Form 2603
2
This space reserved for office use
AUTOMOBILE CLUB
ASSIGNMENT OF CERTIFICATE
OF DEPOSIT
Form #2603 Rev. 05/2019
Submit to:
SECRETARY OF STATE
Registrations Unit
P O Box 13193
Austin, TX 78711-3193
512-475-0775
512-475-2815 - Fax
Filing Fee: None.
ASSIGNOR N
ame:
Mailing Address City State Zip
AUTOMOBILE CLUB Name:
CERTIFICATE
OF DEPOSIT
Number: Payee: The State of Texas
Amount: twenty-five thousand dollars ($25,000.00)
FINANCIAL
INSTITUTION
Name:
Mailing Address City State Zip
AGREEMENT & UNDERSTANDING OF THE PARTIES
In order to obtain a certificate of authority for the automobile club specified (the “auto club”) and for the
purpose of providing security for injuries caused by the auto club’s failure to faithfully perform in selling or
providing club services or failure to pay any fines or penalties levied against the auto club for failure to
comply with the provisions of the Automobile Club Services Act, Transportation Code Chapter 722, the
ASSIGNOR specified, for the benefit of the state or any party injured by the auto club’s failure to faithfully
perform in selling or providing club services, in the name of the auto club, assigns and sets over irrevocably
to the secretary of state any and all right, title, claim and interest of whatever nature of ASSIGNOR in and to
the CERTIFICATE OF DEPOSIT (“CD”) described above.
ASSIGNOR agrees that this assignment carries with it the right to any insurance on the CD that may now or
in the future exist and includes and gives to the secretary of state the exclusive right to redeem, collect and
withdraw at any time any part of or the full amount of the CD to be applied as a payment to the state or to
any party injured by the auto club’s failure to faithfully perform in selling or providing club services. (The
right of the secretary of state to apply the CD shall not be affected by a subsequent change in the trade name
or business location of the person or entity on whose behalf this assignment is executed.)
ASSIGNOR understands and agrees that by this assignment all right, title and claim to interest in, use of and
control over the disposition of the CD is relinquished and that such CD is to be held by the financial
institution identified to the sole use and subject to the exclusive control of the secretary of state. This CD
may be released only by the secretary of state’s written direction.
This is notification by the ASSIGNOR to the financial institution of the terms of this assignment.
Date:
Signature of authorized person for ASSIGNOR
Printed or typed name of authorized person for ASSIGNOR
ACKNOWLEDGEMENT BY FINANCIAL INSTITUTION
The FINANCIAL INSTITUTION acknowledges the assignment of this CERTIFICATE OF DEPOSIT
(“CD”) to the secretary of state. We certify that we have recorded the assignment and have retained a copy.
We certify that we do not have, nor do we have knowledge of, anyone else having any lien, encumbrance,
right, hold, claim to or obligation of the CD. We accept the CD with knowledge that it has been irrevocably
