AzDFI: Download Required Reports/Forms

Download Required Reports/Forms

To print a blank report form, click on the appropriate report form below. Once the file has been downloaded, print the form. Send the completed form to us at

Licensing
Arizona Department of Financial Institutions
2910 N. 44th Street, Suite 310
Phoenix, AZ 85018

NOTE: For MONEY TRANSMITTERS only. DFI is upgrading their current licensing database. As part of this upgrade, DFI needs updated Authorized Delegate information. DFI requests that you please provide an Excel spreadsheet that contains the updated information. Please note that this request will be considered separate from your quarterly reports. You will need to continue to submit your quarterly reports electronically in a timely manner. Please click here for the instructions for submitting the Authorized Delegate information.

Required Reports

Note:

Reports	Forms
Collection Agency: Due 06/30 Annually	Escrow Rate Filing Form
Consumer Lender: Due 10/01 Annually	Arizona Statement of Citizenship and Alien Status for State Public Benefits
Debt Managerment: Due 08/15 Annually	Biographical Statement
Escrow Agent: Due Semi-annually	Collection Agency Bond
Money Transmitter: Due Quarterly	Collection Agency Financial Statement
Premium Finance Company: Due 02/01 Annually	Debt Management Bond
Trust Company: Due 03/31 Annually	Escrow Agent Bond
Consumer Lender Standard Rate of Charge Report	Escrow Agent Certification by Licensing Agency or Supervisory Board
Company Financial Statement	Escrow Agent Industry Experience Questionnaire
	Mortgage Surety Bond
	Money Transmitter Bond
	Money Transmitter Certification by Licensing Agency or Supervisory Board
	Money Transmitter Identification Statement
	Personal Financial Statement

06.17.2007