Fillable APPLICATION FOR REPOSSESSORBOND STATE OF COLORADO (Colorado Dept. of Law)

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APPLICATION FOR REPOSSESSORBOND STATE OF COLORADO (Colorado Dept. of Law)

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PHIL WEISER
Attorney General
NATALIE HANLON LEH
Chief Deputy Attorney General
ERIC R. OLSON
Solicitor General
ERIC T. MEYER
Chief Operating Officer
.
STATE OF COLORADO
DEPARTMENT OF LAW
RALPH L. CARR
C
OLORADO JUDICIAL CENTER
1300 Broadway, 10th Floor
Denver, Colorado 80203
Phone (720) 508-6000
APPLICATION FOR REPOSSESSORBOND
[Pursuant to Colorado Revised Statutes § 4-9-629]
(Please check one) Initial Application @ $150.00 Revised Application @ $25.00
Name of Company (Applicant):
Physical Address:
Street City County State Zip Code
Mailing Address:
Street City County State Zip Code
Telephone number: ( ) Email:
(Please check one): Sole proprietorship General partnership Limited partnership Corporation Limited Liability
Other (Explain here)
1.
Trade name(s) and/or physical address(es) under which Applicant transacts business if different from above:
(If more than two, attach additional sheets.)
*
Trade Name:
*
Physical Address:
Street City County State Zip Code
*
Telephone number: ( )
*
Trade Name:
*
Physical Address:
Street City County State Zip Code
*
Telephone number: ( )
*OFFICIAL USE ONLY*
Filing Date:
Filing fee:
Exp. Date:
Received:
2.
If Applicant is an Individual, please provide the following information:
*
Name:
*
Residence Address:
Street City County State Zip Code
*
Home Telephone #: ( ) -
*
Social Security number: - -
3.
If Applicant is a Partnership, please provide the following information concerning Each Partner:
(If more than three partners, attach additional sheets.)
*
Name
*
Residence Address:
Street City County State Zip Code
*
Home Telephone #: ( ) -
Social Security Number - -
*
Name
*
Residence Address:
Street City County State Zip Code
*
Home Telephone #
:
( ) - Social Security Number - -
*
Name
*
Residence Address:
Street City County State Zip Code
*
Home Telephone #: ( ) -
Social Security Number - -
Attach a copy of current partnership agreement or, if applicant is a limited partnership, attach a copy of
recorded certificate of existence or a certified copy of limited partnership.
4.
If applicant is a Corporation, please provide the following information:
a)
Corporation organized under the laws of the Stateof
b)
Date of incorporation:
c)
Present business conducted at the followinglocation:
d)
Name of Registered Agent:
Street City State Zip Code
e)
Address of RegisteredAgent:
Street City County State Zip Code
f)
Residence Addresses ofOfficers:
Street City County State Zip Code
Attach a copy of Certificate of Good Standing (Colorado Corporation) or Certificate of Authority (Foreign
Corporation).
City
State
Zip Code
City
State
Zip Code
President:
Street
Vice President
:
Street
Secretary:
Street
Treasurer:
City
State
Zip Code
5.
(To be completed by all Applicants) Please provide the following information on your Manager(s):
(If more than two, attach additionalsheets.)
*
Name Social Security Number - -
*
Residence Address:
Street City County State Zip Code
*
Name Social Security Number - -
*
Residence Address:
Street City County State Zip Code
6.
Please provide the following information regarding the Surety company which issued Applicant’s Repossessor Bond:
*
Name
*
Address:
Street City County State Zip Code
*
Telephone number: ( ) - Colorado Insurance Division License No.
7.
Is Surety authorized to transact business in Colorado? Yes No
8.
Has Applicant been involved in any litigation in the past five (5) years with respect to its business, or is any such
litigation pending against Applicant? Yes No
If yes, please specify: (Attach more sheets if necessary.)
I
hereby affirm that the information contained herein is true and accurate to the best of my
knowledge and belief. By submitting this Application, I further state and affirm that I am
aware that various state and local laws exist concerning the activities of Repossessors in Colorado
and that copies of the same are available at my place of business.
(Signature of Individual Owner, Partner, or Officer)
Title
Signed and acknowledged before me this day of , 20 .
Notary Public
My Commission Expires:
Mail completed Application (original signatures required) and:
1.
Filing Fee (Initial: $150.00; Revised: $25.00);
2.
Original Reposessor Bond Form (completed by Surety); original, notarized signatures
required;
3.
Colorado Certificate of Good Standing (obtained through the Colorado Secretary of State
Office).
Colorado Department of Law
Consumer Protection Section
Ralph L. Carr Colorado Judicial Center
1300 Broadway, 7th Floor
Denver, CO 80203
Telephone: (720) 508-6209
Checks should be made payable to: Colorado Department of Law
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APPLICATION FOR REPOSSESSORBOND STATE OF COLORADO (Colorado Dept. of Law)

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Completed 27 January 2021

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