Form Fis 0508 - Debt Management Surety Bond For Licensee Page 2
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2FIS 0508 (05/15) Department of Insurance and Financial Services Page 2 of 2
Debt Management Surety Bond for Licensee
Bond Number: _____________________________
The Surety may at any time terminate its obligation hereunder by giving thirty (30) days written notice to said Principal and to the
Michigan Department of Insurance and Financial Services, P.O. Box 30220, Lansing, MI 48909-8201, in which even the liability of the
Surety shall at the expiration of the said thirty (30) days cease and terminate, except as to such liability of the Principal occurring prior to
the expiration of the said thirty (30) days. If the Surety provides 30 days notice of termination of the Bond, the Principal, if continuing in
.
the debt management business, shall furnish a satisfactory new bond before the expiration of the said thirty (30) day period
This bond becomes effective as of _____________________________________, _______, in support of the license(s) issued for
the term ending December 31, __________.
IN WITNESS WHEREOF, the parties hereto have hereunto set our hands and affixed our seals this ____________________day of
_____________________, ____________.
_________________________________________________ (Seal)
(Name of Firm)
By _______________________________________________________________
(Officer, Partner, Member, or Sole Proprietor)
__________________________________________________
(Seal)
By ________________________________________________________________
1975 PA 148 as amended requires submission of this form by applicants for a license to do business as a debt management company. Failure to
complete and submit this form properly could result in denial, suspension or revocation of your license.
When complete, please mail with Original Bond to:
DIFS -Consumer Finance
PO Box 30220
Lansing MI 48909-7720
Our delivery address is:
DIFS - Consumer Finance
530 W. Allegan Street, 7
Floor
th
Lansing MI 48933
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