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annual report

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  1. Commonwealth of Massachusetts DIVISION OF BANKS 1000 Washington Street, 10th Floor Boston, MA 02118-6400 ANNUAL REPORT TO THE COMMISSIONER OF BANKS FOR THE YEAR END DECEMBER 31, 2009 Each entity licensed under Massachusetts General Laws, chapter 255B, chapter 255C, chapter 255D, and chapter 140, §§96-114A is required to file an Annual Report, accurately executed for the calendar year ended December 31st by April 15th of the following year. Massachusetts General Laws chapter 255B, §3, chapter 255C, §6, chapter 255D, §3 and chapter 140, §98 require licensees to file an Annual Report to the Commissioner of Banks before April 15th of each year. Any licensee neglecting to file an Annual Report or failing to amend such report within 15 days of notice, shall pay a fine of $50.00 per day for each day which such neglect or failure continues. Companies having licenses under Massachusetts General Laws chapter 255B, chapter 255C, chapter 255D, and chapter 140, §§96-114A only need to provide one Annual Report for all of their combined business activity under the four statutes. A licensee whose accounting period is not based on a calendar year must nevertheless prepare this report on the basis of its calendar year activity. The format consists of five schedules. SCHEDULE A FINANCIAL INFORMATION SCHEDULE B MASSACHUSETTS CONSUMER LOAN INFORMATION SCHEDULE C CREDIT INSURANCE INFORMATION SCHEDULE D REPOSSESSIONS AND CANCELLATION INFORMATION SCHEDULE E NOTARIZATION The Annual Report must be completed legibly typewritten or in ink. Reports submitted in pencil are not acceptable. Each schedule needs to be fully completed. Any item which is not applicable to the licensee should be properly noted and reasons provided. Where insufficient space is provided to set forth the facts adequately, please attach an addendum to the schedule giving the details. Also, please round off all monetary figures to the nearest dollar. The form can be downloaded from the Division’s website at http://www.mass.gov/dob The Annual Report must be submitted on or before April 15, 2010 to: Division of Banks Consumer Compliance Unit Attn: Deborah Doyle, Chief Director 1000 Washington Street, 10th Floor Boston, MA 02118-6400 Please Note: For all Annual Reports Filed after March 12th, the mail address will change to the following location: 1000 Washington Street, 10th floor, Boston, MA 02118-6400, the site of the Division’s new office.
  2. Commonwealth of Massachusetts ANNUAL REPORT TO THE COMMISSIONER OF BANKS FOR THE YEAR END DECEMBER 31, 2009 GENERAL INFORMATION: NAME OF LICENSEE: CHECK APPROPRIATE BOX OF THE TYPE OF LICENSE(S) HELD BY THE LICENSEE: MOTOR VEHICLE SALES FINANCE COMPANY (G.L. c. 255B) INSURANCE PREMIUM FINANCE COMPANY (G.L. c. 255C) RETAIL INSTALLMENT SALES FINANCE COMPANY (G.L. c. 255D) SMALL LOAN COMPANY (G.L. c. 140, §§96-114A) PROVIDE A LIST OF ALL LICENSE NUMBERS HELD UNDER EACH LICENSE TYPE: Provide the following information for the person responsible for the information contained in the annual report: NAME: ADDRESS: PHONE NUMBER FAX NUMBER OFFICE USE ONLY DATE REC._______________ FINE PAID:_______________ 5/4/10 1
  3. SCHEDULE A FINANCIAL INFORMATION Provide the following data, as of December 31, 2009, prepared in accordance with Generally Accepted Accounting Principles. Omit the following assets when computing the Adjusted Net Worth. A That portion of the licensee's assets pledged to secure obligations of any person or entity other than that of the licensee. B Any asset due from officers or stockholders of the licensee or persons in which the licensee's officers or stockholders have an interest. C An amount in excess of the lower of the cost of market value of mortgage loans in foreclosure, or real property acquired through foreclosure. D An investment shown on the balance sheet in joint ventures, subsidiaries, or affiliates, which is greater than the market value of the assets. E Goodwill or value placed on insurance renewals or other similar intangible value. F Organization costs. TOTAL ASSETS: $ NET WORTH: $ 1 ADJUSTED NET WORTH: $ 1, 2, 3 REVENUES: $ NET INCOME / LOSS: $ 1 1 Provide details on the financial condition of the licensee if it has (1) a negative stated Net Worth, (2) a negative Adjusted Net Worth, or (3) a Net Loss. Provide a separate addendum if necessary. 2 Please note that entities licensed as a motor vehicle sales finance company under G. L. c. 255B must maintain an Adjusted Net Worth of at least $20,000 as required by 209 CMR 20.00. 3 Please note that entities licensed as a small loan company under G. L. c. 140, §§96-114A must maintain an Adjusted Net Worth of at least $75,000 as required by 209 CMR 12.00. 5/4/10 2
  4. SCHEDULE B CONSUMER LOANS IN MASSACHUSETTS Provide the following information regarding the Licensee’s Massachusetts loans: MOTOR VEHICLES SALES FINANCE COMPANY (G.L. c. 255B) Number of loans as of 12/31/09: Dollar Amount $ Number of loans acquired during 2009: 1. By assignment Dollar Amount $ 2. By direct lending Dollar Amount $ 3. Other Dollar Amount $ Provide the range of interest rates on contracts: INSURANCE PREMIUM FINANCE COMPANY (G.L. c. 255C) Number of loans as of 12/31/09: Dollar Amount $ Number of loans acquired during 2009: 1. By assignment Dollar Amount $ 2. By direct lending Dollar Amount $ 3. Other Dollar Amount $ Provide the range of interest rates on contracts: RETAIL INSTALLMENT SALES FINANCE COMPANY (G.L. C. 255D) Number of loans as of 12/31/09: Dollar Amount $ Number of loans acquired during 2009: 1. By assignment Dollar Amount $ 2. By direct lending Dollar Amount $ 3. Other Dollar Amount $ Provide the range of interest rates on contracts: SMALL LOAN COMPANY (G.L. C. 140, §§96-114A) Number of loans as of 12/31/09: Dollar Amount $ Number of loans closed during 2009: 1. Small loans (unsecured) Dollar Amount $ 2. Small loans (secured) Dollar Amount $ 3. Other Dollar Amount $ Provide the range of interest rates on loans closed: FOR ALL LICENSEES Does the Licensee service contracts for another entity? Yes No If yes, please provide details of servicing, e.g. the number of Massachusetts contracts being serviced and for whom the contracts are being serviced as an addendum to this section. 5/4/10 3
  5. SCHEDULE C CREDIT INSURANCE ON MASSACHUSETTS CONTRACTS Provide information relative to credit insurance provided on Massachusetts contracts. Provide an addendum if necessary. MOTOR VEHICLE SALES FINANCE COMPANY (G.L. c. 255B) Types of Credit Insurance: Rates Claims paid during 2009: Number Dollar Amount Accident and Health Claims Death Claims Other (Please describe in addendum) INSURANCE PREMIUM FINANCE COMPANY (G.L. c. 255C) Types of Credit Insurance: Rates Claims paid during 2009: Number Dollar Amount Accident and Health Claims Death Claims Other (Please describe in addendum) 5/4/10 4
  6. SCHEDULE C (continued) CREDIT INSURANCE ON MASSACHUSETTS CONTRACTS RETAIL INSTALLMENT SALES FINANCE COMPANY (G.L. c. 255D) Types of Credit Insurance: Rates Claims paid during 2009: Number Dollar Amount Accident and Health Claims Death Claims Other (Please describe in addendum) SMALL LOAN COMPANY (G.L. C. 140, §§96-114A) Types of Credit Insurance: Rates Claims paid during 2009: Number Dollar Amount Accident and Health Claims Death Claims Other (Please describe in addendum) 5/4/10 5
  7. SCHEDULE D REPOSSESSIONS and CANCELLATIONS of MASSACHUSETTS CONTRACTS MOTOR VEHICLE SALES FINANCE COMPANY (G.L. c. 255B) Number of repossessions during 2009: Dollar Amount $ INSURANCE PREMIUM FINANCE COMPANY (G.L. C. 255C) Number of contracts cancelled during 2009: Dollar Amount $ RETAIL INSTALLMENT SALES FINANCE COMPANY (G.L. c. 255D) Number of repossessions during 2009: Dollar Amount $ SMALL LOAN COMPANY (G.L. C. 140, §§96-114A) Number of repossessions during 2009: Dollar Amount $ Provide comments if necessary. 5/4/10 6
  8. SCHEDULE E NOTARIZATION I, , the undersigned being (NAME) the of , Licensee, (TITLE) (NAME OF COMPANY) hereby state under the penalties of perjury, that the statements contained in this report, including the accompanying schedules and statements (if any) are true and complete in accordance with the law. SIGNED THIS DAY OF , 2010 (DATE) (MONTH) SIGNATURE ____________ 5/4/10 7

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