Applications, forms, and reports

Portable document format (PDF) : PDFs need to be printed first, then completed, and mailed to the Division for processing. If you are unable to open one, please download Acrobat Reader from Adobe.

MS Word (Word) : If you have MS Word you can fill it in, print it, and mail it to the Division for processing.

Online fillable forms (On-line form) : Form that can be filled out online, then submitted to the Division for processing.

Finance

Title	Form #	Forms	Rev. Date
Application for authority to organize a state bank	440-2208	PDF	01/8/2016
Confidential biographical and financial report	440-2070	PDF Word	01/8/2016
Designation of registered agent and/or office	440-4009	PDF	01/8/2016
Public Records Request	440-4871	PDF	02/2022
Request for a certificate of name compliance	440-4867	PDF	08/2022
Special qualifications registration	440-2042	PDF	01/8/2016
Trust company application	440-4008	PDF	01/8/2016

Title	Form #	Forms	Rev. Date
Check-cashing annual report	440-4803	PDF	07/2022
Reporte Anual de Cambio de Cheques	440-4803s	PDF	07/2022
Check-cashing business - additional location application	440-4770	PDF	08/2023
Check-cashing business - additional location application	440-4770s Español	PDF	07/2022
Check-cashing business initial license application	440-4771	PDF	07/2022
Check-cashing business initial license application	440-4771s Español	PDF	07/2022
Check-cashing business license amendment application (A licensed check cashing business may use this form to make changes to the information on file with the division)	440-5470	PDF Word	07/2022
Criminal background and credit check authorization	440-4912	PDF Word	07/2022
Public Records Request	440-4871	PDF	02/2022

Title	Form #	Forms	Rev. Date
Irrevocable Letter of Credit	440-4881	PDF	07/2022
Public Records Request	440-4871	PDF	02/2022
Request for Waiver - Oregon Collection Agency Registration	440-5218	PDF	07/2022
Oregon Licensing Notice	440-5434	PDF	07/2022

Title	Form #	Forms	Rev. Date
Consumer Finance Licensee Annual Report	440-4818	PDF	10/2022
Consumer Finance Questionnaire for Licensure	440-5874	PDF	07/2023
Criminal background and credit check authorization - Short form	440-5198	PDF	07/2022
Public Records Request	440-4871	PDF	02/2022
Oregon Licensing Notice	440-5434	PDF	07/2022

Title	Form #	Forms	Rev. Date
Branch application and checklist	440-2784	PDF Word	01/8/2016
Bylaw amendment	440-2780	PDF Word	01/8/2016
Change of location	440-2779	PDF Word	01/08/2016
Change of registered office and/or agent	440-2781	PDF Word	01/08/2016
Change to list of officials	440-2935	PDF Word	01/08/2016
List of officials	440-2782	PDF Word	01/08/2016
Model bylaws	440-2783	PDF Word	03/08/2006
Public Records Request	440-4871	PDF	02/2022

Title	Form #	Forms	Rev. Date
Attestation for Reduced Errors and Omissions Insurance Oregon Debt Buyer License	440-5343	PDF Word	07/2022
Oregon Licensing Notice	440-5434	PDF	07/2022

Title	Form #	Forms	Rev. Date
Public Records Request	440-4871	PDF	02/2022
Oregon Licensing Notice	440-5434	PDF	07/2022

Title	Form #	Forms	Rev. Date
Annual report - endowment care cemeteries	440-4016	PDF	01/2023
Endowment Care for Burial Vaults and Markers Penal Bond with Surety	440-3375	PDF	07/2022
Endowment Care for Crypts or Niches Penal Bond with Surety	440-3374	PDF	07/2022
Public Records Request	440-4871	PDF	02/2022

Title	Form #	Forms	Rev. Date
Funeral and Cemetery Consumer Protection Trust Fund Annual Report	440-4013	PDF	07/2022
Funeral and Cemetery Consumer Protection Trust Fund Claim for Restitution	440-4018	PDF	07/2022

Title	Form #	Forms	Rev. Date
Irreducible fund cemetery annual report	440-2929	PDF	07/2022
Public Records Request	440-4871	PDF	02/2022

Title	Form #	Forms	Rev. Date
Irrevocable Letter of Credit	440-3485	PDF	07/2022
Limited Manufactured Structures Dealer License Application	440-2965	PDF	07/2022
Manufactured Structures Dealer and Limited Manufactured Structures Dealer License Correction Application	440-2964	PDF	07/2022
Manufactured Structures Dealer and Limited Manufactured Structures Dealer Surety Bond	440-2966	PDF	07/2022
Manufactured StructuresDealer License Application	440-2962	PDF	07/2022
Manufactured Structures Dealer Supplemental License Application	440-2963	PDF	07/2022
Manufactured Structures License Report of Examination	440-3498	PDF	07/2022
Public Records Request	440-4871	PDF	02/2022
Manufactured Structures Dealer License Renewal Application	440-5454	PDF	07/2022
Limited Manufactured Structures Dealer License Renewal Application	440-5455	PDF Word	07/2022

Title	Form #	Forms	Rev. Date
Criminal background and credit check authorization	440-4912	PDF Word	07/2022
Master Trustee 2% Per Year Reporting	440-4957	PDF Word	07/2022
Master trustee annual report and registration renewal	440-4017	PDF	07/2022
Master trustee election to pay administrative fees & expenses from trust fund deposits	440-4955	PDF	07/2022
Master trustees registration application	440-4012	PDF	07/2022
Notice of appointment of successor depository or master trustee	440-3437	PDF	07/2022
Public Records Request	440-4871	PDF	02/2022

Title	Form #	Forms	Rev. Date
Deposit in lieu of security device	440-4603	PDF	07/2022
Public Records Request	440-4871	PDF	02/2022

Title	Form #	Forms	Rev. Date
Affidavit and undertaking - no clients’ trust account	440-2776	PDF	07/2022
Annual Recertification of Bona Fide Nonprofit Organization	440-4990	PDF	07/2022
Balance sheet and income statement	440-5370	PDF Word	07/2022
Checklist for Determination of Qualification for Bona Fide Nonprofit Organization Status	440-4935	PDF	07/2022
Clients’ trust account, notice of	440-2777	PDF	07/2022
Examination - loan worksheet	440-3369	PDF	07/2022
Examination report	440-3368	PDF	07/2022
Foreclosure Notice Form	440-4795	PDF Word	07/2022
Interest Rate Lock/Float Agreement	440-4828	PDF	07/2022
Investor Disclosure Information	440-4827	PDF	07/2022
Mortgage Servicer Irrevocable Letter of Credit	440-5227	PDF Word	07/2022
Oregon Licensing Notice	440-5434	PDF	07/2022
Personnel Information Ledger	440-4826	Excel	06/2021
Public Records Request	440-4871	PDF	02/2022

Title	Form #	Forms	Rev. Date
Annual report form	440-3371	PDF	04/2024
Application package	440-3232	PDF Word	07/2022
Application amendment	440-5463	PDF Word	07/2022
Criminal background and credit check authorization	440-4912	PDF Word	07/2022
Public Records Request	440-4871	PDF	02/2022

Title	Form #	Forms	Rev. Date
Criminal background and credit check authorization - Long form	440-4912	PDF Word	07/2022
Criminal background and credit check authorization - Short form	440-5198	PDF Word	07/2022
Payday / Title Licensee Annual Report	440-4817	PDF Word	07/2022
Public Records Request	440-4871	PDF	02/2022
Oregon Licensing Notice	440-5434	PDF	07/2022
Underwriting guidelines for payday/title lending license	440-5959	PDF	06/2024

Title	Form #	Forms	Rev. Date
Certified provider annual report and certification renewal	440-4014	PDF	07/2022
Certified provider application	440-4011	PDF	05/2024
Criminal background and credit check authorization	440-4912	PDF Word	07/2022
Endowment Care for Burial Vaults and Markers Penal Bond with Surety	440-3375	PDF	07/2022
Endowment Care for Crypts or Niches Penal Bond with Surety	440-3374	PDF	07/2022
Funeral and Cemetery Consumer Protection Trust Fund Annual Report	440-4013	PDF	07/2022
Funeral and Cemetery Consumer Protection Trust Fund Claim for Restitution	440-4018	PDF	07/2022
Notice of appointment of successor depository or master trustee	440-3437	PDF	07/2022
Public Records Request	440-4871	PDF	02/2022
Annual Report Account & Delivered Merchandise Spreadsheet		Excel	10/2022

Title	Form #	Forms	Rev. Date
Student Loan Servicer Annual Report	440-5817	PDF	07/2023

Securities

Note: The forms listed below are specific to Oregon. For additional required forms, please visit the NASAA or SEC websites.

Title	Form #	Forms	Rev. Date
Personal balance sheet and income statement	440-5515	PDF	12/2020
Dual undertaking	440-2131	PDF	04/18/2017
Non-FINRA Broker-Dealer Renewal Application	440-2785	PDF	10/26/2020
Oregon Broker-Dealer Affidavit	440-4861	PDF Word	01/11/2016
Public Records Request	440-4871	PDF	02/2022
Registration for Resale, or Dealing and Trading	440-2203	PDF Word	01/11/2016
Trade/assumed name	440-2774	PDF	12/2020

Title	Form #	Forms	Rev. Date
Annual financial statement reporting		Excel
Attestation of Errors and Omissions Insurance	440-5379	PDF	03/2022
Personal balance sheet and income statement	440-5515	PDF	12/2020
Dual undertaking	440-2131	PDF	04/18/2017
Public Records Request	440-4871	PDF	02/2022
Surety bond	440-5650	PDF	03/2022
Trade/assumed name	440-2774	PDF	12/2020

Title	Form #	Forms	Rev. Date
Certain Compensatory Benefit Plans	440-5180	PDF	02/2021
Oregon form	440-2013	PDF Word	01/11/2016
Oregon Intrastate Offering Exemption	440-5001	PDF Word	01/11/2016
Oregon Interstate Offering Final Sales Report	440-5353	PDF Word	12/2017
Proceeds Escrow Agreement	440-3517	PDF	01/11/2016
Registration for Resale, or Dealing and Trading	440-2203	PDF Word	01/11/2016
Representative/salesperson initial application	Form U4	PDF	05/2009
Representative/salesperson renewal	440-2118a	PDF	10/26/2020
Representative/salesperson termination	440-2118b	PDF Word	01/11/2016
Solicitation of Interest	440-3008	PDF Word	01/11/2016
Stock Escrow Agreement	440-3438	PDF	01/11/2016

Applications, forms, and reports

Finance

Bank and trust companies

Check-cashing businesses

Collection agencies

Consumer finance companies

Credit unions

Debt buyer license

Debt management service providers

Endowment care

Funeral and cemetery - Consumer Protection Fund

Irreducible fund cemeteries

Manufactured structures dealers

Master Trustees

Money transmitters

Mortgage lenders

Pawnbrokers

Payday lending and title lending

Prearranged funeral plans (preneed certified providers)

Student loan servicing

Securities

Broker dealers

Investment advisors

Securities registration