Money Transmitter Forms
Notice to Individual - Use of Information
The following items comprise the application package for a license to engage in the business of receiving money for the purpose of transmitting the same or its equivalent to foreign countries:
- FDIC 3064-0006 - Interagency Biographical and Financial Report Form
- FDIC 3064-0006 - Interagency Biographical and Financial Report Form Instructions (Adobe PDF)
- Form 2 - Personal Financial Statement (Rev.01-06) (Adobe PDF)
- Form 3 - Confidential Resume (Rev.02-07) (Adobe PDF)
- Form 2110 - Application for a License to Engage in the Business of Receiving Money for the Purpose of Transmitting the Same or its Equivalent (Rev. 01-12) (Adobe PDF)
- Form 2110 - Instructions (Adobe PDF)
- Form 2120 - Complaint Regarding An Unlicensed Money Transmitter/Queja Con Respecto A Un Transmisor De Dinero No Authorizado (Adobe PDF)
- Form 4030 - Authorization for Release of Information (Money Transmitters) (Rev.01-12) (Adobe PDF)
- Form 5025 - Appointment of Commissioner of Financial Institutions as Agent for Service of Process (Money Transmitters) (Adobe PDF)
Julio Prada is available to confer with you in advance of filing an application for the purpose of discussing questions related to the application. However, no application will be decided in advance of filing. You may contact him at (415) 263-8540 or by email jprada@dfi.ca.gov.
Also, the forms needed for fingerprinting are not available on the internet, but may be received by calling Meli Brown at (415) 263-8542 or email at mbrown@dfi.ca.gov.
Application for Approval to Acquire Control of Money Transmitter
