ࡱ> g GxbjbjVV 2r<r<r ddd$PlD8pZ( !Z"P DDDDDDD$GIx3Did0P ^ 003DD3535350RRd D350 D3535IAhB"Bb=}=1vACD0DADJ1DJ BBDJdB`",'835d*,"""3D3D4"""D0000DJ""""""""" :  STATE OF SOUTH CAROLINA DEPARTMENT OF CONSUMER AFFAIRS INITIAL CONSUMER CREDIT GRANTOR NOTIFICATION FORM S.C. Code Ann. 37-6-202 et seq. (Supp. 1997)  HYPERLINK "www.scconsumer.gov" www.scconsumer.gov 803-734-4253/800-922-1594 Note: THIS ORIGINAL FORM MUST ACCOMPANY A $120.00 FILING FEE PER LOCATION Company Name FORMTEXT       FORMTEXT       /  FORMTEXT      D/B/A FORMTEXT      Registration No./Federal ID No.Address FORMTEXT       City/State/Zip FORMTEXT      Telephone No.( FORMTEXT    )  FORMTEXT     -  FORMTEXT     E-Mail Address: FORMTEXT       FORMTEXT     -  FORMTEXT    -  FORMTEXT     Contact Person FORMTEXT      SSN (Sole Proprietor) TO AVOID PENALTY FILE BY JANUARY 31 OF EACH YEAR InstructionsIndividuals, partnerships, corporations and associations may be persons required to file and pay. Examples of consumer credit include installment payment plans, regular and revolving charge accounts, personal loans and leases of goods for more than four months. Persons who take assignments of and collect payments or enforce rights arising from such consumer debts are also required to file if they have an office in South Carolina. Direct credit sellers and lenders without a location in South Carolina must file one notification fee if the annual gross volume exceeds $150,000. Call (803) 734-4253 if you have questions concerning the filing requirements.  Filing And Status1.Will your annual gross volume of business exceed $150,000 in cash and credit combined? (Gross volume/sales is the amount reported to the Internal Revenue Service). Yes  FORMCHECKBOX  No  FORMCHECKBOX 2.Do you use written agreements to extend consumer credit in South Carolina? (Written agreements include but are not limited to installment contracts, promissory notes and written billing statements with credit terms for open accounts.) Yes  FORMCHECKBOX  No  FORMCHECKBOX 3.Do you engage solely in rental-purchase (rent-to-own) transactions in South Carolina? If you answered yes, you need to complete the Credit Grantor Notification for rent-to-own businesses only. Yes  FORMCHECKBOX  No  FORMCHECKBOX 4.If your answers to BOTH questions 1 and 2 are YES, enter the number of all South Carolina addresses at which consumer credit is made or assignment of same are accepted and attach a list of all addresses. If you have no South Carolina address enter 1 for number of locations.  FORMTEXT       5.All credit grantors who answered NO to either question 1 or 2 proceed to question 7. 6.Multiply the number of locations determined in question 4 by $120.00. YOUR FILING FEE IS: $  FORMTEXT      7.Do you charge an Annual Percentage Rate of more than 18%?Yes  FORMCHECKBOX  No  FORMCHECKBOX 8.Check the ways in which consumer transactions are made FORMCHECKBOX  Consumer Credit Sales  FORMCHECKBOX  Rent-to-Own FORMCHECKBOX  Consumer Leases  FORMCHECKBOX  Consumer Loans FORMCHECKBOX  Credit and Charge Cards  FORMCHECKBOX  Revolving Credit9.All creditors must list the name and address of their designated agent for service of process. (This is the person, either yourself or someone you designate, to receive any legal documents served on your business in the event of administrative or legal action.) ___________________________________________________________________________ FILING MUST BE RECEIVED BY JANUARY 31 OF EACH YEAR 10.If consumer credit transactions made in South Carolina are NOT made from a retail store or office in South Carolina, describe the manner in which such business is conducted. ___________________________________________________________________________11.If your consumer credit contracts are sold to a finance company, bank or other assignee, please attach a list of all businesses to whom you sold contracts. 12.If you accept assignment of (purchase) consumer credit or rental-purchase contracts from a credit grantor, attach a list of those businesses from whom you purchased contracts. 13.If you previously extended rental-purchase contracts but no longer do so, please check this box. Indicate the date you stopped extending consumer credit or rental-purchase contracts.  FORMCHECKBOX  ______________________ Remit to S.C. Department of Consumer Affairs Accounting Section Post Office Box 5246 Columbia, SC 29250-5246  Make checks payable to S.C. Department of Consumer Affairs _______________________________ Signature (Officer of Company) _______________________________ ________________________________ Date Name of Officer (Print) IF YOUR GROSS VOLUME OF BUSINESS EXCEEDS $150,000 AND YOU USE WRITTEN AGREEMENTS TO EXTEND CONSUMER CREDIT, YOU MUST FILE A GRANTOR NOTIFICATION FORM. 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Personal Identifying Information will be released only if required by law.      Initial Consumer Grantor Notification Revised 04/11 Page  PAGE 1 of 2 Consumer Grantor Notification - Initial Revised 10/06 Page  PAGE 2 of 2 Street Address 2221 Devine Street, Suite 200 Columbia, SC 29205-2418 Mailing Address P.O. 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