uncertainty evaluation for the measurement of gauge block - utem
TRANSCRIPT
DEPARTMENT OF BUSINESS OVERSIGHT
To: COMMISSIONER OF BUSINESS OVERSIGHT, STATE OF CALIFORNIA
1. Name of Licensee (as shown on the license )
and Address of Main Office:
2. Business Phone No.: ( ) Fax No.: ( )
Website Address:
E-mail Address:
3.
STATE OF CALIFORNIA -- BUSINESS, CONSUMER SERVICES AND HOUSING AGENCY EDMUND G. BROWN JR., Governor
(Finance Lender and Broker)
ANNUAL REPORT
PLEASE READ THE ATTACHED INSTRUCTIONS CAREFULLY BEFORE COMPLETINGTHE REPORT.
Address Change: If you wish to change the address of your place of business, you must submit a Change of Address Form (1/2014), hereby incorporated by reference, to the Department of Business Oversight. The Change of Address form must be received by the Department of Business Oversight ten (10) days prior to the date of your move, or the Department of Business Oversight may assess an administrative penalty of $500. The Change of Address form is available on the Department’s website at www.dbo.ca.gov.
LICENSEES ENGAGED IN BUSINESS UNDER THECALIFORNIA FINANCE LENDERS LAW (CFLL)
SCHEDULE AGENERAL INFORMATION
For the Year Ended December 31, 2013
CFL 812 (Rev. 11/13)
4.
a) License Number for Main Office:
b) NMLS Number (if applicable):
6.
7.
8.
[ ] Limited Liability Company [ ] Other (specify)
9. Person preparing the Annual Report:
Name & Title (Typed)
Phone No.: ( )
Email address:
SCHEDULE A
GENERAL INFORMATION
Office Hours:
(Continuation)
Type of Organization: [ ] Corporation
C. [ ] Broker Only
Total number of licenses held at December 31, 2013:
Licensed Authority: A. [ ] Lender Only B. [ ] Lender and Broker
[ ] Partnership [ ] Individual
Signature
CFL 812 (Rev. 11/13) 2
STATE OF )) SS.
COUNTY OF )
Complete Section (A) OR Section (B) as appropriate.
Date , at ,
Date ,
at
Subscribed and sworn to before me on
(SEAL) , (Year)
(City)
(City)
(Year)
(B) IF LOCATED OUTSIDE CALIFORNIA IN A STATE WHICH DOES NOT PERMIT A DECLARATION UNDER PENALTY OF PERJURY, COMPLETE THIS SECTION. NOTARIZATION IS REQUIRED.
Name and Title (Typed)
(State)
(Month / Day)
(Year)
(A) IF LOCATED IN CALIFORNIA OR IN A STATE WHICH PERMITS A DECLARATION UNDER PENALTY OF PERJURY, COMPLETE THIS SECTION. NOTARIZATION IS NOT NECESSARY.
Signature of Affiant
Signature of Declarant
and I have read and signed the report and the documents filed herewith and know the contents thereof. I certify that the financial statements contained therein were prepared in conformity with generally accepted accounting principles consistently applied, and the statistical information supplied is to the best of my knowledge true and exact.
By signing this report I hereby authorize the Commissioner to contact our main office regarding issues and concerns for all branches of the company.
Notary Public in and for said County and State
Name and Title (Typed)
(Month / Day)
I certify (or declare) under the penalty of perjury that the foregoing is true and correct.
(State)
(Month / Day)
VERIFICATION
Additional certification of licensees with two or more licensed locations:
I, the undersigned, state: That I am an officer, or general partner or the sole proprietor, or have a position of similar proprietary interest of (insert name of licensee as shown on the license)
CFL 812 (Rev. 11/13) 3
A.
B.
C.
D.
E.
F.
G.
H.
SCHEDULEC-2C-3
L and M
The Verification section must be completed. AN UNSIGNED OR INCOMPLETE VERIFICATION WILL NOT BE ACCEPTED, AND WILL RESULT IN REJECTION AND RETURN OF THE ANNUAL REPORT TO THE LICENSEE.
B-1B-1(a)
B-2C-1
If any schedule is inapplicable, indicate “Not Applicable” at the top of the schedule.
IJK
OFE
JK
B-1(a)B-2C-1C-2C-3
SCHEDULEA
VERIFICATION
If no business was conducted under the license(s) during the year, complete Schedules A through C-3, Schedule K and Verification section only. The remaining pages need not be submitted. “No business” means no loans were made, refinanced, or brokered in the calendar year, and no loan payment or broker fee was received during the year. Include the following statement at the bottom of the Verification section, “No business was conducted under the license(s) during the calendar year 2013.”
LMN
B-1
For purposes of completing the annual report, all income derived from loans originated under the Personal Property Broker, Consumer Finance Lender, and /or Commercial Finance Lender Laws should be treated as income earned under the California Finance Lenders Law.
Your annual assessment is based on the gross income you report on activities conducted under your California Finance Lenders Law license (Schedule C-1, Statement of Income and Expense, Line 1). Income earned under other state or federal lending licenses, activities not requiring a license, or activities conducted under licenses of other government agencies should be reported on Schedule C-1, Line 2.
If you are licensed as a CFLL BROKER, complete:
If you are licensed as both a CFLL LENDER and CFLL BROKER, complete all schedules.
D
VERIFICATION H
If you are licensed as a CFLL LENDER, complete:
TABLE OF SCHEDULES TO BE COMPLETED
The following schedules in the annual report must be completed:
SCHEDULEA
SCHEDULEG
CFL 812 (Rev. 11/13) 4
CFLL License No. ____________
1. $
2. Investments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.
4.
5.
6. Fixed Assets (Less: Accumulated Depreciation $ )(Fixed assets include land, buildings, equipment, furniture and fixtures, automobiles, and leasehold improvements, less accumulated depreciation.)
7. Prepaid Expenses and Deferred Charges . . . . . . . . . . . . . . . . . . . . . .
8. Commissions Receivable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9. Other Assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
10. Total Assets (sum of lines 1 thru 9 and must equal line 22 ) . . . . . . . . . $
11. $
12.
13.
14.
15.
16.
17.
18.
19.
20. $
21.$
22. Total Liabilities and Net Worth (add lines 20 & 21 and must equal $line 10 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other Liabilities and Accruals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total Liabilities (sum of lines 11 thru 19 ) . . . . . . . . . . . . . . . . . . . . .
Net Worth (line 10 less line 20 must equal Schedule B-1(a), line10, 13, 14, or 19 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Dealers Reserves and Withholds . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Accrued Taxes Other Than Income Tax . . . . . . . . . . . . . . . . . . . . . . .
Reserve for Income Taxes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Credit Insurance Premiums Due Insurer . . . . . . . . . . . . . . . . . . . . . . .
Loans and Notes Payable from Parents and Affiliates . . . . . . . . . . . . . . . .
Bonds, Debentures, and Certificates of Indebtedness . . . . . . . . . . . . . . .
Accounts Payable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
CFLL Loans Receivables (must equal Schedule B-2, line 6 ) . . . . . . . . . . .
Other Receivables (must equal Schedule B-2, line 14 ) . . . . . . . . . . . . . .
Reserves and Withholds by Banks and Finance Companies . . . . . . . . . . .
Name of Licensee: _______________________________________________
SCHEDULE B-1BALANCE SHEET
ASSETS
LIABILITIES AND NET WORTH
Cash . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
AS OF DECEMBER 31, 2013
Loans and Notes Payable from Third Parties . . . . . . . . . . . . . . . . . . . . .
CFL 812 (Rev. 11/13) 5
"NONPUBLICLY TRADED PERSON" (persons with securities owned by 35 or fewer individuals"
By:
Name (typed):
Position:
PURSUANT TO SECTION 22159(a) OF THE FINANCIAL CODE, I REQUEST CONFIDENTIAL TREATMENT OF THE BALANCE SHEET. THE LICENSEE QUALIFIES FOR CONFIDENTIAL TREATMENT OF THE BALANCE SHEET AS A:
SCHEDULE B-1(Continuation)
Name of Licensee (as shown on the license):
CFLL File Number:
REQUEST FOR CONFIDENTIAL TREATMENT
(CHECK ONE)
SOLE PROPRIETOR
Signature of Authorized Person
CFL 812 (Rev. 11/13) 6
1. $
2.
3.
4. ( )
5. $
6. Retained Earnings at 01/01/13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
7. Adjustments to Retained Earnings . . . . . . . . . . . . . . . . . . . .
8. Net Income or Loss (from Schedule C-1, line 23 ) . . . . . . . . . .
9.
10. Total Net Worth (sum of lines 5 and 9 and must equal Schedule B-1, line 21 ) $
11. Partnership Capital Accounts:
Name (General Partners) Percentage Amount
$
12. Limited Partners (in total ) . . . . . . . . . . . . . . . . . . . . . . . . . .
13. $
14. $
15.
16.
17.
18.
19. $
CFLL File No. _____________Name of Licensee: _____________________________________________________
Total Net Worth (sum of lines 11 and 12, and must equal Schedule B-1, line 21 )
FOR INDIVIDUALS, TRUSTEES, AND OTHERS:
FOR CORPORATION ONLY:
Common Stock . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Preferred Stock . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Paid In Capital in Excess of Par . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Net Worth of Individuals, Trustees, and Others (enter amount from Schedule B-1, line 21 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Less: Treasury Stock, Donated Stock, etc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total Capital (sum of lines 1 through 4 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Retained Earnings at 12/31/13 (sum of lines 6 through 8 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
FOR PARTNERSHIP ONLY:
SCHEDULE B-1(a)CALCULATION OF NET WORTH
Net Income (Loss) (from Schedule C-1, line 23 )
Total Members' Equity (sum of lines15 - 18 and must equal Schedule B-1, line 21 )
FOR LIMITED LIABILITY COMPANY:
Members' Contributions
Members' Draws
Members' Equity
AS OF DECEMBER 31, 2013
CFL 812 (Rev. 11/13) 7
(may include outstanding receivables originated under the Personal Property Broker, Consumer Finance Lender, and Commercial Finance Lender laws)
1. Consumer Loans . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
2. Commercial Loans . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3. Subtotal (sum of lines 1 and 2 ) . . . . . . . . . . . . . . . . . . . . . . . . . . $
4. Less: Unearned Pre-computed Charges . . . . . . . . . . . . . . . . . . . . . . . ( )
5. Less: Allowance for Bad Debts . . . . . . . . . . . . . . . . . . . . . . . . . . . . ( )
6. Net California Finance Lenders Loans Receivables (sum oflines 3 thru 5 and must equal Schedule B-1, line 3 ) . . . . . . . . . . . . . . . $
OTHER RECEIVABLES NOT SUBJECT TO THE CFLL:
7. Sales Contracts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
8. Leases (True leases ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9. Factoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
10. Others . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
11. Subtotal (sum of lines 7 and 10 ) . . . . . . . . . . . . . . . . . . . . . . . . . $
12. Less: Unearned Pre-computed Charges . . . . . . . . . . . . . . . . . . . . . . . ( )
13. Less: Allowance for Bad Debts . . . . . . . . . . . . . . . . . . . . . . . . . . . . ( )
14. Net Other Receivables (sum of lines 11 thru 13, and must equal Schedule B-1, line 4 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
SCHEDULE B-2ANALYSIS OF LOANS AND RECEIVABLES OUTSTANDING
Aggregate Balance
(See instructions for Schedule B-2 for classification of receivables)Aggregate Balance
CALIFORNIA FINANCE LENDERS LOAN RECEIVED:
AS OF DECEMBER 31, 2013
CFL 812 (Rev. 11/13) 8
1. Gross Income from CFLL Loans and CFLL Brokered Loans (from Schedule C-2, line 16 ) . REPORT ONLY CFLL GROSS INCOME ON THIS LINE . . . . . $ 2. Gross Income from All Other Business and Sources (from Schedule C-3,
line 7 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3. Total Gross Income (sum of lines 1 and 2 ) . . . . . . . . . . . . . . . . . . . . . . $
4. Loss on Loans Receivable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
5. Professional Audit and Accounting Services . . . . . . . . . . . . . . . . . . . . . .
6. Insurance and Bond Premiums . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7. Legal Services and Expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
8. Occupancy Expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9. Provision for Bad Debt Allowance . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
10. Salaries and Bonuses: Employees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
11. Salaries and Bonuses: Owners, Partners, Executives . . . . . . . . . . . . . . . .
12. Depreciation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
13. License Fees and Taxes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
14. Telephone and Utilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
15. Advertising and Promotions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
16. Other Expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17. Total Expenses before Interest and Income Taxes (sum of lines 4
thru 16 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
18. Income or (loss) before Interest and Income Taxes (line 3 lessline 17 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
19. Interest Paid to Bona Fide Third Parties . . . . . . . . . . . . . . . . . . . . . . . . .
20. Interest Paid to Parent Company and Affiliates . . . . . . . . . . . . . . . . . . . . .
21. Income or (Loss) before Income Taxes (subtract lines 19 and 20 from line 18 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
22. Provision for Income Taxes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
23. Net Income or (Loss) (line 21 less line 22 ) . . . . . . . . . . . . . . . . . . . . . $
(If the licensee is incorporated, the Net Income or Loss amount in line 23 must agree with Schedule B-1(a), line 8.)
INCOME
EXPENSES
SCHEDULE C-1STATEMENT OF INCOME AND EXPENSES
FOR CALENDAR YEAR 2013
CFL 812 (Rev. 11/13) 9
1. Charges Earned or Collected from loans . . . . . . . . . . . . . . . . . . . . . . . $ $ $
2. Collection from Charged Off Accounts .
3. Income from Credit Insurance . . . . . . .
4. Other Insurance Commissions . . . . . . .
5. Administrative and Loan Fees . . . . . . . . 6. Commissions from Brokering CFLL Consumer Loans (from Schedule D, line 8 ) . . . . . . . . . . . . .
7. Other income . . . . . . . . . . . . . . . . . 8. Total Consumer Loans Income (sum of lines 1 thru 7 ) . . . . . . . . . . . $ $ $
9. $ 10.
11.
12.
13.
14.
15. $ 16.
$
Income from Credit Insurance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other Insurance Commissions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total Gross Income from CFLL Loans and Brokered Loans (sum of lines 8,Column 3 and line 15, and must equal Schedule C-1, line 1 ) . . . . . . . . . . . . . . . . . . . . .
Other Income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total Commercial Loan Income (sum of lines 9 thru 14 ) . . . . . . . . . . . . . . . . . . . . . .
Commissions from Brokering CFLL Commercial Loans (from Schedule D, line 13 ) . . . . . . . .
CFL LENDERS AND BROKERS LOANS:
CONSUMER LOANS:
COMMERCIAL LOANS:
Loans
(Column 1)Under $2,500
Collection from Charged Off Accounts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(Column 2)
SCHEDULE C-2ANALYSIS OF INCOME RECEIVED FROM CFLL LENDERS AND BROKERS LOANS
Charges Earned or Collected from Loans . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total Loans of
$2,500 & Over(Column 3)
FOR CALENDAR YEAR 2013
CFL 812 (Rev. 11/13) 10
1. Charges Earned or Collected . . . . . . . . . . . . . . . . . . . . . . . $
2. Other Interest or Return on Investment . . . . . . . . . . . . . . . .
3. Collection from Charged Off Accounts . . . . . . . . . . . . . . . .
4. Income from Credit Insurance . . . . . . . . . . . . . . . . . . . . . .
5. Other Insurance Commissions . . . . . . . . . . . . . . . . . . . . . .
6. Other Income (describe below ) . . . . . . . . . . . . . . . . .
7. Total Income from All Other Business and Sources (sum of lines 1 through 6, and must equal Schedule C-1, line 2 ) . . . . . . . . $
ALL OTHER BUSINESS AND SOURCES:
SCHEDULE C-3ANALYSIS OF INCOME RECEIVED FROM OTHER BUSINESS AND SOURCES
Describe source(s) of other income reported on lines 1 through 6:
FOR CALENDAR YEAR 2013
CFL 812 (Rev. 11/13) 11
A.
Lender's Number of Name of Lender License Number Loans Brokered of Loans Commissions Received
1. $ $
2.
3.
4.
5.
6.
7. 8.
$ $
8a Residential Mortgage Loans Brokered (seeSchedule D instructions to complete this section)
9. $ $
10.
11.
12.13.
$ $
14. $ $
B.
Total Number of Loans Brokered
$ $
identified Section B: Government Agency: _______________________________ License Number:____________
Principal Amount Amount of
SCHEDULE OF OTHER BROKERED LOANS (e.g., to any lender not licensed under the CFLL)
LIST CONSUMER LOANS BROKERED ONLY:
Schedual C-2, line 13 ) . . . . . . . . . . . . . . . . . (sum of lines 9 thru 12, and must equal
Total Loans Brokered (sum of lines 8
Describe the method of computing commissions and how commissions are paid (i.e., in advance, from loan proceeds, etc.). If commissions are prepaid, describe method of refunding commissions in the event a loan is not funded.
LIST COMMERCIAL LOANS BROKERED ONLY:
SCHEDULE OF CFLL BROKERED LOANS (e.g., to any lender licensed under the CFLL)
SCHEDULE DSCHEDULE OF BROKERED LOANS
FOR CALENDAR YEAR 2013
and 13 ) . . . . . . . . . . . . . . . . . . . . . .
Total Commercial Loans Brokered
Schedual C-2, line 6, column 3 ) . . . . . . . . . .
Total Consumer Loans Brokered (sumof lines 1 through 7 and must equal
TOTALS
Provide the name of the government agency and your broker license number authorizing you to broker other loans
Total Amount ofCommissions Received
Total Principal Amount of
Loans Brokered
CFL 812 (Rev. 11/13) 12
Loans of Number of Loans
1. $ 499 or Less . . . . . . . . . . . . . . . . . . . . . . . $
2. 500 to 1,999 . . . . . . . . . . . . . . . . . . . . . . .
3. 2,000 to 2,499 . . . . . . . . . . . . . . . . . . . . . . .
4. 2,500 to 4,999 . . . . . . . . . . . . . . . . . . . . . . .
5. 5,000 to 9,999 . . . . . . . . . . . . . . . . . . . . . . .
6. 10,000 or More . . . . . . . . . . . . . . . . . . . . . . .
7. Total Consumer Loans Made (Sum of lines 1through 6) . Totals must equal Schedule F, line 27 $
and Schedule G, line 40.)
8. $ 5,000 or More . . . . . . . . . . . . . . . . . . . . . . . $
9. Total Commercial Loans Made. (Totals must equal Schedule F, line 34 and Schedule G, line 49.) . $
10. Total Loans Made - All Categories (sum of lines7 and 9) . Totals must equal Schedule F, line 35 and Schedule G, line 50). . . . . . . . . . . . . . . . . . $
SCHEDULE ECALIFORNIA FINANCE LENDERS
FOR CALENDAR YEAR 2013LOANS MADE OR REFINANCED DURING THE YEAR BY SIZE OF LOAN
CONSUMER LOANS ONLY
Principal Amount
COMMERCIAL LOANS ONLY
CFL 812 (Rev. 11/13) 13
Number of Loans
1. $
2. Personal Property (household items ) . . . . . . . . .
3.1
3.2
4.
5.
6. $
7. $
8. Personal Property (household items ) . . . . . . . . .
9.1
9.2
10.
11.
12. $
13. $
14.
15.1
15.2
16.
17.
18.
19. $
SCHEDULE FCALIFORNIA FINANCE LENDERS
FOR CALENDAR YEAR 2013
Type of Security Principal Amount
CONSUMER LOANS
LOANS MADE OR REFINANCED DURING THE YEAR BY TYPE OF SECURITY
Loans Under $2,500
Unsecured . . . . . . . . . . . . . . . . . . . . . . . . . .
Automobiles and Other Motor Vehicles . . . . . . .
Wage Assignment . . . . . . . . . . . . . . . . . . . . .
Other Security . . . . . . . . . . . . . . . . . . . . . . .
Total Loans Made (sum of lines 1 thru 5 ) . . . . . .
Auto Title Loans . . . . . . . . . . . . . . . . . . . . . .
Loans $2,500 to $4,999
Unsecured . . . . . . . . . . . . . . . . . . . . . . . . . .
Automobiles and Other Motor Vehicles . . . . . . .
Wage Assignment . . . . . . . . . . . . . . . . . . . . .
Other Security . . . . . . . . . . . . . . . . . . . . . . .
Total Loans Made (sum of lines 7 thru 11) . . . . .
Auto Title Loans . . . . . . . . . . . . . . . . . . . . . .
Loans $5,000 to $9,999
Total Loans Made (sum of lines 13 thru 18) . . . . .
Real Property . . . . . . . . . . . . . . . . . . . . . . . .
Personal Property (household items ) . . . . . . . . .
Unsecured . . . . . . . . . . . . . . . . . . . . . . . . . .
Automobiles and Other Motor Vehicles . . . . . . .
Wage Assignment . . . . . . . . . . . . . . . . . . . . .
Other Security . . . . . . . . . . . . . . . . . . . . . . .
Auto Title Loans . . . . . . . . . . . . . . . . . . . . . .
CFL 812 (Rev. 11/13) 14
Type of Security Number of Loans Principal Amount
20. $
21.
22.1
22.2
23.
24.
25.
26. $
27.
$
28. $
29.
30.
31.
32.
33.
34.
line 9 and Schedule G, line 49.). . . . . . . . . . . . . . . $
35.lines 27 and 34) . Totals must equal Schedule E, line 10 and Schedule G, line 50.) . . . . . . . . . . . . . . $
SCHEDULE F
LOANS MADE OR REFINANCED DURING THE YEAR BY TYPE OF SECURITY
CONSUMER LOANS ONLY
Loans $10,000 or More
Unsecured . . . . . . . . . . . . . . . . . . . . . . . . . . .
28 through 33) . Totals must equal Schedule E,
Real Property . . . . . . . . . . . . . . . . . . . . . . . . .
(Continuation)
Real Property . . . . . . . . . . . . . . . . . . . . . . . . .
CALIFORNIA FINANCE LENDERS
FOR CALENDAR YEAR 2013
Personal Property (Household Items ) . . . . . . . . . .
line 7 and Schedule G, line 40) . . . . . . . . . . . . . . . . . . . . . . . .
Automobiles and Other Motor Vehicles . . . . . . . .
Business Equipment . . . . . . . . . . . . . . . . . . . . .
Other Security . . . . . . . . . . . . . . . . . . . . . . . .
Automobiles and Other Motor Vehicles . . . . . . . .
Total Consumer Loans Made (sum of lines 6,12, 19, & 26) . Totals must equal Schedule E,
Other Security . . . . . . . . . . . . . . . . . . . . . . . . .
Unsecured . . . . . . . . . . . . . . . . . . . . . . . . . . .
Personal Property . . . . . . . . . . . . . . . . . . . . . .
Wage Assignment . . . . . . . . . . . . . . . . . . . . . .
Total Loans Made - All Gategories (sum of
Auto Title Loans . . . . . . . . . . . . . . . . . . . . . . . .
COMMERCIAL LOANS ONLY
Total Loans Made (sum of lines 20 through 25 ) . . . . .
Total Commercial Loans Made (Sum of lines
CFL 812 (Rev. 11/13) 15
Number of Loans
Loans under $2,500
1. $
2.
3.
4.
5.
6.
7.
8.
9.
10.1
10.2
10.3
12. $
13. $
14.
15.
16.
17.
18.
19.1
19.2
19.3
21. $
This page must agree with Schedule G by Loan Type, Total of All Loans on page 45.
SCHEDULE G(Continuation)
CALIFORNIA FINANCE LENDERSLOANS MADE OR REFINANCED DURING THE YEAR BY RATES CHARGED
FOR CALENDAR YEAR 2013
CONSUMER LOANS ONLY
Annualized Rate of Charge Principal Amount
Step Rate: 2.5%, 2%, 1.5%, & 1% Per Month
Alternate Rates: 1.6% Per Month . . . . . . . . . . . . . . . . . . . . .
Federal Reserve Bank Rate plus 10% . . . . . . . .
Other Rates: Up to 14.999 APR . . . . . . . . . . . . . . . .
15.000 to 19.999 APR . . . . . . . . . . . . . . . .
20.000 to 24.999 APR . . . . . . . . . . . . . . . .
25.000 to 29.999 APR . . . . . . . . . . . . . . . .
30.000 to 34.999 APR . . . . . . . . . . . . . . . .
30.000 to 34.999 APR . . . . . . . . . . . . . . . .
35.000 to 39.999 APR . . . . . . . . . . . . . . . .
35.000 to 39.999 APR . . . . . . . . . . . . . . . .
40.000 to 69.999 APR . . . . . . . . . . . . . . . .
70.000 to 99.999 APR . . . . . . . . . . . . . . . .
100.000 or More APR . . . . . . . . . . . . . . . .
Total Loans Made (sum of lines 1 thru 10.3) . . . . . .
Loans $2,500 to $4,999
40.000 to 69.999 APR . . . . . . . . . . . . . . . .
70.000 to 99.999 APR . . . . . . . . . . . . . . . .
100.000 or More APR . . . . . . . . . . . . . . . .
Total Loans Made (sum of line 13 thru 19.3 ) . . . . . .
(From Schedule G by Loan Type)TOTAL OF ALL LOANS
Up to 14.999 APR . . . . . . . . . . . . . . . .
15.000 to 19.999 APR . . . . . . . . . . . . . . . .
20.000 to 24.999 APR . . . . . . . . . . . . . . . .
25.000 to 29.999 APR . . . . . . . . . . . . . . . .
CFL 812 (Rev. 11/13) 16
Annualized Rate of Charge Number of Loans Principal Amount
22. $
23.
24.
25.
26.
27.
28.1
28.2
28.3
30. $
31. $
32.
33.
34.
35.
36.
37.1
37.2
37.3
39. $
40. Total Consumer Loans Made (sum of lines$
This page must agree with Schedule G by Loan Type, Total of All Loans on page 46.
SCHEDULE G(Continuation)
CALIFORNIA FINANCE LENDERSLOANS MADE OR REFINANCED DURING THE YEAR BY RATES CHARGED
FOR CALENDAR YEAR 2013
CONSUMER LOANS ONLY (From Schedule G by Loan Type)
Loans $5,000 to $9,999
Up to 14.999 APR . . . . . . . . . . . . . . .
15.000 to 19.999 APR . . . . . . . . . . . . . . .
20.000 to 24.999 APR . . . . . . . . . . . . . . .
25.000 to 29.999 APR . . . . . . . . . . . . . . .
30.000 to 34.999 APR . . . . . . . . . . . . . . .
35.000 to 39.999 APR . . . . . . . . . . . . . . .
40.000 to 69.999 APR . . . . . . . . . . . . . . .
70.000 to 99.999 APR . . . . . . . . . . . . . . .
100.000 or More APR . . . . . . . . . . . . . . .
Total Loans Made (sum of line 22 thru 28.3 ) . . . .
Loans $10,000 and Over
Up to 14.999 APR . . . . . . . . . . . . . . .
15.000 to 19.999 APR . . . . . . . . . . . . . . .
20.000 to 24.999 APR . . . . . . . . . . . . . . .
25.000 to 29.999 APR . . . . . . . . . . . . . . .
Total Loans Made (sum of line 31 thru 37.3 ) . . . . .
12, 21, 30, & 39 ) . (A) . . . . . . . . . . . . . . . . .
NOTE : (A) Totals must equal Schedule E, line 7 and Schedule F, line 27.
TOTAL OF ALL LOANS
30.000 to 34.999 APR . . . . . . . . . . . . . . .
35.000 to 39.999 APR . . . . . . . . . . . . . . .
40.000 to 69.999 APR . . . . . . . . . . . . . . .
70.000 to 99.999 APR . . . . . . . . . . . . . . .
100.000 or More APR . . . . . . . . . . . . . . .
CFL 812 (Rev. 11/13) 17
Note Rate or Contract Rate Number of Loans Principal Amount
41. $
42.
43.
44.
45.
46.
47.1
47.2
47.3
48.
49.
line 9 and Schedule F, line 34 . . . . . . . . . . . . . . $
50.
line 10 and Schedule F, line 35. . . . . . . . . . . . . . $
TOTAL OF ALL LOANS
CALIFORNIA FINANCE LENDERS
COMMERCIAL LOANS ONLY
SCHEDULE G(Continuation)
LOANS MADE OR REFINANCED DURING THE YEAR BY RATES CHARGEDFOR CALENDAR YEAR 2013(Round to Nearest Dollar - Omit Cents)
Total Loans Made - All Categories (Sum of
40.000 to 69.999 . . . . . . . . . . . . . . . . . .
lines 40 & 49 ) . Totals must equal Schedule E,
30.000 to 34.999 . . . . . . . . . . . . . . . . . .
35.000 to 39.999 . . . . . . . . . . . . . . . . . .
100.000 or More . . . . . . . . . . . . . . . . . .
Variable Rates Based on Index . . . . . . . . . . . .
70.000 to 99.999 . . . . . . . . . . . . . . . . . .
Up to 14.999 . . . . . . . . . . . . . . . . . .
15.000 to 19.999 . . . . . . . . . . . . . . . . . .
20.000 to 24.999 . . . . . . . . . . . . . . . . . .
25.000 to 29.999 . . . . . . . . . . . . . . . . . .
Total Commercial Loans Made (Sum of lines 41 through 48 ) . Totals must equal Schedule E,
CFL 812 (Rev. 11/13) 18
1.
2. Is the insurance company(s) named in item 1 above a parent corporation, affiliated company, or in any
3.
Credit Life$ Personal Property $$ Real Property $
Credit Disability$ Personal Property $$ Real Property $
Credit Loss-of-Income$ Personal Property $$ Real Property $
4.
5.
6.
Minimum MaximumCredit LifeCredit DisabilityCredit Loss-of-Income
7.
8.
________________________________________________________________________________________
Credit insurance premiums charged per year per hundred dollars of initial indebtedness:
Is the credit insurance premium deducted from the loan proceeds? Yes [ ] No [ ]
Are the credit insurance premiums that have been collected from borrowers remitted in total to the carrier?
_______________________________________________________________________________________
If the answer is “no”, explain how the credit insurance proceeds are paid:
SCHEDULE HCREDIT INSURANCE
Joint CoverageSingle Premium
Provide the name(s) and address(s) of insurance company(s) underwriting your credit insurance.
Name: ___________________________________________________________________________Address: _________________________________________________________________________
other manner connected with you: Yes [ ] No [ ]
If the answer to item 2 is “yes”, explain the relationship:
GENERAL INFORMATION
List exclusions from coverage, if any:______________________________________________________________________________________________________________________________________________________________________________
_______________________________________________________________________________________
Does the credit disability policy contain a "14-day" non-retroactive provision? Yes [ ] No [ ]
If the answer is “No”, provide an explanation:_______________________________________________________________________________________
carrier? Yes [ ] No [ ]
If the answer is “no”, provide an explanation:
What is the age limit to qualify for credit insurance?
CFL 812 (Rev. 11/13) 19
1.
A.
Dollar Value of Dollar Amount of Loans Servicing FeesNo. of Loans Sold
$ $ $
Yes [ ] No [ ]
Did you sell any of those loans to affiliated companies? Yes [ ] No [ ]
Are trust accounts established for those loans serviced? Yes [ ] No [ ]
B Loans Sold Under Other AuthorityReport only those loans originated under your California Finance Lenders license(s), or purchased from an institutional lender or from another licensee pursuant to Division 9 of the Financial Code that were sold, but not sold under the authority of the California Finance Lenders Law.
No. of Loans Sold
$ (License Number)
Please state under which authority the loans were sold:
2. Loans Serviced Under the California Finance Lenders License (includes all loans originated, purchased or sold):
Loan Type Number of Loans
Residential Real Estate Secured $ $All Other Loans $ $
Report only those loans originated under your California Finance Lenders license(s), or purchased from an institutionallender or from another licensee pursuant to Division 9 of the Financial Code, and subsequently sold to institutional investors.
Report all loans you serviced as of December 31, 2013
Loans Sold
Are these loans sold to institutional investors?
Dollar Value ofLoans Sold
FOR CALENDAR YEAR 2013
Loans Sold Pursuant to Financial Code Sections 22340, 22340.1, 22600 or 22600.1:
SCHEDULE ISALE OF LOANS TO INSTITUTIONAL INVESTORS AND LOANS SERVICED
BalanceServicing Fees
Earned
EarnedSold Retained for Servicing
CFL 812 (Rev. 11/13) 20
1. SALE OF INSURANCE PRODUCTS
Credit Life Insurance $
Credit Disability Insurance
Accidental Death & Dismemberment
Personal Property Insurance
Real Estate Loan Insurance
Others (auto, whole life, etc. )
2.
License AuthorityDescription of Services Provided (If Applicable)
$
3.
License AuthorityDescribe Activity (If Applicable)
$
4.
License AuthorityDescribe Activity (If Applicable)
$
5.AND HELD BY THE LICENSEE:
Name of License Name of Agency License Number
(Example: Sale and/or financing of precious metals or other commodities)
LIST ANY OTHER LICENSES ISSUED BY STATE OF CALIFORNIA GOVERNMENT AGENCIES
2013 Revenue
2013 Revenue
OTHER BUSINESS ACTIVITY CONDUCTED AT LICENSED LOCATION (not already included in items 1, 2, or 3 above. )
BUSINESS CONDUCTED PURSUANT TO THE COMMODITY BROKERS LAW OF 1990
2013 Revenue
2013 Revenue
OTHER SERVICES PROVIDED (Examples: loan servicing, leasing, automobile contracts, etc.)
SCHEDULE JOTHER BUSINESS ACTIVITIES AND COVERED LOANS
Insurer
Schedule J must be completed for any other activities conducted at the licensed locations(s), in addition to making and/or brokering loans under your California Finance Lender license(s).
A. OTHER BUSINESS ACTIVITIES:
CFL 812 (Rev. 11/13) 21
$
OTHER BUSINESS ACTIVITIES AND COVERED LOANS
SCHEDULE J
This section must be completed by a licensee that made “covered loans” as defined in Financial Code Section 4970(b)(1).
(Continuation)
B. COVERED LOANS:
Number of Covered Loans Principal Amount
CFL 812 (Rev. 11/13) 22
Name of Licensee: CFLL File No. _________________
% OF BUSINESS ADDRESSFIRST LAST OWNERSHIP (Street, City, State & Zip Code)
Complete the following directory for ALL directors, officers, members, managing members, branch managers and any person (as defined in Section 22008 of the Financial Code) owning or controlling directly or indirectly 10 percent or more of the outstanding interest or equity securities. If an individual was required to be included in the initial application for a license under the California Finance Lenders Law or in a subsequent report of changes in personnel, the individual must be included in this directory.
In addition to this directory, submit a Statement of Identity and Questionnaire (SIQ), for those individuals who did not submit the SIQ to the Department previously. The SIQ form is available on the Department of Business Oversight’s website at www.dbo.ca.gov.
FULL NAME
SCHEDULE KDIRECTORY OF DIRECTORS, OFFICERS, MEMBERS, MANAGING MEMBERS, BRANCH MANAGERS AND ANY
POSITION HELD OR TO BE HELDMIDDLE
A self-designed form may be substituted in place of Schedule K if a licensee has more than 21 directors, officers, members, managing members, branch managers and persons holding 10 percent or more of the outstanding interests. The self designed form must contain at a minimum the following information.
PERSON OWNING OR CONTROLLING (DIRECTLY OR INDIRECTLY) 10% OR MORE OF INTEREST OR EQUITY SECURITIES
CFL 812 (Rev. 11/13) 23
% OF BUSINESS ADDRESSFIRST LAST OWNERSHIP (Street, City, State & Zip Code)
FULL NAME POSITION HELD OR TO BE HELDMIDDLE
(Continuation)SCHEDULE K
PERSON OWNING OR CONTROLLING (DIRECTLY OR INDIRECTLY) 10% OR MORE OF INTEREST OR EQUITY SECURITIESDIRECTORY OF DIRECTORS, OFFICERS, MEMBERS, MANAGING MEMBERS, BRANCH MANAGERS AND ANY
CFL 812 (Rev. 11/13) 24