Form 107 - Registration Of Money Services Business Instructions (Page 2 of 3) in pdf

FinCEN Form 107

Registration of Money Services Business Instructions

Part III Owner or Controlling Person

entity. A post of fice box number should not be

The Enterprise Computing Center-Detroit (ECC-

used for an individual, unless no other address is

D) will send an acknowledgment of receipt to the

available. For an individual, also enter any apartment

General: Any person who owns or controls a

registrant listed in Part II within approximately 60

money services business is responsible for

number, suite number, or road or route number. If

days after the form is processed (See note below).

registering the MSB. Only one registration form is

a P.O. Box is used for an entity , enter the street

ECC-D can respond to general questions over the

required for any business in any registration period.

name, suite number, and road or route number.

phone at telephone (800) 800-2877.

If more than one person owns or controls the

If the address of the individual or entity in PART

General Instructions

business, they may enter into an agreement

III is in a foreign country, enter the city, province

or state, postal code and the name of the country .

designating one of them to register the business.

Complete any part of the address that is known,

The designated owner or controlling person must

NOTE: All items on FinCEN Form 107 should be

even if the entire address is not known. If the

complete Part III and provide the requested

completed fully and accurately. Items marked

information. In addition, that person must sign and

with an asterisk (*) must be completed for the

address is in the United States leave country code

date the form as indicated in Part VII. Failure by

blank.

registration to be accepted, processed, and

the designated person to register the business does

recorded. Acknowledgment letters will not be

Specific Instructions

not relieve any other person who owns or controls

provided if these items are not complete.

the business of the liability for failure to register

Part I Filing Information

the business.

1. This form is available on the Financial Crimes

An “Owner or Controlling Person” includes the

See “When to Register” in the General Information

Enforcement Network’s web site for MSBs at

part of these instructions.

following:

, or FinCEN’ s web site at

, or by calling the IRS Forms

Registrant Business

Owner or

Item 1-- Check either box a, b, or d (only one) for

Distribution Center at (800) 829-3676.

Controlling Person

Sole Proprietorship................. the individual who

the type of filing. If this report correct s an earlier

owns the business

filing, check box “c” and either box a, b, or d.

2. Unless there is a specific instruction to the

Partnership..............................a general partner

contrary, leave blank any items that do not apply or

Trust........................................ a trustee

Item 2-- If you checked box 1d, please indicate

for which information is not available.

Corporation.............................the largest single

the reason by checking boxes a, b, or c (check all

that apply).

shareholder

3. Complete the form by providing as much

If two or more persons own equal numbers of

information as possible.

Part II Registrant Information

shares of a corporation, those persons may enter

into an agreement as explained above that one of

4. Do not include supporting documents with this

Enter the US State or Territory operating location.

those persons may register the business.

form.

If the owner or controlling person is a corporation, a

Item *3--Legal name of the money services

duly authorized officer of the owner-corporation may

business. Enter the full legal name of the registrant

5. Type or complete the form using block written

execute the form on behalf of the owner-corporation.

money services business as it is shown on the charter

letters.

or other document creating the entity . For example,

Item 12--Individual’s last name, or organization’s

enter Good Hope Enterprises, Inc. when the money

6. Enter all dates in MM / DD / YYYY format

services business is Good Hope Enterprises, Inc. If a

name. If the registrant is a publicly held corporation,

where MM= month, DD= day , and YYYY= year.

sole proprietorship, enter the business name of

it is sufficient to write “public corporation” in item

Precede any single number with a zero, i.e., 01,02,

the proprietorship.

12. Where registrant is a public corporation, a

etc.

duly authorized officer of the registrant must

execute the form in Part VII.

Item 4-- Doing business as. If applicable, enter the

7. List all U.S. telephone numbers with area code

separate doing business as name of the registrant. For

first and then the seven-digit phone number

Items 13 to 22--Enter the applicable information

example, if Good Hope Enterprises, Inc., i s doing

using the format (XXX) XXX-XXXX.

for the owner or controlling person. Their home

business as “Joe’s Check Cashing” enter in item 4,

address and phone number should not be used,

Joe’s Check Cashing.

8. Always enter an individual’s name as last name,

unless a business address and phone number are

first name, and middle initial (if known). If a legal

Items *5, *6, *7 and 8-- Address.

Enter the

unavailable.

entity is listed, enter its name in the last name

field.

permanent United States address of the registrant’s

Item 23-- Identification information.

If you

US operations that is being registered.

completed item 22, you may omit this item. If you

9. Enter identifying numbers starting from left to

did not complete item 22, enter separately the

Item *9-- EIN (entity), SSN/ITIN (individual). If

right. Do not include spaces, dashes, or other

form of identification, the ID number , and the

the registrant is an entity enter its employer

punctuation. Identifying numbers include social

issuing state or country . Do not provide “other”

identification number (EIN). If the registrant is an

security number (SSN), employer identification

identification unless no driver’s license/state ID,

individual and a U. S. Citizen or an alien with a

number (EIN), individual taxpayer identification

social security number, enter his/her SSN. If the

passport or alien registration number is available.

number (ITIN), alien registration number , driver’s

registrant is an individual who is an alien and has

“Other” identification includes any unexpired official

license/state identification, foreign national

an individual taxpayer identification number, enter

identification that is issued by a government al authority.

identification, and passport number.

If you check item 23z, give a brief description of

his/her ITIN.

the “other” identification.

10. Enter all Post Office ZIP Codes from left to

Item 10-- T elephone number. Enter the telephone

right with at least the first five numbers, or with all

Part IV Money Services and Product

number of the MSB listed in item 3.

nine (ZIP + 4) if known.

Information

Item 11-- E-mail address (Optional). If the MSB

11. Addresses: Enter the US permanent street

Item 2 4--States and/or territories where the

has an e-mail address please enter it here. An e-

address, city , two-letter st ate or territory

mail address may be used to contact the MSB should

registrant, its agents or branches are located.

abbreviation used by the U.S. Postal Service and

Check box “a” for All States and Territories, “b”

ZIP Code (ZIP+4 if known) of the individual or

questions arise regarding their registration.

for All States, or “c” for All Territories (Check only

Form 107 - Registration Of Money Services Business Instructions Page 2

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