* BRANCH APPLICATION *
FORECLOSURE PURCHASER

STATE OF MAINE
BUREAU OF CONSUMER CREDIT PROTECTION
35 STATE HOUSE STATION
AUGUSTA, MAINE 04333-0035
FOR OFFICE USE ONLY

DATE NOTIFICATION REC’D:  __________________________

AMOUNT FEE REC’D:  ________________________________

CASH [      ]  CC [      ]   CHECK [        ]  CHECK #:____________

CHECKED BY:  _____________________________________

DATA ENTRY:  _____________________________________
                                                                         Phone: (207)624-8527
                            Fax: (207) 582-7699

In accordance with the provisions of Title 32 MRS §§6191-6200,
“the Foreclosure Purchasers Act,” application is hereby made for a license to acquire foreclosure reconveyances as a “foreclosure purchaser”.

1.	FULL COMPANY TRADE NAME:  ______________________________________________________________

2.	ADDRESS OF BRANCH OFFICE TO BE LICENSED:  ______________________________________________

TELEPHONE: (        )______________________   FAX:  (          )_____________________________________

3.	ADDRESS OF HOME OFFICE:  ________________________________________________________________

TELEPHONE: (       )___________________   FAX:  (        )_________________ 

FED. ID #:_________________

4.	HOME OFFICE LICENSE # _____________________ EXPIRATION DATE:  ___________________________

5.	résumé:  Attach to the application a résumé of the person who will oversee the daily operations of the branch office and its personnel.

6.	RECORDS LOCATION:  If foreclosure purchasing records will not be stored at this branch location, list the location where they will be stored:  __________________________________________________________________________________________
	__________________________________________________________________________________________     

7.	FINANCIAL STATEMENT:  Attach a sworn financial statement and any other information necessary to substantiate the availability of at least $25,000 in net assets for the operation of the branch location.  (Upon issuance of a license, each licensee must maintain net assets of at least $25,000 which are either used or readily available for use in the conduct of the business of each office of the licensee from which Foreclosure Purchases are made.)  

8.		BOND:  Attach a duly executed bond in the amount of $50,000, on the form included in the licensing package for each office location.  NOTE:  A company may submit a single bond covering both the main office and all branch offices, so long as the bond includes $50,000 for each location (up to a maximum of $500,000), and so long as the single bond (or an accompanying letter from the bond company) lists the addresses of each licensed location.

9.		LICENSE FEE:  Include a license fee for each branch location of $100.

Maine law [5 M.R.S. §130 (1991)] requires assessment of $20 for any check returned by your bank for insufficient funds.

(If a Corporation, affix
corporate seal here)							          ________________________________

By:   __________________________________

Title: __________________________________

STATE OF _________________________________
                                    , ss.								                                   , 20_____            

	Personally, appeared the above-named                                                  and made oath to the truth of the statements subscribed,
Before me,                                                                 
									         __________________________________                                      
Notary Public/Justice of the Peace  
PLEASE MAIL YOUR APPLICATION ADDRESSED AS FOLLOWS:
   
REGULAR MAIL:							EXPRESS/OVERNIGHT (PRIVATE) MAIL:

STATE OF MAINE							BUREAU OF CONSUMER CREDIT PROTECTION
BUREAU OF CONSUMER CREDIT PROTECTION			GARDINER ANNEX
35 STATE HOUSE STATION						76 NORTHERN AVENUE
AUGUSTA, ME 04333-0035						GARDINER, ME 04345

Notice regarding Public Information

This application is a public record for purposes of Maine’s Freedom of Access Law, 1 MRSA § 401, et seq.  Public records must be made available to any person upon request.  Information that you supply as part of this application (except your Social Security number, fingerprint cards, residential addresses of officers and applicants’ credit reports) is public information.  Other licensing records to which this information may later be transferred are also considered public records.  Where permitted by law, your name, license number, mailing address and other information listed on this application may be posted on the State’s website.  

Revised:09/29/2023