Rev. 02/09/18 Pg. 1 of 3
Please TYPE or PRINT legibly and firmly in BLACK ink. Neither the County Clerk nor his deputies are permitted by law to give
legal advice and/or assistance. This filing will be a public record and there are no refunds.
Registration Number: ___________________________ Expiration Date: _____________________________
If a renewal, a new # must be assigned if there is a Two years from date of filing or bond expiration
lapse of three years or more in the period of registration.
Filing Fees:
Filing registration: $175.00
Filing bond $ 35.00
Total fees $210.00
A. Business and Personal Information
Name o
f
Corporat
i
on or Partners
hi
p
Bus
i
ness Nam
e
Bus
i
ness Street A
dd
ress C
i
t
y
Stat
e
Z
i
p Co
de
Bus
i
ness Te
l
ep
h
one Num
b
e
r
Num
b
er o
f
l
ega
l
d
ocument ass
i
stants emp
l
oye
d
b
y t
h
e corporat
i
on or partners
hi
p
Space above for County Clerk use only
Each additional ID card $ 10.00
Additional Fees:
Record the bond – 1
st
page of bond $ 14.00
Each additional page of bond $ 3.00
San Bernardino County
Recorder-Clerk
222 W. Hospitality Lane, 1
st
Floor
San Bernardino CA 92415-0022
855 REC-CLRK
www.sbcounty.gov/arc
Completely fill in all business and personal information requested in Part A. Check each applicable box in Parts B-E
and provide information as requested for each box that is checked. Attach legible copies of all documents requested for
each box that is checked (attach certified copies and originals as specified). The completed application must be signed
under penalty of perjury by a senior executive officer or general partner.
UNLAWFUL DETAINER ASSISTANT REGISTRATION
(Corporation or Partnership)
One to four ($25,000 bond)
Five to nine ($50,000 bond) Ten or more ($100,000
b
ond)
Rev. 02/09/18 Pg. 2 of 3
List the name, address, telephone number and date of birth of each corporate officer or general partner:
(
1
)
Nam
e
Ag
e
Te
l
ep
h
one Num
b
e
r
(
1
)
A
dd
ress C
i
t
y
State Z
i
p Co
d
e
(
2
)
Nam
e
Ag
e
Te
l
ep
h
one Num
b
e
r
(
2
)
A
dd
ress C
i
t
y
State Z
i
p Co
d
e
(
3
)
Nam
e
Ag
e
Te
l
ep
h
one Num
b
e
r
(
3
)
A
dd
ress C
i
t
y
State Z
i
p Co
d
e
(
4
)
Nam
e
Ag
e
Te
l
ep
h
one Num
b
e
r
(
4
)
A
dd
ress C
i
t
y
State Z
i
p Co
d
e
(
5
)
Nam
e
Ag
e
Te
l
ep
h
one Num
b
e
r
(
5
)
A
dd
ress C
i
t
y
State Z
i
p Co
d
e
(
6
)
Nam
e
Ag
e
Te
l
ep
h
one Num
b
e
r
(
6
)
A
dd
ress C
i
t
y
State Z
i
p Co
d
e
B. Disbarment/Suspension (Note: This information must be provided for each corporate officer or general
partner)
Is an
y officer or general partner presently disbarred or suspended from the practice of law pursuant to
Business and Professions Code §6100-6117?
Yes. Date of disbarment or suspension:
No
Name of corporate officer(s) or general partner(s) for whom disbarment/suspension information is provided:
C. Civil Judgment (Note: This infor
mation must be provided for each corporate officer o
r g
eneral partner)
Has any officer or general partner had a civil judgment entered against him or her in a action arising out
of negligent, reckless or willful failure to properly perform the obligation of a Legal Document
Assistant or an Unlawful Detainer Assistant?
Has any officer or general partner been held liable in a final judgment or a stipulated judgment entered in
a civil action that alleged fraud, use of an untrue or misleading representation, or use of an unfair,
unlawful or deceptive business practice?
Yes (attach certified copy of each judgment).
No
Yes. Date of disbarment or suspension:
No
Name of corporate officer(s) or general partner(s) for who judgment information is provided:
Name of corporate officer(s) or general partner(s) for who judgment information is provided:
____________________
Rev. 02/09/18 Pg. 3 of 3
D. Criminal Conviction (Note: This information must be provided for each corporate officer or general partner.
Conviction means a plea or verdict of guilty or a conviction following a plea of nolo contendere. Any
conviction dismissed under Penal Code §1203.4 must be included.)
E. Revocation of Registration
RENEWAL OF REGISTRATION
To be eligible to renew registration, registrant shall complete 15 hours of continuing legal education courses during the
two-year period preceding renewal.
I declare under penalty of perjury under the laws of the State of California that all information on this application and
on all accompanying documents is true and correct.
*
S
i
gnature T
i
t
l
eDate
*
S
i
gnature T
i
t
l
eDate
*Corporate applicant: Application must be signed by: The chairman of the board or the president; or by any vice
president AND the secretary, any assistant secretary, the chief financial officer or any assistant treasurer.
*Partnership applicant: Application must be signed by at least one general partner.
Has any officer or general partner been convicted of a felony?
(attach certified copies of each
conviction and disposition).
Yes (attach certified copies of each conviction and disposition
No
Name of corporate officer(s) or general partner(s) for who conviction information is provided:
Has any officer or general partner been convicted of a misdemeanor unlawful practice of law or contempt of
the authority of a court pursuant to Business and Professions Code §6126 or §6127?
Yes (attach certified copies of each conviction and disposition)
No
Name of corpo
rate officer(s) or general partner(s) for whom conviction information is provided:
Has any officer or general partner been convicted of a misdemeanor violation of the provisions on Legal
Document Assistants and Unlawful Detainer Assistants pursuant to Business and Professions Code
§64
00-6416?
Yes (attach certified copies of each conviction and disposition)
No
Name of
corporate officer(s) or general partner(s) for whom conviction information is provided:
Has an officer or general partner had a registration as a Legal Document Assistant or an Unlawful Detainer
Assistant revoked by a County Clerk pursuant to Business and Professions Code
§6413 (attach certified
copy of each revocation).
Yes (attach certified copy o
f each revocation)
No
Name of corporate officer(s) or general partner(s) for whom conviction information is provided:
I am renewing my registration and I have completed the 15 hours of legal education courses required by
Business and Professions Code Section 6402.2