correctxxx

RegistrationofMoneyServicesBusinessFinCENForm107March2011PreviouseditionswillnotbeacceptedafterSeptember30,2011.
Pleasetypeorprint.
Alwayscompleteentirereport.
22SSN/ITIN(individual),EIN(entity)16City17State18ZIPCode/PostalCode12Individual'slastname,ororganization'sname13Firstname14Middleinitial15Address19Country(ifotherthanUS)21DateofbirthPartIFilingInformationPartIIIOwnerorControllingPerson20Telephonenumber-(includeareacode)PartIVMoneyServicesandProductInformation24Statesand/orterritorieswheretheregistrant,itsagentsorbranchesarelocated.
Checkboxa,b,orcasappropriate(Checkonlyone)anddonotcheckindividualstate/territoryboxes.
Ifboxa,b,orcdoesnotapply,checkasmanystate/territoryboxesasnecessary.
Alabama(AL)Alaska(AK)AmericanSomoa(AS)Arizona(AZ)Arkansas(AR)California(CA)Colorado(CO)Connecticut(CT)Delaware(DE)DistrictofColumbia(DC)FSofMicronesia(FM)Florida(FL)Georgia(GA)Guam(GU)Hawaii(HI)Idaho(ID)Illinois(IL)Indiana(IN)Iowa(IA)Kansas(KS)Kentucky(KY)Louisiana(LA)Maine(ME)MarshallIslands(MH)Maryland(MD)Massachusetts(MA)Michigan(MI)Minnesota(MN)Mississippi(MS)Missouri(MO)Montana(MT)Nebraska(NE)Nevada(NV)NewHampshire(NH)NewJersey(NJ)NewMexico(NM)NewYork(NY)NorthCarolina(NC)NorthDakota(ND)N.
MarianaIsls.
(MP)Ohio(OH)Oklahoma(OK)Oregon(OR)Palau(PW)Pennsylvania(PA)PuertoRico(PR)RhodeIsland(RI)SouthCarolina(SC)SouthDakota(SD)Tennessee(TN)Texas(TX)Utah(UT)Vermont(VT)VirginIslands(VI)Virginia(VA)Washington(WA)WestVirginia(WVWisconsin(WI)Wyoming(WY)1Indicatethetypeoffilingbycheckinga,b,ordbelow(Checkonlyone).
Iffilingacorrection,check"c"andeithera,b,ord.
aInitialregistrationbRenewalcCorrectingapriorfilingdRe-registration2Ifyoucheckeditem1dpleaseindicatethereason(s).
Checkallthatapply.
aRe-registeredunderstatelawbMorethan10percenttransferofequityinterestcMorethan50percentincreaseinagentsaDriver'slicense/stateIDbPassportcAlienregistrationzOthereIDnumberfIssuingstateorcountry23Skipthisitemifyoucompleteditem22.
Iftheownerorcontrollingpersonisanindividualentertheirformofidentification,theIDnumber,andtheissuingstateorcountry.
MMDDYYYY___________________________________________________*3Legalnameofthemoneyservicesbusiness4Doingbusinessas*5Address10Telephonenumber(includeareacode)*6City*9EIN(entity),SSN/ITIN(individual)PartIIRegistrantInformationCompleteandsendto:EnterpriseComputingCenter-Detroit,Attn:MoneyServicesBusinessRegistration,P.
O.
Box33116,Detroit,MI48232-0116CatalogNumber39578NRev.
3/11OMBNo.
1506-0013Seeinstructionsforitemsmarkedwithanasterisk(*).
*7State8ZIPCode___11E-mailaddress(Ifavailable)aAllStates&TerritoriesbAllStatescAllTerritories___________________________________________________()________________________()___________________________PartIV(continued)226Moneyservicesbusinessactivitiesoftheregistrant.
Checkasmanyasapply.
Seeinstructionsforanexplanationoftheterms"issuer","seller","redeemer","checkcasher",and"moneytransmitter".
aIssueroftraveler'schecksbSelleroftraveler'scheckscRedeemeroftraveler'schecksdIssuerofmoneyorderseSellerofmoneyordersfRedeemerofmoneyordershCheckcashergCurrencydealerorexchangeriMoneytransmitter30Iftheregistranthasmorethanonetransactionaccountformoneyservicesbusinessactivitiescheckhere.
Seeinstructionsforanexplanationoftheterm"transactionaccount".
Theregistrant'sprimarytransactionaccountistheonethathasthegreatestannualdollaramountofmoneyservicesbusinessactivity.
Initems31through36enterinformationabouttheregistrant'sprimarytransactionaccountformoneyservicesbusinessactivities.
PartVPrimaryTransactionAccountforMSBActivitiesIfthesupportingdocumentationiskeptattheU.
S.
locationreportedinPartIIcheckhereandcontinuetoPartVII.
34State35ZIPCode31Nameoffinancialinstitutionwheretheprimarytransactionaccountisheld32Address33City36PrimarytransactionaccountnumberPartVILocationofSupportingDocumentation_______________________________________________________________IamauthorizedtofilethisformonbehalfofthemoneyservicesbusinesslistedinPartII.
Ideclarethattheinformationprovidedistrue,correctandcomplete.
IunderstandthatthemoneyservicesbusinesslistedinPartIIissubjecttotheBankSecrecyActanditsimplementingregulations.
See31CFRPartChapterX.
ThemoneyservicesbusinesslistedinPartIImaintainsacurrentlistofallagents,anestimateofitsbusinessvolumeinthecomingyear,andallotherinformationrequiredtocomplywith31U.
S.
C.
5330andtheregulationsthereunder.
Thesignatureoftheowner,controllingpersonorauthorizedcorporateofficerismandatory.
38City39State40ZIPCode37AddressPartVIIAuthorizedSignature___28Isanypartoftheregistrant'smoneyservicesbusinessconductedasamobileoperation27Isanypartoftheregistrant'smoneyservicesbusinessaninformalvaluetransfersystemSeetheexplanationof"moneytransmitter"intheinstructions.
aYesbNoaYesbNodMoneyorderredemption29Enterthenumberofagentsauthorizedtoconducteachmoneyservicesbusinessactivity.
Donotincludebranches,orpersonswhoaresolelyemployees.
Seeinstructionsforanexplanationoftheterm"agent".
______________________________aTraveler'schecksalesbTraveler'scheckredemptioncMoneyordersaleseCurrencyexchangeordealerfCheckcashinggMoneytransmission____________________________________________________________41Signature42Printname43Title44DateofsignatureMMDDYYYY25Enterthenumberofbranchesoftheregistrant.
Reminder:donotseparatelyregistereachbranch.
Seeinstructionsforanexplanationoftheterm"branch".
____________________________________________________________________________________GeneralInformationWhoMustRegisterGenerallyeachmoneyservicesbusinessmustregisterwiththeDepartmentoftheTreasury.
Thisformmustbeusedbyamoneyservicesbusiness(alsoreferredtoasanMSB)toregister.
However,notallMSBsarerequiredtoregister.
Forexample,ifyouareanMSBsolelybecauseyouareanagentofanotherMSB,youarenotrequiredtoregister.
ThediscussionbelowwillhelpyoudeterminewhetherornotyouareanMSBthatisrequiredtoregister.
Formoreinformationvisitwww.
msb.
gov.
Thetermmoneyservicesbusinessincludes:1.
Currencydealersorexchangerswhoexchangemorethan$1,000foranyonecustomeronanyday.
2.
Checkcasherswhocashcheckstotalingmorethan$1,000foranyonecustomeronanyday.
3.
Issuersoftraveler'schecks,moneyordersorstoredvaluewhoissuemorethan$1,000intraveler'schecks,moneyordersorstoredvalueforanyonecustomeronanyday.
4.
Sellersoftraveler'schecks,moneyordersorstoredvaluewhosellmorethan$1,000intraveler'schecks,moneyordersorstoredvalueforanyonecustomeronanyday.
5.
Redeemersoftraveler'schecks,moneyordersorstoredvaluewhoredeemmorethan$1,000intraveler'schecks,moneyordersorstoredvalueforanyonecustomeronanyday.
6.
Moneytransmitters.
7.
U.
S.
PostalService.
Thefollowingarenotrequiredtoregister:1.
AbusinessthatisanMSBsolelybecauseitservesasanagentofanotherMSB.
Forexample,asupermarketcorporationthatsellsmoneyordersforanissuerofmoneyordersisnotrequiredtoregister.
ThisistrueevenifthesupermarketcorporationservesasanagentfortwoormoreMSBs.
However,anMSBthatservesasanagentofanotherMSBandengagesinMSBactivitiesonitsownbehalfmustregister.
Forexample,asupermarketcorporationmustregisterif,inadditiontoactingasanagentofthemoneyorderissuer,itprovidescheckcashingorcurrencyexchangeservicesonitsownbehalfinanamountgreaterthan$1,000foranyonepersononanyday.
2.
TheUnitedStatesPostalService,anyagencyoftheUnitedStates,ofanystate,orofanypoliticalsubdivisionofanystate.
3.
Atthistime,personsarenotrequiredtoregistertotheextentthattheyissue,sellorredeemstoredvalue.
If,however,amoneyservicesbusinessprovidesmoneyservicesinadditiontostoredvalue,theprovisionofstoredvalueservicesdoesnotrelieveitoftheresponsibilitytoregister,ifrequired,asaproviderofthoseotherservices.
Fortheregulatorydefinitionof"moneyservicesbusiness"see31CFR1010.
100(t)and(ff).
Thefollowingtermsareusedintheformandinstructionstodescribeamoneyservicesbusiness:1.
An"agent"isaseparatebusinessentityfromtheissuerthattheissuerauthorizes,throughwrittenagreementorotherwise,tosellitsinstrumentsor,inthecaseoffundstransmission,tosellitssendandreceivetransferservices.
ApersonwhoissolelyanemployeeoftheMSBisnotanagentofthatMSB.
2.
A"branch"isanownedlocationofeitheranissueroragentatwhichfinancialservicesaresold.
AnMSBshouldnotseparatelyregistereachofitsbranches.
AmobileoperationownedbyanMSBisabranchofthatMSB.
TheMSB'sheadquartersisnotabranch.
IftheMSBhasonlyonelocation,thatlocationisnotabranch.
3.
A"checkcasher"isapersonengagedinthebusinessofprovidingcashtopersonsinreturnforacheck.
4.
A"currencydealerorexchanger"isapersonwhoengagesinthephysicalexchangeofcurrencyforretailcustomers.
5.
"Informalvaluetransfersystem".
Seeexplanationofthetermmoneytransmitter.
6.
An"issuer"isthebusinessthatisultimatelyresponsibleforpaymentofmoneyordersortravelerschecksasthedrawerofsuchinstruments,oramoneytransmitterthathastheobligationtoguaranteepaymentofamoneytransfer.
7.
A"moneytransmitter"isapersonthatengagesasabusinessinthetransferoffundsthroughafinancialinstitution.
Generally,acceptanceandtransmissionoffundsasanintegralpartoftheexecutionandsettlementofatransactionotherthanthefundstransmissionitself(forexample,inconnectionwiththebonafidesaleofsecurities)willnotcauseapersontobeamoneytransmitter.
An"informalvaluetransfersystem"isakindofmoneytransmitter.
Aninformalvaluetransfersystemincludesanypersonwhoengagesasabusinessinaninformalmoneytransfersystemoranynetworkofpeoplewhoengageasabusinessinfacilitatingthetransferofmoneydomesticallyorinternationallyoutsideoftheconventionalfinancialinstitutionssystem.
8.
A"person"isanindividual,acorporation,apartnership,atrustorestate,ajointstockcompany,anassociation,asyndicate,jointventure,orotherunincorporatedorganizationorgroup,anIndianTribe(asthattermisdefinedintheIndianGamingRegulatoryAct),andallentitiescognizableaslegalpersonalities.
FinCENForm107aRegistrationofMoneyServicesBusinessInstructions19.
A"redeemer"isabusinessthatacceptsinstrumentsinexchangeforcurrencyorotherinstrumentsforwhichitisnottheissuer.
Youarenotaredeemerifyoutaketheinstrumentsinexchangeforgoodsorgeneralservices,providedthattheamountofcashreturnedisnotmorethan$1,000foranyonecustomeronanyday.
10.
A"seller"isabusinessthatissuersauthorize,throughwrittenagreementorotherwise,toselltheirinstrumentsortheirsendandreceivetransferservices.
11.
A"transactionaccount"isadepositoraccountonwhichthedepositororaccountholderispermittedtomakewithdrawalsbynegotiableortransferableinstrument,paymentordersofwithdrawal,telephonetransfers,orothersimilaritemsforthepurposeofmakingpaymentsortransferstothirdpersonsorothers.
Suchtermsincludedemanddeposits,negotiableorderofwithdrawalaccounts,savingsdepositsubjecttoautomatictransfers,andsharedraftaccounts.
See12USC461(b)(1)(c).
WhentoRegisterInitialregistration:Filetheformwithin180daysafterthedatethebusinessisestablished.
Renewal:EachMSBmustrenewitsregistrationeverytwoyears,onorbeforeDecember31.
See31CFR1022.
380(b)(2).
Forexample,ifanMSBregisteredonOctober15,2003,itmustfilearenewalbyDecember31,2004,andthenevery24monthsthereafter(onorbeforeDecember31,2006,thenDecember31,2008,etc.
).
RenewalsmustbesubmittedonanewForm107.
PhotocopiesofpreviouslysubmittedformsorfacsimileswillnotbeacceptedforrenewalpurposesCorrection:Usetheformtocorrectapriorreport.
CompletePartIinitsentiretyandonlythoseotherentriesthatarebeingaddedorchanged.
Stapleacopyofthepriorreport(ortheacknowledgmentfromECC-Difreceived)tothecorrectedreport.
Re-registration:Refileanewregistrationformwhenoneofthefollowingeventsoccurs:1.
achangeinownershiprequiringre-registrationunderstateregistrationlaw;2.
morethan10percentofvotingpowerorequityinterestistransferred(exceptcertainpublicly-tradedcompanies)or;3.
thenumberofagentsincreasesbymorethan50percent.
WheretoRegisterSendyourcompletedformto:EnterpriseComputingCenter-DetroitAttn:MoneyServicesBusinessRegistrationP.
O.
Box33116Detroit,MI48232-0116Rev.
7/10TheEnterpriseComputingCenter-Detroit(ECC-D)willsendanacknowledgmentofreceipttotheregistrantlistedinPartIIwithinapproximately60daysaftertheformisprocessed(Seenotebelow).
ECC-Dcanrespondtogeneralquestionsoverthephoneattelephone(800)800-2877.
GeneralInstructionsNOTE:AllitemsonFinCENForm107shouldbecompletedfullyandaccurately.
Itemsmarkedwithanasterisk(*)mustbecompletedfortheregistrationtobeaccepted,processed,andrecorded.
Acknowledgmentletterswillnotbeprovidediftheseitemsarenotcomplete.
1.
ThisformisavailableontheFinancialCrimesEnforcementNetwork'swebsiteforMSBsatwww.
msb.
gov,orFinCEN'swebsiteatwww.
fincen.
gov,orbycallingtheIRSFormsDistributionCenterat(800)829-3676.
2.
Unlessthereisaspecificinstructiontothecontrary,leaveblankanyitemsthatdonotapplyorforwhichinformationisnotavailable.
3.
Completetheformbyprovidingasmuchinformationaspossible.
4.
Donotincludesupportingdocumentswiththisform.
5.
Typeorcompletetheformusingblockwrittenletters.
6.
EnteralldatesinMM/DD/YYYYformatwhereMM=month,DD=day,andYYYY=year.
Precedeanysinglenumberwithazero,i.
e.
,01,02,etc.
7.
ListallU.
S.
telephonenumberswithareacodefirstandthentheseven-digitphonenumber,usingtheformat(XXX)XXX-XXXX.
8.
Alwaysenteranindividual'snameaslastname,firstname,andmiddleinitial(ifknown).
Ifalegalentityislisted,enteritsnameinthelastnamefield.
9.
Enteridentifyingnumbersstartingfromlefttoright.
Donotincludespaces,dashes,orotherpunctuation.
Identifyingnumbersincludesocialsecuritynumber(SSN),employeridentificationnumber(EIN),individualtaxpayeridentificationnumber(ITIN),alienregistrationnumber,driver'slicense/stateidentification,foreignnationalidentification,andpassportnumber.
10.
EnterallPostOfficeZIPCodesfromlefttorightwithatleastthefirstfivenumbers,orwithallnine(ZIP+4)ifknown.
11.
Addresses:EntertheUSpermanentstreetaddress,city,two-letterstateorterritoryabbreviationusedbytheU.
S.
PostalServiceandZIPCode(ZIP+4ifknown)oftheindividualorentity.
Apostofficeboxnumbershouldnotbeusedforanindividual,unlessnootheraddressisavailable.
Foranindividual,alsoenteranyapartmentnumber,suitenumber,orroadorroutenumber.
IfaP.
O.
Boxisusedforanentity,enterthestreetname,suitenumber,androadorroutenumber.
IftheaddressoftheindividualorentityinPARTIIIisinaforeigncountry,enterthecity,provinceorstate,postalcodeandthenameofthecountry.
Completeanypartoftheaddressthatisknown,eveniftheentireaddressisnotknown.
IftheaddressisintheUnitedStatesleavecountrycodeblank.
SpecificInstructionsPartIFilingInformationSee"WhentoRegister"intheGeneralInformationpartoftheseinstructions.
Item1--Checkeitherboxa,b,ord(onlyone)forthetypeoffiling.
Ifthisreportcorrectsanearlierfiling,checkbox"c"andeitherboxa,b,ord.
Item2--Ifyoucheckedbox1d,pleaseindicatethereasonbycheckingboxesa,b,orc(checkallthatapply).
PartIIRegistrantInformationEntertheUSStateorTerritoryoperatinglocation.
Item*3--Legalnameofthemoneyservicesbusiness.
Enterthefulllegalnameoftheregistrantmoneyservicesbusinessasitisshownonthecharterorotherdocumentcreatingtheentity.
Forexample,enterGoodHopeEnterprises,Inc.
whenthemoneyservicesbusinessisGoodHopeEnterprises,Inc.
Ifasoleproprietorship,enterthebusinessnameoftheproprietorship.
Item4--Doingbusinessas.
Ifapplicable,entertheseparatedoingbusinessasnameoftheregistrant.
Forexample,ifGoodHopeEnterprises,Inc.
,isdoingbusinessas"Joe'sCheckCashing"enterinitem4,Joe'sCheckCashing.
Items*5,*6,*7and8--Address.
EnterthepermanentUnitedStatesaddressoftheregistrant'sUSoperationsthatisbeingregistered.
Item*9--EIN(entity),SSN/ITIN(individual).
Iftheregistrantisanentityenteritsemployeridentificationnumber(EIN).
IftheregistrantisanindividualandaU.
S.
Citizenoranalienwithasocialsecuritynumber,enterhis/herSSN.
Iftheregistrantisanindividualwhoisanalienandhasanindividualtaxpayeridentificationnumber,enterhis/herITIN.
Item10--Telephonenumber.
EnterthetelephonenumberoftheMSBlistedinitem3.
Item11--E-mailaddress(Optional).
IftheMSBhasane-mailaddresspleaseenterithere.
Ane-mailaddressmaybeusedtocontacttheMSBshouldquestionsariseregardingtheirregistration.
FinCENForm107RegistrationofMoneyServicesBusinessInstructions2PartIIIOwnerorControllingPersonGeneral:AnypersonwhoownsorcontrolsamoneyservicesbusinessisresponsibleforregisteringtheMSB.
Onlyoneregistrationformisrequiredforanybusinessinanyregistrationperiod.
Ifmorethanonepersonownsorcontrolsthebusiness,theymayenterintoanagreementdesignatingoneofthemtoregisterthebusiness.
ThedesignatedownerorcontrollingpersonmustcompletePartIIIandprovidetherequestedinformation.
Inaddition,thatpersonmustsignanddatetheformasindicatedinPartVII.
Failurebythedesignatedpersontoregisterthebusinessdoesnotrelieveanyotherpersonwhoownsorcontrolsthebusinessoftheliabilityforfailuretoregisterthebusiness.
An"OwnerorControllingPerson"includesthefollowing:RegistrantBusinessOwnerorControllingPersonSoleProprietorship.
theindividualwhoownsthebusinessPartnership.
ageneralpartnerTrust.
atrusteeCorporation.
thelargestsingleshareholderIftwoormorepersonsownequalnumbersofsharesofacorporation,thosepersonsmayenterintoanagreementasexplainedabovethatoneofthosepersonsmayregisterthebusiness.
Iftheownerorcontrollingpersonisacorporation,adulyauthorizedofficeroftheowner-corporationmayexecutetheformonbehalfoftheowner-corporation.
Item12--Individual'slastname,ororganization'sname.
Iftheregistrantisapubliclyheldcorporation,itissufficienttowrite"publiccorporation"initem12.
Whereregistrantisapubliccorporation,adulyauthorizedofficeroftheregistrantmustexecutetheforminPartVII.
Items13to22--Entertheapplicableinformationfortheownerorcontrollingperson.
Theirhomeaddressandphonenumbershouldnotbeused,unlessabusinessaddressandphonenumberareunavailable.
Item23--Identificationinformation.
Ifyoucompleteditem22,youmayomitthisitem.
Ifyoudidnotcompleteitem22,enterseparatelytheformofidentification,theIDnumber,andtheissuingstateorcountry.
Donotprovide"other"identificationunlessnodriver'slicense/stateID,passportoralienregistrationnumberisavailable.
"Other"identificationincludesanyunexpiredofficialidentificationthatisissuedbyagovernmentalauthority.
Ifyoucheckitem23z,giveabriefdescriptionofthe"other"identification.
PartIVMoneyServicesandProductInformationItem24--Statesand/orterritorieswheretheregistrant,itsagentsorbranchesarelocated.
Checkbox"a"forAllStatesandTerritories,"b"forAllStates,or"c"forAllTerritories(Checkonlyone)asappropriate,anddonotcheckanyindividualstateorterritoryboxes.
Ifboxa,b,orcdoesnotapply,checkasmanystateorterritoryboxesasnecessary.
Ifaserviceisofferedontriballands,marktheboxforthestate,territoryordistrictinwhichthetriballandsarelocated.
Item25--Enterthenumberofbranchesoftheregistrant.
EnterthenumberofbranchesofthemoneyservicesbusinessatwhichoneormoreMSBactivitiesareoffered.
Iftherearenobranches,enterzero.
SeetheGeneralInformationforanexplanationoftheterm"branch".
Item26--MSBactivitiesoftheregistrant.
Items25athrough25iareMSBactivities.
ChecktheboxofeachMSBactivityconductedbytheregistrantatitsbranches.
SeetheGeneralInformationforanexplanationoftheterms"issuer","seller","redeemer","checkcasher",and"moneytransmitter".
Item27--Informalvaluetransfersystem.
Ifanypartoftheregistrant'smoneyservicesbusinessisaninformalvaluetransfersystem,checkyes.
Aninformalvaluetransfersystemisakindofmoneytransmitter.
SeetheGeneralInformationexplanationoftheterm"moneytransmitter".
Item28--Mobileoperation.
Ifanypartoftheregistrant'smoneyservicesbusinessisconductedasamobileoperation,checkyes.
Amobileoperationisonebasedinavehicle.
Forexample,acheckcashingserviceofferedfromatruckisamobileoperation.
ForpurposesofItem25,eachmobileoperationshouldbecountedasaseparatebranch.
Item29--Numberofagents.
EnterthenumberofagentsthattheregistranthasauthorizedtosellordistributeitsMSBservices.
DonotcountbranchesoranypersonwhoissolelyanemployeeoftheMSB.
Abankisnotanagentforthispurpose.
SeetheGeneralInformationforanexplanationoftheterm"agent".
PartVPrimaryTransactionAccountforMSBActivitiesItem30--Checktheboxiftheregistranthasmorethanoneprimarytransactionaccountformoneyservicesbusinessactivities.
Example:Iftheregistrantisbothanissuerofmoneyordersandanissueroftraveler'schecksandtheregistranthasseparateclearingaccountsformoneyordersandtraveler'schecks,theboxshouldbechecked.
Item31--Nameofthefinancialinstitutionwheretheprimarytransactionaccountisheld.
Enterthenameofthebankorotherfinancialinstitutionwheretheregistranthasitsprimarytransactionaccount.
IfyouindicatedthattheregistranthasmorethanoneprimarytransactionaccountinItem30,enterinformationabouttheaccountwiththegreatestmoneyserviceactivitytransactionvolumeasmeasuredbyvalueindollars.
SeetheGeneralInformationforanexplanationoftheterm"transactionaccount".
FinCENForm107RegistrationofMoneyServicesBusinessInstructionsItems32to35--Enterthepermanentaddressforthefinancialinstitution.
Item36--Primarytransactionaccountnumber.
Entertheprimarytransactionaccountnumber.
PartVILocationofSupportingDocumentationGeneral:Theregistrantmustretainforfive(5)yearscertaininformationatalocationwithintheUnitedStates.
Thatinformationincludes:1.
Acopyoftheregistrationform.
2.
Annualestimateofthevolumeoftheregistrant'sbusinessinthecomingyear.
3.
Thefollowinginformationregardingownershiporcontrolofthebusiness:thenameandaddressofanyshareholderholdingmorethan5%oftheregistrant'sstock,anygeneralpartner,anytrustee,and/oranydirectororofficerofthebusiness.
4.
Anagentlist.
Iftheregistranthasagentsitmustprepareandmaintainalistofitsagents.
ThatagentlistmustbeupdatedannuallyandretainedbythebusinessatthelocationintheUnitedStatesreportedonthisregistrationforminPartIIorPartVI.
Theagentlistshouldnotbefiledwiththisregistrationform.
Theagentlistmustinclude:a.
Eachagent'sname,b.
Eachagent'saddress,c.
Eachagent'stelephonenumber,d.
Thetypeofservice(s)providedbyeachagentonbehalfoftheregistrant,e.
Alistingofthemonthsintheimmediatelypreceding12monthsinwhichthegrosstransactionamountofeachagentwithrespecttofinancialproducts/servicesissuedbytheregistrantexceeds$100,000,f.
Thenameandaddressofanydepositoryinstitutionatwhicheachagentmaintainsatransactionaccountforthemoneyservicesbusinessactivitiesconductedbytheagentonbehalfoftheregistrant,g.
Theyearinwhicheachagentfirstbecameanagentoftheregistrant,andh.
Thenumberofbranchesorsubagentsofeachagent.
Items37to40--IfthesupportingdocumentationisretainedatalocationotherthantheaddresslistedinPartII,enterthelocationinformationinitems37through40.
PartVIIAuthorizedSignatureItems41to44--TheownerorcontrollingpersonlistedinPartIIImustsignanddatetheformasindicatedinPartVII.
Iftheownerorcontrollingpersonisacorporation,adulyauthorizedofficerofthecorporationmustexecutetheformonbehalfofthecorporation.
Enterthedatethisdocumentwassigned.
Penaltiesforfailuretocomply:Anypersonwhofailstocomplywiththerequirementstoregister,keeprecords,and/ormaintainagentlistspursuantto31CFR1022.
380maybeliableforcivilpenaltiesofupto$5,000foreachviolation.
Failuretocomplyalsomaysubjectapersonto3criminalpenalties,whichmayincludeimprisonmentforuptofive(5)yearsandcriminalfines.
See18USC1960.
Note:Thisregistrationdoesnotsatisfyanystateorlocallicensingorregistrationrequirements.
PaperworkReductionActNotice.
Thepurposesofthisformaretoprovideaneffec-tiveandconsistentmeansformoneyservicesbusi-nessestoregisterwiththeFinancialCrimesEn-forcementNetwork,andtoassuremaintenanceofreportsorrecordswheresuchreportsorrecordshaveahighdegreeofusefulnessincriminal,tax,orregulatoryinvestigationsorproceedings.
Thisreportisrequiredbylaw,pursuanttoauthoritycontainedinPublicLaw103-305;31USC5330;5USC301;31CFRChapterX.
TheinformationcollectedmaybeprovidedtothoseofficersandemployeesofanyconstituentunitoftheDepart-mentoftheTreasurywhohaveaneedfortherecordsintheperformanceoftheirduties.
Therecordsmaybereferredtoanyotherdepart-mentoragencyoftheUnitedStates,toanyState,orTribalGovernment.
Publicreportingandre-cordkeepingburdenforthisinformationcollec-tionisestimatedtoaverage30minutesperre-sponse,andincludestimetogatherandmaintaindatafortherequiredreport,reviewtheinstruc-tions,andcompletetheinformationcollection.
Sendcommentsregardingthisburdenestimate,includingsuggestionsforreducingtheburden,totheOfficeofManagementandBudgetPaper-workReductionProject,Washington,DC20503andtothePaperworkReductionAct;DepartmentoftheTreasury,FinancialCrimesEnforcementNetwork,P.
O.
Box39,Vienna,VA22183-0039.
Theagencymaynotconductorsponsor,andanorganization(oraperson)isnotrequiredtore-spondto,acollectionofinformationunlessitdis-playsacurrentlyvalidOMBcontrolnumber.
PrivaryActNotice.
PursuanttotherequirementsofPublicLaw93-579(PrivacyActof1974),noticeisherebygiventhat,inaccordancewith5U.
S.
C.
552a(e),theau-thoritytocollectinformationonFinCENForm107isPublicLaw103-305;31USC5330;5USC301;31CFRChapterX.
TheDepartmentoftheTrea-surymayuseandsharetheinformationwithanyotherdepartmentoragencyoftheUnitedStates,toanyState,orTribalGovernment,orpartthereof,upontherequestoftheheadofsuchdepartmentoragency,orauthorizedStateorTribalGovern-mentofficialforuseinacriminal,tax,orregula-toryinvestigationorproceeding,andtoforeigngovernmentsinaccordancewithanagreement,oratreaty.
Disclosureofthisinformationismandatory.
Civilandcriminalpenalties,includingincertaincir-cumstancesafineofnotmorethan$5,000perdayandimprisonmentofnotmorethanfiveyears,areprovidedforfailuretofiletheform,supplyinformationrequestedbytheform,andforfilingafalseorfraudulentform.
Disclosureofthesocialsecuritynumberortaxpayeridentificationnumberismandatory.
Theauthoritytocollectis31CFRChapterX.
Thesocialsecuritynumber/taxpayeridentificationnumberwillbeusedasameanstoidentifytheindividualorentitywhofilesthere-port.