OFFICE OF SUPERINTENDENT OF INSURANCEP.O. BOX 1689

SANTA FE, NEW MEXICO 87504-1689(505) 827-4362

SUMMARY OF REQUIRED DOCUMENTS FROMINSURANCE PREMIUM FINANCE COMPANIES SEEKING ADMISSION

TO TRANSACT BUSINESS IN THE STATE OF NEW MEXICO

(Name of Insurance Premium Finance Company)

In support of the application, please furnish the OSI with the items listed below:

_1. APPLICATION FEE A non-refundable application fee in the sum of $100.00must accompany this application before it can be reviewed in accordance withNMSA §59A-6-1-(S) (1). Make the check payable to the Office ofSuperintendent of Insurance or OS/.

2. APPLICATION FOR INSURANCE PREMIUM FINANCE LICENSE

IF A NATURAL PERSON OR PARTNERSHIP:Apply by letter stating that the individual or partnership is seeking admission totransact insurance premium finance business in the State of New Mexico.

IF A CORPORATION:Apply by letter, transmitting a certified copy of the Resolution of the Board ofDirectors stating under oath, of the president or vice president, or other chiefofficer on behalf of the company, that the company is seeking admission as aninsurance premium finance company. The Resolution must be notarized.

IF ANY OTHER LEGAL ENTITY:Apply by letter stating the company is seeking admission to transact business asan insurance premium finance company in the State of New Mexico and submitcopies of all governing documents.

_3. ARTICLES OF INCORPORATION If a corporation provide the company's initialArticles of Incorporation and all amendments thereto. The Articles ofIncorporation must be certified, and bear the seal of the state official havingcustody of the original documents.

_4. BY-LAWS If a corporation provide a copy of the By-Laws certified by the stateofficial having custody of the original or the company's corporate secretary.Ensure that the corporate seal is affixed to the secretary's certification.

_5. CERTIFICATE OF COMPLIANCE If a corporation, provide a Certificate ofCompliance certified by the state of domicile.

Insurance Premium Finance Company(Rev. 11/18)

_6. CERTIFICATE OF GOOD STANDING If a corporation, provide a Certificate ofGood Standing certified by the New Mexico Office of Secretary of State,Corporations Division.

_7. INSURANCE PREMIUM FINANCE AGREEMENT A copy of the insurancepremium finance agreement to be issued by the company, which complies withthe provisions of the Insurance Premium Financing Law (NMSA Section 59A-45-1 to59A-45-16).

_8. CONTACT PROCESSING FORM Must be completed in its entirety.

_9. SURETY BOND A surety bond or a Certificate of Deposit in the sum of$10,000.00 must be submitted. A surety company authorized to do business inNew Mexico on a form acceptable to the superintendent must issue the suretybond. The Certificate of Deposit must be issued by a New Mexico bank andmust be pre-approved by our Division prior to issuance of the Certificate ofDeposit. Please provide the original Surety Bond and three original (threeoriginal signatures) Deposit Forms 600. The deposit forms and Surety Bondforms can be found athttps://www.osi.state.nm.us/CompanyLicensinci/statutorydeposits.aspx

Please mail the application fee along with items 1 through 9 in paper form to:

Office of Superintendent of Insurance (OSI)Attn: Company Licensing Bureau1120 Paseo De Peralta, Room 439

Santa Fe, New Mexico 87501

If you have any questions regarding the requested documents above, please contactthe Company Licensing Bureau at 505-827-4362.

Insurance Premium Finance Company(Rev. 11/18)

OFFICE OF SUPERINTENDENT OF INSURANCECOMPANY LICENSING BUREAUP.O. BOX 1689SANTA FE, NEW MEXICO 87504-1689(505) 827-4362

PLEASE READ BEFORE COMPLETING:

-PLEASE TYPE OR PRINT NEATLY

-COMPLETE ENTIRE FORM-DO NOT LEAVE ANY BLANKS

-CONTACT PERSON & PHONE NUMBER-MUST BELOCATED AT ADDRESS INDICATED

CONTACT PROCESSING FORM

COMPANY COMPLETE NAME - Do not abbreviate name.

COMPANY HOME ADDRESS - MUST BE LOCATED IN STATE OF DOMICILE (PER NMSA S59A-5-22 (Bl)Phvsical location only:

City:

Contact Person:

State:

Email Address:

Zip Code:

Phone Number:

COMPANY MAILING ADDRESSStreet, P 0 Box, etc.:

City:

Contact Person:

State:

Emajl_Address:

Zip Code:

Phone Number:

COMPANY CONTACT FOR GENERAL & SPECIAL DEPOSITS/SURETY BONDSStreet, PO Box, etc.:

City:

Contact Person:

State;

Email Address:

Zip Code:

Phone Number;

Revised 11/18