? Made and retained a copy of the entire application for your records? Enclosed a check for the appropriate amount?

PENNSYLVANIA DEPARTMENT OF BANKING AND SECURITIES NON-DEPOSITORY LICENSING OFFICE 17 N 2ND ST, STE 1300 HARRISBURG, PA 17101-2290

12. Please review before mailing this application.

13. Please mail completed original application to:

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The Pennsylvania Department of Banking and Securities (“the Department”) regulates the financial service industry in Pennsylvania and requires license applicant(s) to complete a Pennsylvania State Police criminal background history check and an FBI Fingerprint Check when applying for licensure.

Please review the following requirements and conditions for the Pennsylvania Check:

1. Each applicant or control person listed on the license application must complete an online criminalbackground history check using the Pennsylvania Access to Criminal History (PATCH) located athttps://epatch.state.pa.us All criminal history background checks must be completed within 30 days ofsubmission of the application.

2. Cost of the online criminal background history check is $8.00 for each request and is payable throughPATCH by credit card.

3. Please select Company Request under Requestor Details

4. When completing the application, the “Personal Information” section of the PATCH application mustcontain identifying information for the Department to ensure the results of the criminal background historycheck are forwarded directly to this Department. Results of the criminal background history checkwill not be accepted directly from the applicant and will only be accepted from PATCH. Below isthe information that must be entered in the “Company Details” section of the PATCH application:

Reason for Request: EmploymentCompany Name: PADOBSCompany Address Line 1: Market Square PlazaCompany Address Line 2: 17 N 2nd St, Ste 1300City: Harrisburg State: PA Zip: 17101 Phone Number: (717) 787-3717

Below is the information that must be entered in the “Company Contact Details” section of the PATCH application:

First Name: NonDepository Last Name: Licensing Email Address: ra-asklicensing@pa.gov

After completing the “Personal Information” section of the PATCH application, navigate to the “Record Check Request Form” section of the application and enter the information of the applicant or control person. Although not required by PATCH, it is a requirement of the Department to provide your Social Security number in the “Record Check Request Form” section of the application.

5. After making payment for the criminal background history check, you will be provided with a “RequestResults” page which must be provided to the Department in order to verify the background historycheck was completed and to track the results of any “No Record” responses. Print the “RequestResults” page and send it with the other state specific information. The “Request Results” page willcontain your First and Last name as you typed them into the system, the date that you submitted therequest and a control number

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In addition to the Pennsylvania State Police criminal background history check, all applicants are also subject to a search of the national criminal history database via an FBI Fingerprint Check.

Please review the following requirements and conditions for the FBI Fingerprint Check:

ALL CRIMINAL HISTORY REQUESTS MUST BE DATED WITHIN 30 DAYS OF SUBMISSION OF THE APPLICATION

Available to Pennsylvania residents and those working in the Commonwealth of Pennsylvania:

To Schedule your ten-minute fingerprint appointment, simply click on the link associated with yourlicense type below:

Collector Repossessor Consumer Discount Company

Installment Seller Sales Finance Company

PLEASE BRING ONE OF THE IDENTIFICATION DOCUMENTS FROM THE LIST BELOW TO YOUR ENROLLMENT

APPOINTMENT:

Driver's License issued by a State or outlying possession of the U.S.

Driver's License PERMIT issued by a State or outlying possession of the U.S.

ID card issued by a federal, state, or local government agency or by a Territory of the United States

State ID Card (or outlying possession of the U.S.) with a seal or logo from State or State Agency

Commercial Driver's License issued by a State or outlying possession of the U.S.

Canadian Driver's License

Department of Defense Common Access Card

Employment Authorization Card/ Document (I-766) with Photo

Foreign Driver's License (Mexico and Canada only)

Foreign passport

Military Dependent's Identification Card

Permanent Resident Card or Alien Registration Receipt Card (Form I-551)

U.S. Coastguard Merchant Mariner Card

U.S. Military Identification Card

U.S. Passport

Enhanced Tribal Identification Card (for federally recognized U.S. tribes)

U.S. Visa issued by the U.S. Department of Consular Affairs for travel to or within, or residence within, the United States

Uniformed Services Identification Card (Form DD-1172-2)

IdentoGO locations are updated regularly.

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Non-Resident Cardscan

Universal Enrollment Platform Processing Overview

Cardscan processing is available for those applicants residing outside of Pennsylvania and/or Pennsylvania residents physically unable to visit an IdentoGO location. To complete the process, applicants must complete the following steps.

1. Obtain fingerprints on FBI (FD-258) fingerprint card and complete personal information fields on fingerprint card.

2. Click on the link associated with your license type on the previous page. 3. Click on the ‘Submit A Fingerprint Card by Mail’ link and complete the pre-enrollment information

necessary to submit a fingerprint card enrollment by mail. All processing fees will be collected during the pre-enrollment process. A pre-enrollment confirmation page will be provided once registration is complete.

4. Print and sign the completed pre-enrollment confirmation page, which includes the barcode printed on the top right of the page. Mail the signed pre-enrollment confirmation page and the completed fingerprint card to IdentoGO using the mailing address provided during this pre-enrollment process.

DO NOT MAIL THE COMPLETED FBI CARD TO THE DEPARTMENT OF BANKING AND SECURITIES

Third Party Investigatory Background Checks: Each control person (including the qualifying individual) who does not or has not resided in the US for at least 5 years must provide an investigative background report. The report must be prepared by an acceptable search firm and submitted directly to the Department in addition to other background information required in the application. At a minimum, the report must contain the following:

• A comprehensive credit report/history

• Civil court and bankruptcy court records for the past 5 years, including a search of the court data in the country(ies), states, towns where the individual resided and worked and in contiguous areas

• Criminal records for the past 5 years, including felonies, misdemeanors and violations including a search of court data in the countries, states, towns where the individual resided and worked and in contiguous areas.

Results of the background checks are not mailed to applicants. If there is a problem with the results of your background check you will be notified.

Applicant Notification and Record Challenge: Your fingerprints will be used to check the criminal history records of the FBI. You have the opportunity to complete or challenge the accuracy of the information contained in the FBI identification record. The procedure for obtaining a change, correction, or updating the FBI identification record are set for the in Title 28, CFR, 16.34.

All applicants undergoing a fingerprint-based FBI record check are required to be provided with an adequate written FBI Privacy Act Statement and a written notice of the procedures for accessing and amending an FBI identification record. As you may be aware, applicant notification is one of the most common audit findings among the Authorized Recipient’s that are supported by FBI-approved channelers.

As a matter of information, the FBI Privacy Act Statement and the Noncriminal Justice Applicant’s Privacy Rights brochure are available on the National Crime Prevention and Privacy Compact Council’s public website. Both of these documents are available in English and in Spanish (on page 2 of each document).

Privacy Act Statement: https://www.fbi.gov/services/cjis/compact-council/privacy-act-statement

Noncriminal Justice Applicant’s Privacy Rights: https://www.fbi.gov/services/cjis/compact-council/guiding- principles-noncriminal-justice-applicants-privacy-rights