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Consumer Discount Company Forms

ALL documents that will be mailed to the Non-Depository Deputate or placed in the drop-box MUST be sent electronically to the appropriate email address below.  If there is a paper check included in the mail for an application fee or otherwise, a copy of the check must be included in the email."

Licensing:                    ra-AskLicensing@pa.gov

Examinations:             ra-AskExams@pa.gov

Compliance:                ra-AskCompliance@pa.gov

All forms, unless noted, are in PDF format.
Address Change Form [PDF]
Use this form to notify the Department of Banking and Securities of any office location changes. 
 
Alternate Site Recordkeeping [PDF]
Use this form to request permission to store records at a site other than the principal place of business or to make changes to previously approved requests.
 
 
 
Consumer Discount Company Application [PDF]
Use this form to apply for a consumer discount company license.
 
Consumer Discount Branch Application [PDF]
Use this form to apply for a consumer discount branch company license.
 
Use this bond form for all Non-Mortgage Consumer Discount Companies.
 
Consumer Discount Company Surrender Form [PDF]
Use this form to surrender your license to the Department of Banking and Securities.
 
Contact Change Form [PDF]
Use this form to notify the Department of Banking and Securities of any changes to your primary contacts.
 
Criminal Record Check and Fingerprint Check [PDF]
These forms must be completed along with license applications.  It is also required for all owners, partners, corporations, managers, and officers.
 
License Renewal or Annual Report Filing (online only)
Renew a license online.
 
Name Change Form [PDF]
Use this form to notify the Department of Banking and Securities of business name changes. 
 
Officer Change Form [PDF]
Use this form to notify the Department of Banking and Securities of Officer or Branch Manager changes.