ࡱ>       @ '"bjbjqq @/K((((???8?DBC QY(YYY]`obBDDDDDD$MRhn\]nnh((YY#|||nR(YYB|nB||6|YQ }ru$?ln|6 0C|#n #|((((#| Scjfp|-i!kScScSchh${ STATE OF SOUTH CAROLINA DEPARTMENT OF CONSUMER AFFAIRS INSTRUCTIONS FOR CERTIFICATE OF AUTHORITY TO DO BUSINESS AS A PAWNBROKER S.C. Code Ann. 40-39-10 et seq. (Supp. 2003)  HYPERLINK "http://www.state.sc.us/consumer" www.scconsumer.gov 803-734-4236/800-922-1594 INSTRUCTIONSA.Complete the TWO PAGE APPLICATION for a Certificate of Authority to do business as a Pawnbroker.B.Complete a SUPPLEMENTAL FORM A, OWNER/EMPLOYEE INFORMATION, for each employee. The term employee on this form means any person employed by the business in any capacity, full or part time, permanent or temporary, regardless of the nature of that employees work or duties. Owner means any individual, director or officer having any ownership interest, however slight, in the businessC.Complete a SUPPLEMENTAL FORM B, LIST (of) LOCATIONS, for each location in which your company will transact pawn business, or store records, or store pledged or purchased goods. The term Physical Address on this form means a clear description of the site on which the business or storage facility will be located, such as: Approx. 100 yards south of intersections of Highway 1 and Apex Lane. Your description should be sufficiently detailed to communicate to an average person how to find your location.D.Submit with each application a copy of your most recent FINANCIAL STATEMENT, dated not more than 120 days prior to the date of the application, certified by your signature or by an accountant licensed by this state.E.If you are applying as a corporation, submit a certified copy of a CERTIFICATE OF EXISTENCE dated not more than 180 days prior to the date of the application, issued by the Secretary of State. You must also submit a certified copy of your ARTICLES OF INCORPORATION and a completed SUPPLEMENTAL FORM C, CORPORATE INFORMATION. (Copies of articles of incorporation or certificates of existence may be obtained by contacting the South Carolina Secretary of States Office at (803)-734-2158.F.When the forms described in Items A through E above are completed as required, you must take them to the Law Enforcement Agency having jurisdiction over the location (s) identified on Supplemental Form(s) B. Every employee and owner must appear at the appropriate Law Enforcement Agency to be fingerprinted. A fee may be required for fingerprinting. This fee is SEPARATE FROM AND NOT INCLUDED IN THE APPLICATION FEE YOU WILL EVENTUALLY PAY THE DEPARTMENT OF CONSUMER AFFAIRS. THE FEE IS THE RESPONSIBILITY OF THE APPLICANT AND DUE TO THE LAW ENFORCEMENT AGENCY AT THE TIME OF FINGERPRINTING. A FINGERPRINT Certification FORM must be completed by law enforcement at the time of fingerprinting and submitted to the Department. Fingerprint cards are not accepted in lieu of Fingerprint verification forms.G.The Law Enforcement Officer may wish to retain a copy of the application materials for his records. When all owners and employees have been fingerprinted, have completed all forms and left copies with the Law Enforcement Agency, a background check will be performed on each person and, upon its completion and together with any appropriate recommendations, will be forwarded to the South Carolina Department of Consumer Affairs. ALL ORIGINAL MATERIALS MUST BE SUBMITTED BY YOU DIRECTLY TO THE DEPARTMENT OF CONSUMER AFFAIRS.H.On receipt of the materials described above the Administrator or his designee will review the application and attendant forms to determine whether issuance of a Certificate to that applicant would comply with the requirements and intent of the Law and be in the best interests of the consumer in South Carolina.I.The Administrator will then either:1.Deny issuance of a Certificate; or,2.Inform the applicant by mail that a Certificate of Authority will be issued upon the Departments receipt of:(a)An application fee of two hundred and seventy-five dollars for each location, payable by certified or cashiers check, AND(b)A separate bond or letter of credit in favor of the Department in the sum of five thousand dollars for each application.J.On receipt of the materials required under I.2, above, the Administrator or his designee will issue the Certificate of Authority to do Business as a Pawnbroker at the location(s) specified on the application. THE CERTIFICATE MUST BE RENEWED ANNUALLY AS IT EXPIRES JUNE 30 OF EACH YEAR.Remit applications to:South Carolina Department of Consumer Affairs P.O. Box 5757 Columbia, S.C. 29250-5757 STATE OF SOUTH CAROLINA DEPARTMENT OF CONSUMER AFFAIRS APPLICATION FOR CERTIFICATE OF AUTHORITY TO DO BUSINESS AS A PAWNBROKER S.C. Code Ann. 40-39-10 et seq. (Supp. 2003)  HYPERLINK "http://www.state.sc.us/consumer" www.scconsumer.gov 803-734-4236/800-922-1594 Note: ALL REQUESTED INFORMATION MUST BE COMPLETED OR YOUR APPLICATION WILL BE DENIED1.Name of business as displayed to publicYesNo2.Is this business incorporated? FORMCHECKBOX  FORMCHECKBOX If yes, complete Supplemental Form C3.Is this business owned buy a:Corporation FORMCHECKBOX  FORMCHECKBOX Name: FORMTEXT      Partnership FORMCHECKBOX  FORMCHECKBOX Name: FORMTEXT      Sole Proprietorship FORMCHECKBOX  FORMCHECKBOX Name: FORMTEXT      4.List all employees and owners.Each must complete a Supplemental Form A and a fingerprint verification form (enclosed) FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT      5.(a)Address of Business (Physical Location): FORMTEXT       FORMTEXT      (b)Mailing Address of Business: FORMTEXT       FORMTEXT      (c)Telephone Number of Business FORMTEXT      6.County in which business is located: FORMTEXT      Is it within any city limitsYes FORMCHECKBOX No FORMCHECKBOX If so, which city? FORMTEXT      7.List all Pawn business locations, including main, branches and storage facilities separately on a Supplemental Form A. (The Supplemental Form A may be duplicated)8.How long has this business been in existence? FORMTEXT      9.List any prior business locations. Give complete addresses, including county and name of business.  FORMTEXT       FORMTEXT       10.List any other personal names under which you have done business. FORMTEXT       FORMTEXT      11.Has the location for which you are seeking a Certificate of Authority been in business under any other name as a pawn shop? YesNo FORMCHECKBOX  FORMCHECKBOX 12.Give your full name, physical and mailing address, and telephone number FORMTEXT       FORMTEXT      13.What is your relationship to this business? FORMTEXT      14.Who is the agent for service of process for this business? Give full name, address (mailing address and physical location) and telephone number. (This is a person, either yourself or someone you designate to receive any legal  documents served on your business in the event of administrative or legal action).  FORMTEXT       FORMTEXT       FORMTEXT      I swear, affirm and certify that I have completed and/or reviewed all information required in this application and that all information contained herein and in all addending and supplemental forms is true and correct. I further certify that I understand that giving false information in this application or any addending or supplemental forms constitutes cause for denial or revocation of my application for Certificate of Authority and subject me to criminal prosecution for perjury, I acknowledge that I have a duty and agree to update and correct this information as it changes. SWORN AND SUBSCRIBED to before methis _____ day of _______________, 20_____Signature FORMTEXT      Print your name and relationship to businessNotary Public for South CarolinaMy Commission Expires: LOCATIONSSUPPLEMENTAL FORM BGive complete information for each location, including those for storage. Complete physical and mailing addresses, county and city and telephone number should be provided. This form must also be completed for your main location listed in application Question 5. Duplicate and complete this form for each additional location. Each form must be signed and notarized.Business: FORMTEXT      Owner(s): FORMTEXT       FORMTEXT      DBA: FORMTEXT       FORMTEXT      Physical Address: FORMTEXT       FORMTEXT      Employees: FORMTEXT       FORMTEXT      Mailing Address: FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT      Telephone: FORMTEXT       FORMTEXT       FORMTEXT      Contact Person: FORMTEXT       FORMTEXT      County: FORMTEXT       FORMTEXT       FORMTEXT      Within Limits Of What City: FORMTEXT      I swear, affirm and certify that I have completed and/or reviewed all information required in this application and that all information contained herein and in all addending and supplemental forms is true and correct. I further certify that I understand that giving false information in this application or any addending or supplemental forms constitutes cause for denial or revocation of my application for Certificate of Authority and subject me to criminal prosecution for perjury. I acknowledge that I have a duty and agree to update and correct this information as it changes. SWORN AND SUBSCRIBED to before methis _____ day of _______________, 20_____Signature FORMTEXT      Print your name and relationship to businessNotary Public for South CarolinaMy Commission Expires: OWNER/EMPLOYEE INFORMATIONSUPPLEMENTAL FORM AThe following information MUST be provided for EACH OWNER, DIRECTOR, PRINCIPAL OFFICER AND EMPLOYEE. You may make and use additional copies of this form as necessary, submitting a separate and completed form for EACH OWNER, DIRECTOR, PRINCIPAL OFFICER AND EMPLOYEE. Note: This includes all Directors and Officers noted in your Articles of Incorporation. FAILURE TO SUBMIT COMPLETED FORMS WILL RESULT IN YOUR APPLICATION BEING DENIED. Business Name: FORMTEXT      Branch Name: FORMTEXT      (If applicable)Name: FORMTEXT      Relationship to Business: FORMTEXT      Present Home Address: FORMTEXT       FORMTEXT       FORMTEXT    FORMTEXT       FORMTEXT      StreetCityStateZipCountyHow long at this address? FORMTEXT      Home telephone number: FORMTEXT      Work telephone number: FORMTEXT      Social Security Number FORMTEXT      Have you ever been convicted of a felony?Yes FORMCHECKBOX No FORMCHECKBOX If so, what felony, in what state, county and year? FORMTEXT      Date of Birth FORMTEXT      State & County of Birth FORMTEXT      Height FORMTEXT      Weight FORMTEXT       lbsHair Color FORMTEXT      Eye Color FORMTEXT      Complexion FORMTEXT      Race FORMTEXT      U.S. CitizenYes FORMCHECKBOX No FORMCHECKBOX SexM FORMCHECKBOX F FORMCHECKBOX Give any unusual or identifying marks, scars or characteristics: FORMTEXT      Drivers License # FORMTEXT      State  FORMTEXT   Expiration Date: FORMTEXT      Name and relationship of closest living relative:  FORMTEXT      His/her mailing address and telephone number: FORMTEXT      I swear, affirm and certify that I have completed and/or reviewed all information required in this application and that all information contained herein and in all addending and supplemental forms is true and correct. I further certify that I understand that giving false information in this application or any addending or supplemental forms constitutes cause for denial or revocation of my application for Certificate of Authority and subject me to criminal prosecution for perjury. I acknowledge that I have a duty and agree to update and correct this information as it changes. SWORN AND SUBSCRIBED to before methis _____ day of _______________, 20____Signature FORMTEXT      Print your name and relationship to businessNotary Public for South CarolinaMy Commission Expires: FINGERPRINT VERIFICATIONThis is to be completed by a Law Enforcement Officer of the policy agency having jurisdiction over the location. A separate fingerprint verification form must be completed and submitted for each owner, director, principal officer and employee. Fingerprint cards may not be submitted in lieu of this form. This form may be duplicated. Onday of,20,I(Law Enforcement Officer)took the fingerprints of(Applicant)ofand received a photocopy of the original application(Name of Business)for the Pawnbroker Certificate of Authority. I SWEAR that all information contained herein is true and correct. SWORN AND SUBSCRIBED to before methis _____ day of _______________, 20____Signature of Law Enforcement OfficerPrint Name of Law Enforcement OfficerNotary Public for South CarolinaMy Commission Expires:Law Enforcement AgencyMailing Address (include zip)Telephone Number CORPORATE INFORMATIONSUPPLEMENTAL FORM CThe following information must be provided for all incorporated businesses. Enclose a copy of your Certificate of Existence from the Secretary of State of South Carolina and your Articles of Incorporation. INCOMPLETE INFORMATION WILL RESULT IN DENIAL OF YOUR APPLICATION. 1.Name of Corporation: FORMTEXT      2.DBA (Doing Business As): FORMTEXT      3.Physical Address of Corporation: FORMTEXT       FORMTEXT      4.Mailing Address of Corporation: FORMTEXT       FORMTEXT      5.List of names of all officers and principals of the corporation: FORMTEXT       FORMTEXT       FORMTEXT      6.List the agent for service for the corporation. (This is a person, either yourself or someone you designate, to receive any  legal documents served on your business in the event of administrative or legal action.  FORMTEXT      7.Physical and mailing address of agent for service of process for the corporation, including Zip Code and county.  FORMTEXT       FORMTEXT      I swear, affirm and certify that I have completed and/or reviewed all information required in this application and that all information contained herein and all addending and supplemental forms is true and correct. I further certify that I understand that giving false information in this application or any addending or supplemental forms constitutes cause for denial or revocation of my application for Certificate of Authority and subject me to criminal prosecution for perjury. I acknowledge that I have a duty and agree to update and correct this information as it changes. SWORN AND SUBSCRIBED to before methis _____ day of _______________, 20____SignaturePrint your name and relationship to businessNotary Public for South CarolinaMy Commission Expires: Bond No.PAWNBROKERSPECIAL DEPOSIT BONDState of ,KNOW ALL MEN BY THESE PRESENTS. That the undersigned __________________ as principal of _______________ and the undersigned _______________ as surety, of _______________ are firmly held and bound unto the Administrator of the Department of Consumer Affairs of the State of South Carolina in full and just sum of five thousand dollars, to which payment we bind ourselves and our respective successors and assigns jointly and severally. Sealed with our seal and dated at __________ this ________ day of _______________ in the year of our Lord two thousand and ________________. WHEREAS, Section 40-39-50 of the Code of Laws of South Carolina, 1976 as amended, requires that a Pawnbroker deposit and thereafter continuously maintain a bond in the amount of five thousand dollars. The bond is to be executed by a surety company authorized by the laws of this State to transact business in South Carolina and must be for the use of the State, as well as any pledgers or customers that may have a cause of action against the Pawnbroker. AND WHEREAS, the undersigned principal _______________ aforesaid, desires to transact business within the State of South Carolina in accordance with the terms of its laws and to deposit with the Administrator a good and solvent bond in the sum of five thousand dollars, does by this instrument furnish that bond. NOW, THEREFORE, the condition of this bond is such that if the above principal has failed tocomply with the S.C. Pawnbroker Act, S.C. Code 40-39-10, et seq. (LAW CO-OP 1986, as amend.) or has failed to provide contracted for pawnbroker services to customers as determined by the Administrator after notice and opportunity for hearing, then we the Beneficiary (South Carolina Department of Consumer Affairs) are entitled to the sum of five thousand dollars. PROVIDED, HOWEVER, that liability hereunder may be terminated either (s) by written notice,from the surety to the Administrator, that liability shall terminate upon the expiration of forty-five (45) days from the date of such notice, or (b) upon written authorization mailed to the surety by the Administrator. IN WITNESS whereof the principal and surety have set their hand and affixed their seals in themanner and form following: In presence of witness as to principalName of PrincipalBy:(President/Officer)In presence of witness as to suretyName of SuretyBy:(President/Officer)EXECUTION BY PRINCIPAL AND SURETY MUST BE PROBATED ON REVERSE SIDEWITNESS AS TO PRINCIPALSTATE OF ,COUNTY.Before me, the subscribing Notary Public, personally appearedand madeWitness number one (see front of bond)oath that he/she saw the within namedCompany represented bysign, seal, and deliver the within Bond, and that he/she withsubscribed their names as witness thereto. Witness number two (see front of bond)To be signed by witness one or two (see front of bondSWORN AND SUBSCRIBED to before methis _____ day of _______________, 20____Notary Public for South CarolinaMy Commission Expires:WITNESS AS TO SURETYSTATE OF ,COUNTY.Before me, the subscribing Notary Public, personally appearedand madeWitness number one (see front of bond)oath that he/she saw the within namedCompany represented bysign, seal, and deliver the within Bond, and that he/she withsubscribed their names as witness thereto. Witness number two (see front of bond)To be signed by witness one or two (see front of bondSWORN AND SUBSCRIBED to before methis _____ day of _______________, 20____Notary Public for South CarolinaMy Commission Expires: PAWNBROKER SERVICES IRREVOCABLE DOCUMENTARY LETTER OF CREDIT LANGUAGE (Bank Name & Address on Bank Lettterhead) Applicant: (Applicant Name) (Applicant Address) Beneficiary: South Carolina Department of Consumer Affairs 3600 Forest Drive P.O. Box 5757 Columbia, SC 29250-5757 Letter of Credit No.: ______________________ Expiration Date: _________________________ Dear Sir: We hereby issue this documentary letter of credit in your favor which is available against beneficiarys draft at sight drawn on __________(bank name)__________, bearing the clause drawn under documentary letter of credit number _______________ accompanied by the following documents: 1) Beneficiarys signed statement addressed to the applicant, stating: __________(applicants name) __________ has failed to comply with the S.C. Pawnbroker Act, S.C. Code Section 40-39-10 et seq. or has failed to provide contracted for pawnbroker services to customers as determined by the Administrator after notice and opportunity for hearing. We are therefore entitled to the sum of $5,000.00 drawn under letter of credit _______________. Or 2) Beneficiarys signed statement addressed to the applicants stating that: __________(applicants name)__________ has not replaced this letter of credit number _______________ with another letter of credit or other evidence of financial responsibility acceptable to the Administrator within 45 days of the expiration date of the credit, and we are therefore entitled to the sum of $5,000.00 drawn under letter of credit number _______________. ______________________________ (Signature of authorized bank officer) (Title) SAMPLE PAWN TICKET INFORMATIONXYZ PAWN SHOPOriginal Loan NumberDevine Street(These are pre-printed sequential numbers)Columbia, SC 29250(803) 700-0000Date MadeTime MadeDate DuePawned FORMCHECKBOX Sold FORMCHECKBOX Pledgor/Seller:ANNUAL PERCENTAGE RATE. Cost of your credit as a yearly rate based on amount financedResidence of Pledgor/Seller:Drivers License:FINANCE CHARGE. The dollar amount the credit will cost you. SSN:Date of Birth:Sex:RaceAMOUNT FINANCED. The amount of cash advanced or credit extended to you. Hair:Eyes:Height:Weight:Residence Phone:TOTAL OF PAYMENTS. Amount required to redeem pawn on date due. PAYMENT SCHEDULE. Prepayment. If you pay off early you will not be entitled to a refund of part of the finance charge. 1@ ________ Pawnbroker SignatureLIST EACH ITEM SEPARATELY AND GIVE DETAILED DESCRIPTION OF MERCHANDISE, WHETHER PAWNED OR SOLD.Serial Number:Special Markings:Engravings:YesNoHas Serial Number been altered?  FORMCHECKBOX  FORMCHECKBOX Any evidence of third party ownership? FORMCHECKBOX  FORMCHECKBOX Any other identifiers or unusual characteristics? FORMCHECKBOX  FORMCHECKBOX I represent the above listed collateral as wholly owned and unencumbered and I acknowledge receipt of a true copy of this contractOn this date I request that the items on this ticket and ticket # _____ be split into _____ separate pawn transactions and I understand that this splitting will cost me _____ dollars in additional interest.Pledgor SignaturePledgor Signature(One of the following statements should appear on your ticket):This ticket is non-negotiable, non-transferableORPlease give article(s) pawned by me to bearer of this ticket. Signed ______________NOTE: You should refer to the remainder of this contract document (back of this page) for information about nonpayment and default. The pawnshop will retain a security interest in the following items by keeping possession of these until you make the shown payment.  In consideration of and to secure the amount identified as the Amount Financed, Customer hereby deposits with the issuer of this pawn ticket the described Pledged Goods listed on the reverse side, warranting absolute ownership, free and clear of any encumbrance or claim whatsoever. NO REFUND OF FINANCE CHARGE ON PREPAYMENT. Customer agrees the issuer hereof may, at issuers option, extend this agreement one or more times. In the event you do not redeem the pawned item(s) after thirty days, the pawnbroker may add interest at the rate allowed by the contract terms until the end of the forfeiture period. If any loan remains unpaid for a period of sixty days from the due date or any renewal or extension thereof, the title of the borrower or pledgor to the property pledged to secure the loan shall vest in the pawnbroker, without advertising, sale or accountability to the pledgor, if the pawn ticket or memorandum delivered to the borrower in accordance with Section 40-39-80, contains on the back thereof a notice to that effect, and if a printed or written notice of the impending forfeiture is mailed to the pledgor at the address given on the pawn ticket, at least ten days prior to the forfeiture date. This notice must contain a description of the article pledged, and the amount due thereon as of the date of the notice. No notice is required on loans of fifty dollars or less (S.C. Code Ann. 40-39-110). Pawnbrokers are regulated by the S.C. Department of Consumer Affairs. If you have a consumer complaint please call this toll free number 1-800-922-1594. Optional payment record (below) should be included on ticket if you do not use a separate ledger book with the same information. See Regulation 28-200C.(2). Total PaymentsDate PaidInterestPrincipalLost TicketNew Due DateI hereby acknowledge receipt of my pledge. PAWNBROKERS RATE SCHEDULE[Section 40-39-100; S.C. Code of Laws, 1976, as amended]CONSUMERS: All pawnbrokers operating in South Carolina are required by law to post a schedule showing the maximum rate of LOAN FINANCE CHARGES stated as dollars for each ten dollars for each thirty-day period that the pawnbroker intends to charge for various types of pawn transactions. The purpose of this requirement is to assist you in comparing the maximum rates that pawnbrokers charge, thereby furthering your understanding of the terms of pawn transactions and helping you to avoid the uninformed use of credit. 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