An application for registration shall be signed under penalty of false statement and include:
The applicant's name, principal business address and telephone number, and all otherbusiness addresses in this state, electronic-mail addresses, and internet website addresses;
All names under which the applicant conducts business;
The address of each location in this state at which the applicant will provide debtmanagement services or a statement that the applicant will have no such location;
The name and home address of each officer and director of the applicant and eachperson that owns at least ten percent of the applicant;
Identification of every jurisdiction in which, during the five years immediately preceding the application:
The applicant or any of its officers or directors has been licensed or registered toprovide debt-management services; or
Individuals have resided when they received debt-management services from theapplicant;
A statement describing, to the extent it is known or should be known by the applicant, any material civil or criminal judgment or litigation and any material administrative or enforcement action by a governmental agency in any jurisdiction against the applicant, any of its officers, directors, owners, or agents, or any person who is authorized to initiate transactions to the trust account required by section 5-19-222;
The applicant's financial statements, audited by an accountant licensed to conductaudits, for each of the two years immediately preceding the application or, if it has not been in operation for the two years preceding the application, for the period of its existence;
A description of the three most commonly used educational programs that the applicant provides or intends to provide to individuals who reside in this state and a copy of any materials used or to be used in those programs;
A description of the applicant's financial analysis and initial plan, including any formor electronic model, used to evaluate the financial condition of individuals. The description shall be deemed to be confidential commercial data under section 24-72-204 (3)(a)(IV).
A copy of each form of agreement that the applicant will use with individuals whoreside in this state;
The schedule of fees and charges that the applicant will use with individuals whoreside in this state;
At the applicant's expense, the results of a state and national fingerprint-based criminal history records check, conducted within the immediately preceding twelve months, covering every officer of the applicant and every employee or agent of the applicant who is authorized to initiate transactions to the trust account required by section 5-19-222. The administrator shall be the authorized agency to receive information regarding the result of the national criminal history records check.
The names and addresses of all employers of each director during the five yearsimmediately preceding the application; except that if a director receives no compensation from the provider, the applicable period shall be two years. The names and addresses shall be deemed to be confidential.
A description of any ownership interest of at least ten percent by a director, owner,or employee of the applicant in:
Any affiliate of the applicant; or
Any entity that provides products or services to the applicant or any individual relating to the applicant's debt-management services;
For not-for-profit providers, a statement of the amount of compensation of the applicant's five most highly compensated employees for each of the three years immediately preceding the application or, if it has not been in operation for the three years immediately preceding the application, for the period of its existence;
The identity of each director who is an affiliate, as defined in section 5-19-202 (2)(A) or (2)(B)(i), (2)(B)(ii), (2)(B)(iv), (2)(B)(v), (2)(B)(vi), or (2)(B)(vii), of the applicant; and
Any other information that the administrator reasonably requires to perform theadministrator's duties under section 5-19-209.
Source: L. 2017: Entire article added with relocations, (HB 17-1238), ch. 260, p. 1142, § 4, effective August 9.
Editor's note: This section is similar to former § 12-14.5-206 as it existed prior to 2017.