ANNUAL REPORT INTRODUCTION & INSTRUCTIONS Pursuant to Tennessee Code Annotated (Tenn. Code Ann.) §45-18-109 1 , Tenn. Code Ann. §45-17- 110 2 , Tenn. Code Ann. §45-12-109 3 and Tenn. Code Ann. §45-15-106 4 , each license issued pursuant to these chapters shall expire on December 31 st . Each license may be renewed for the ensuing twelve-month period upon application by the license holder showing continued compliance with the requirements of each Act 5 and the payment of the nonrefundable supervision fee. A licensee making timely and complete application for renewal of its license may continue to operate under its existing license until its application is approved or denied. The completed renewal application and the payment of the annual supervision fee must be sent to the department on or before December 31, but no earlier than November 1, of each year. IMPORTANT: In order to renew your current License(s) you must file, submit and upload the following three (3) items per License type. Note, License Transitions, Licensure Renewal Applications and Financial Statements must be filed and submitted via NMLS; the Annual Report Form must be uploaded via the Annual Report Upload Center. All three (3) items must be filed, submitted and uploaded on or before December 31, 2018 in order for your current License(s) to be renewed for 2019. Check Casher Licensee: Licensees are required to transition their license(s) to NMLS by December 31, 2018. When the transition is approved, the license will also be renewed for calendar year 2019. If a Licensee has NOT yet requested transition, the Licensee must complete Steps 1, 2 and 3 below. If a Licensee requested transition prior to November 1, 2018, the Licensee must complete Steps 2 and 3. More information about NMLS can be found on the NMLS Resource Center or see TN Check Casher License Transition Checklist for more information regarding the Transition. 1. Submit a License Transition request through NMLS by filing a Company Form (MU1) and an Individual Form (MU2). Additionally, for each branch holding a TN Check Casher License, a company must complete and submit a Branch Form (MU3) through NMLS. The Licensee will pay $625 for each license. This is the supervision fee for renewing the license for calendar year 2019. The filing deadline is December 31, 2018. 2. Submit Financial Statements, including, but not limited to, a Balance Sheet, Statement of Income or Loss, for the immediately preceding fiscal year end (December 31, 2017), prepared in 1 Tennessee Check Cashing Act. 2 Tennessee Deferred Presentment Services Act. 3 Tennessee Flexible Credit Act. 4 Tennessee Title Pledge Act. 5 Tennessee Check Cashing Act, Tenn. Code Ann. §45-18-105, Tennessee Deferred Presentment Services Act, Tenn. Code Ann. §45-17-104, Tennessee Flexible Credit Act, Tenn. Code Ann. §45-12-104 & Tennessee Title Pledge Act, Tenn. Code Ann. §45-15-106. Tennessee Tower 26 th Floor • 312 Rosa L. Parks Avenue • Nashville, TN 37243 Tel: 615-741-2236 • Fax: 615-253-7794 • http://www.tn.gov/tdfi
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ANNUAL REPORT INTRODUCTION & INSTRUCTIONS
Pursuant to Tennessee Code Annotated (Tenn. Code Ann.) §45-18-1091, Tenn. Code Ann. §45-17-1102, Tenn. Code Ann. §45-12-1093 and Tenn. Code Ann. §45-15-1064, each license issued pursuant to these chapters shall expire on December 31st. Each license may be renewed for the ensuing twelve-month period upon application by the license holder showing continued compliance with the requirements of each Act5 and the payment of the nonrefundable supervision fee. A licensee making timely and complete application for renewal of its license may continue to operate under its existing license until its application is approved or denied. The completed renewal application and the payment of the annual supervision fee must be sent to the department on or before December 31, but no earlier than November 1, of each year.
IMPORTANT: In order to renew your current License(s) you must file, submit and upload the following three (3) items per License type. Note, License Transitions, Licensure Renewal Applications and Financial Statements must be filed and submitted via NMLS; the Annual Report Form must be uploaded via the Annual Report Upload Center. All three (3) items must be filed, submitted and uploaded on or before December 31, 2018 in order for your current License(s) to be renewed for 2019. Check Casher Licensee: Licensees are required to transition their license(s) to NMLS by December 31, 2018. When the transition is approved, the license will also be renewed for calendar year 2019. If a Licensee has NOT yet requested transition, the Licensee must complete Steps 1, 2 and 3 below. If a Licensee requested transition prior to November 1, 2018, the Licensee must complete Steps 2 and 3.
More information about NMLS can be found on the NMLS Resource Center or see TN Check Casher License Transition Checklist for more information regarding the Transition. 1. Submit a License Transition request through NMLS by filing a Company Form (MU1) and an
Individual Form (MU2). Additionally, for each branch holding a TN Check Casher License, a company must complete and submit a Branch Form (MU3) through NMLS. The Licensee will pay $625 for each license. This is the supervision fee for renewing the license for calendar year 2019. The filing deadline is December 31, 2018.
2. Submit Financial Statements, including, but not limited to, a Balance Sheet, Statement of
Income or Loss, for the immediately preceding fiscal year end (December 31, 2017), prepared in
1 Tennessee Check Cashing Act. 2 Tennessee Deferred Presentment Services Act. 3 Tennessee Flexible Credit Act. 4 Tennessee Title Pledge Act. 5 Tennessee Check Cashing Act, Tenn. Code Ann. §45-18-105, Tennessee Deferred Presentment Services Act, Tenn. Code Ann. §45-17-104, Tennessee Flexible Credit Act, Tenn. Code Ann. §45-12-104 & Tennessee Title Pledge Act, Tenn. Code Ann. §45-15-106.
Tennessee Tower 26th Floor • 312 Rosa L. Parks Avenue • Nashville, TN 37243 Tel: 615-741-2236 • Fax: 615-253-7794 • http://www.tn.gov/tdfi
accordance with generally accepted accounting principles (GAAP) via NMLS. Financial Statements must be on the Licensee, in accordance with GAAP and submitted via NMLS. You may confer with a Certified Public Accountant (CPA) or Public Accounting Firm.
IMPORTANT: 1. Financial Statements must be in accordance with generally accepted accounting
principles GAAP, thus on an Accrual Basis.
2. If the Licensee is a Sole Proprietor the Financial Statements must reflect the individual’s Net Worth by including their personal assets and liabilities, as well as their investment in the business.
• Upload the Financial Statements in NMLS. Financial Statements are uploaded separately under
the Filing tab and Financial Statement submenu link. See the Financial Statement Quick Guide for instructions.
3. Complete the Annual Report Form electronically, then save and upload your file according to
the instructions under the Annual Report Upload Center. The Annual Report Form includes a Financial Statement Questionnaire and an Analysis of the Business Activities conducted for the period January 1, 2017 through December 31, 2017. Information for the Financial Statement Questionnaire must be pulled directly from the Licensee’s Financial Statements prepared in accordance with generally accepted accounting principles.
Note: An additional step has been added for uploading the Annual Report. As you will see when you access the upload center, a security code is required in order to complete the upload process. The security code is Cp458a!#. In addition, the upload center will only be available between the hours of 7:00 AM and 7:00 PM Central Standard Time.
Deferred Presentment Services Licensee:
1. File Licensure Renewal Applications via NMLS. In addition to the Supervision Fee of $625 for
each license, note that the NMLS will charge a processing fee of $100 for the company headquarters (MU1) and a processing fee of $20 for each company branch (MU3). In order to initiate the Licensure Renewal process, licensees should access the NMLS Resource Center at http://mortgage.nationwidelicensingsystem.org and “click” the GREEN BUTTON marked ANNUAL RENEWAL. The filing deadline is December 31, 2018.
2. Submit Financial Statements, including, but not limited to, a Balance Sheet, Statement of Income or Loss, for the immediately preceding fiscal year end (December 31, 2017), prepared in accordance with generally accepted accounting principles (GAAP) via NMLS. Financial Statements must be on the Licensee, in accordance with GAAP and submitted via NMLS. You may confer with a Certified Public Accountant (CPA) or Public Accounting Firm.
IMPORTANT: 1. Financial Statements must be in accordance with generally accepted accounting
Tennessee Tower 26th Floor • 312 Rosa L. Parks Avenue • Nashville, TN 37243 Tel: 615-741-2236 • Fax: 615-253-7794 • http://www.tn.gov/tdfi
2. If the Licensee is a Sole Proprietor the Financial Statements must reflect the individual’s Net Worth by including their personal assets and liabilities, as well as their investment in the business.
• Upload the Financial Statements in NMLS. Financial Statements are uploaded separately under
the Filing tab and Financial Statement submenu link. See the Financial Statement Quick Guide for instructions.
3. Complete the Annual Report Form electronically, then save and upload your file according to
the instructions under the Annual Report Upload Center. The Annual Report Form includes a Financial Statement Questionnaire and an Analysis of the Business Activities conducted for the period January 1, 2017 through December 31, 2017. Information for the Financial Statement Questionnaire must be pulled directly from the Licensee’s Financial Statements prepared in accordance with generally accepted accounting principles.
Note: An additional step has been added for uploading the Annual Report. As you will see when you access the upload center, a security code is required in order to complete the upload process. The security code is Cp458a!#. In addition, the upload center will only be available between the hours of 7:00 AM and 7:00 PM Central Standard Time.
Flexible Credit Licensee: 1. File Licensure Renewal Applications via NMLS. In addition to the Supervision Fee of $1025 for
each license, note that the NMLS will charge a processing fee of $100 for the company headquarters (MU1) and a processing fee of $20 for each company branch (MU3). In order to initiate the Licensure Renewal process, licensees should access the NMLS Resource Center at http://mortgage.nationwidelicensingsystem.org and “click” the GREEN BUTTON marked ANNUAL RENEWAL. The filing deadline is December 31, 2018.
2. Submit Audited Financial Statements, including, but not limited to, a Balance Sheet, Statement of Income or Loss, and Statement of Changes in Financial position, for the immediately preceding fiscal year end, prepared in accordance with generally accepted accounting principles (GAAP) by a Certified Public Accountant (CPA) or Public Accounting Firm, neither of which is affiliated with the licensee via NMLS. Audited Financial Statements must be on the licensee, in accordance with GAAP and submitted via NMLS.
IMPORTANT: If the Licensee is a Sole Proprietor the Financial Statements must reflect the individual’s Net Worth by including their personal assets and liabilities, as well as their investment in the business.
• Upload the Audited Financial Statements in NMLS. Financial Statements are uploaded separately under the Filing tab and Financial Statement submenu link. See the Financial Statement Quick Guide for instructions.
Tennessee Tower 26th Floor • 312 Rosa L. Parks Avenue • Nashville, TN 37243 Tel: 615-741-2236 • Fax: 615-253-7794 • http://www.tn.gov/tdfi
3. Complete the Annual Report Form electronically, then save and upload your file according to
the instructions under the Annual Report Upload Center. The Annual Report Form includes a Financial Statement Questionnaire and an Analysis of the Business Activities conducted for the period January 1, 2017 through December 31, 2017. Information for the Financial Statement Questionnaire must be pulled directly from the Licensee’s Financial Statements prepared in accordance with generally accepted accounting principles.
Note: An additional step has been added for uploading the Annual Report. As you will see when you access the upload center, a security code is required in order to complete the upload process. The security code is Cp458a!#. In addition, the upload center will only be available between the hours of 7:00 AM and 7:00 PM Central Standard Time.
Title Pledge Lender Licensee: 1. File Licensure Renewal Applications via NMLS. In addition to the Supervision Fee of $625 for
each license, note that the NMLS will charge a processing fee of $100 for the company headquarters (MU1) and a processing fee of $20 for each company branch (MU3). In order to initiate the Licensure Renewal process, licensees should access the NMLS Resource Center at http://mortgage.nationwidelicensingsystem.org and “click” the GREEN BUTTON marked ANNUAL RENEWAL. The filing deadline is December 31, 2018.
2. Submit Financial Statements, including, but not limited to, a Balance Sheet, Statement of Income or Loss, for the immediately preceding fiscal year end (December 31, 2017), prepared in accordance with generally accepted accounting principles (GAAP) by a Certified Public Accountant (CPA) or Public Accounting Firm, neither of which is affiliated with the licensee via NMLS. Note: Financial Statements must be on the licensee, in accordance with GAAP and submitted via NMLS.
IMPORTANT: 1. Financial Statements must be in accordance with generally accepted accounting
principles GAAP, thus on an Accrual Basis.
2. If the Licensee is a Sole Proprietor the Financial Statements must reflect the individual’s Net Worth by including their personal assets and liabilities, as well as their investment in the business.
• Upload the Financial Statements in NMLS. Financial Statements are uploaded separately under
the Filing tab and Financial Statement submenu link. See the Financial Statement Quick Guide for instructions.
3. Complete the Annual Report Form electronically, then save and upload your file according to
the instructions under the Annual Report Upload Center. The Annual Report Form includes a Financial Statement Questionnaire and an Analysis of the Business Activities conducted for the period January 1, 2017 through December 31, 2017. Information for the Financial Statement
Tennessee Tower 26th Floor • 312 Rosa L. Parks Avenue • Nashville, TN 37243 Tel: 615-741-2236 • Fax: 615-253-7794 • http://www.tn.gov/tdfi
Questionnaire must be pulled directly from the Licensee’s Financial Statements prepared in accordance with generally accepted accounting principles.
Note: An additional step has been added for uploading the Annual Report. As you will see when you access the upload center, a security code is required in order to complete the upload process. The security code is Cp458a!#. In addition, the upload center will only be available between the hours of 7:00 AM and 7:00 PM Central Standard Time.
If you currently have more than one of the License types above, you will only submit one set of Financial Statements. If you are a Flexible Credit Licensee the Financial Statements must be audited. Please contact us if you have any questions or experience any difficulties in completing the upload process. You may contact Steve Henley, Director of Licensing, at [email protected] or 615-532-6993, or Mandy Jones Heady at [email protected] or 615-253-6198.
Tennessee Tower 26th Floor • 312 Rosa L. Parks Avenue • Nashville, TN 37243 Tel: 615-741-2236 • Fax: 615-253-7794 • http://www.tn.gov/tdfi
This form must be completed for each Licensee. If a company operates more than one licensed location, the report must be filed on a composite basis. When preparing the report, do not underline or change captions. Report all amounts in whole dollars.
1 Name of Licensee _______________________________________________________________________________________
2 NMLS ID Number _________________________________
3 Legal Status
a Proprietorship
b Partnership
c Limited Partnership TN Secretary of State ID _________________________________
d Limited Liability Company TN Secretary of State ID _________________________________
e Corporation TN Secretary of State ID _________________________________
f Other __________________________________________________________________
4 Designate which License Type(s) the Licensee held in Calendar Year 2017 (Jan. 1st – Dec. 31st)
a Check Casher (CC) Complete Schedule A
b Deferred Presentment Services (DP) Complete Schedules A & B
c Flexible Credit (FC) Complete Schedules A & C
d Title Pledge Lender (TP) Complete Schedules A & D
Complete the following Schedules of the Annual Report Form electronically, then save and upload your file according to the instructions under the License Renewal Upload Center. Information for the Financial Statement Questionnaire (Schedule A) must be pulled directly from the Licensee’s Financial Statements prepared in accordance with Generally Accepted Accounting Principles (GAAP) by a Certified Public Accountant (CPA) or Public Accounting Firm, neither of which is affiliated with the Licensee. You may allocate expenses based on revenue.
DEADLINE: DECEMBER 31, 2018REPORTING ENTITY
ANNUAL REPORT
BK0242 (Rev. 10/18) Page 1 of 7 RDA2944
Check CasherDeferred
PresentmentFlexible Credit Title Pledge Other
1 Fees and Interest Income Earned
2 Repossession Charges Earned
3 Total Income
4 Bad Debts5 Expenses associated w/ Repossession,
Storage & Resale of Pledged Property6 Compensation of Officers, Owners,
Partners & LLC Members7 Compensation of Employees
8 Total Operating Expenses*
9 Income Before Tax
10 Income Tax (Federal)
11 Net Income After Tax
1 Total Assets
2 Total Liabilities
3 Net Worth
SCHEDULE AFinancial Statement Questionnaire
* Total Operating Expenses must include all Direct Variable Expenses and all General & Administrative Expenses.
STATEMENT OF INCOME AND EXPENSES
BALANCE SHEET
EXPENSES
INCOME
BK0242 (Rev. 10/18) Page 2 of 7 RDA2944
1Number
a $0 - $150
b $151 - $250
c $251 - $500
Total
23 Number of checks returned due to insufficient funds (NFS),
closed accounts or stop payments orders
Distribution of Transactions During Calendar Year 2017
SCHEDULE B
ANALYSIS OF REGULATED BUSINESS ACTIVITY IN TENNESSEEFOR THE PERIOD FROM JANUARY 1, 2017 THROUGH DECEMBER 31, 2017
Dollar Amount of Transactions During Calendar Year 2017
DEFERRED PRESENTMENT SERVICES
BK0242 (Rev. 10/18) Page 3 of 7 RDA2944
Number Dollar Amount
1
23
4
56
7
8
9
10
a
b
c
d
e
Minimum Maximum
11
12
Periodic Interest Rate charged on all Flex Loans
Customary Fee charged on all Flex Loans
$501 - $1,000
$1,001 - $2,000
$2,001 - $3,000
$3,001 - $4,000
TOTAL
SCHEDULE C
ANALYSIS OF REGULATED BUSINESS ACTIVITY IN TENNESSEEFOR THE PERIOD FROM JANUARY 1, 2017 THROUGH DECEMBER 31, 2017
Percentage
FLEXIBLE CREDIT
Flex Loans outstanding as of January 1, 2017
New Flex Loans entered into since January 1, 2017Flex Loans purchased from other Lender since January 1, 2017TOTAL
Flex Loan balances charged-off as of December 31, 2017Flex Loan balances sold to other Lender as of December 31, 2017Flex Loans paid-in full as of December 31, 2017
TOTAL
Flex Loans outstanding as of December 31, 2017
Distribution of NEW Flex Loans
$0 - $500
BK0242 (Rev. 10/18) Page 4 of 7 RDA2944
Number Dollar Amount
1
23
4
56
7
8
9
10
a
b renewed 1 time
c renewed 2 times
d renewed 3 times
e renewed 4 times
f renewed 5 times
g renewed 6 times
h renewed 7 times
i renewed 8 times
j renewed 9 times
k renewed 10 times
l renewed 11 times
m renewed 12 times
n renewed 13 times
o renewed 14 times
p renewed 15 times
q renewed 16 times
r renewed 17 times
s renewed 18 times
t renewed 19 times
u renewed 20 times
v renewed 21 times
w renewed 22 times
Paid in FULL after 30 days (NO renewing)
Of the Agreements paid-in full as of December 31, 2017 (Line 7)
TOTAL AGREEMENTS PAID-IN FULL IN 2017 (should equal Line 7)
SCHEDULE D
ANALYSIS OF REGULATED BUSINESS ACTIVITY IN TENNESSEEFOR THE PERIOD FROM JANUARY 1, 2017 THROUGH DECEMBER 31, 2017
Agreement balances sold to other Lender as of December 31, 2017Agreements paid-in full as of December 31, 2017
Total
Agreements outstanding as of December 31, 2017
Agreements outstanding as of January 1, 2017
New Agreements entered into since January 1, 2017Agreements purchased from other Lender since January 1, 2017Total
Agreement balances charged-off as of December 31, 2017
TITLE PLEDGE LENDER
BK0242 (Rev. 10/18) Page 5 of 7 RDA2944
Number Dollar Amount
11
1213
14
Number
a $0 - $250
b $251 - $500
c $501 - $750
d $751 - $1,000
e $1,001 - $1,250
f $1,251 - $1,500
g $1,501 - $1,750
h $1,751 - $2,000
i $2,001 - $2,250
j $2,251 - $2,500
1516
17
Minimum Maximum18
19
20
Defaults in 2017
Vehicles Repossessed/Total Repossession Costs
SCHEDULE D (continued)
ANALYSIS OF REGULATED BUSINESS ACTIVITY IN TENNESSEEFOR THE PERIOD FROM JANUARY 1, 2017 TO DECEMBER 31, 2017
TITLE PLEDGE LENDER
ANNUAL PERCENTAGE RATE (APR)
Percentage
Interest Rate charged on Title Pledge or Property AgreementsCustomary Fee charged on Title Pledge or Property Agreements
Repossessed Vehicles Sales Resulting in Surplus/Surplus Returned to PledgorDistribution of NEW Title Pledge Agreements
Total (should equal Line 2)
Number of Pledgor(s) as of December 31, 2017Number of Pledgor(s) that deferred a principal reduction payment as of December 31, 2017Average number of principal reduction payment(s) deferred as of December 31, 2017
BK0242 (Rev. 10/18) Page 6 of 7 RDA2944
AFFIRMATION I _________________________________________________, _________________________________________________ of Authorized Person Name Title
___________________________________________________ on this date _______________________________________ Company Name (Licensee) Date
make oath and say as follows, that I executed this form on behalf and with authority, of said Licensee and said Licensee agrees to and represents the following: 1. That the information and statements contained herein, including exhibits attached hereto, and
other information filed herewith, all of which are made a part of this form, are current, true and complete and are made under the penalty of perjury, or un-sworn falsification to authorities, or similar provisions as provided by law;
2. To the extent any information previously submitted is not amended, such information remains accurate and complete;
3. To comply with the provisions of law, including the maintenance of accurate books and records,
pertaining to the conduct of business upon which the applicant is basing the data on this form.