Notice Of Collections Manager Change Form - State Of Colorado - Department Of Law
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4R
L. C
C
H. C
ALPH
ARR
YNTHIA
OFFMAN
Attorney General
C
J
C
OLORADO
UDICIAL
ENTER
1300 Broadway, 6th Floor
M
J. S
NYDER
Chief Deputy Attorney General
Denver, Colorado 80203
Phone (720) 508-6020
L
J
EORA
OSEPH
Chief of Staff
STATE OF COLORADO
Consumer Protection Section
F
R. Y
REDERICK
ARGER
Consumer Credit Unit
DEPARTMENT OF LAW
Solicitor General
NOTICE OF COLLECTIONS MANAGER CHANGE FORM
Licensed collection agencies should use this form to report any changes to their Collections Manager. Per section 5-16-
122(3)(a), C.R.S. and Rule 1.01, Rules of the Administrator, a licensee shall notify the Administrator within thirty days
For the required qualifications a Collections Manager must meet, p lease refer to sections 5-16-
of such change.
119(1)(a) and 5-16-123(2), C.R.S.
COLLECTION AGENCY’S LEGAL NAME:
LICENSE #:
PERSON TO CONTACT REGARDING
THIS CHANGE:
NAME:
PHONE #:
EMAIL:
PLEASE SELECT ONE OF THE FOLLOWING:
New Collections Manager replaces existing approved Collections Manager on file
New Collections Manager is serving as a backup to existing Collections Manager on file
NAME OF NEW COLLECTIONS MANAGER:
NAME OF EXISTING APPROVED COLLECTIONS MANAGER:
:
DATE EXISTING APPROVED COLLECTIONS MANAGER CEASED ROLE
(if applicable)
Statements made herein are made under oath. False statements may be punishable as second-degree
perjury.
_______________
____________________________________
(Date)
(Signature)
____________________________________
(Print Name & Title)
Mail the Completed Form to:
Colorado Department of Law
Consumer Credit Unit, CAR
Ralph L. Carr Colorado Judicial Center
1300 Broadway, 6th Floor
Denver, CO 80203
8/9/17
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