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Application Forms

Any of the application forms listed below may be physically mailed to the Bureau of Financial Institutions or submitted via email to BFIApplications@scc.virginia.gov.  Upon receipt of electronically filed applications, the Bureau respond with an invoice for any applicable application fees and instructions on how to remit the fees online.

All applications are investigated by the Bureau of Financial Institutions. Certain application decisions are made by the Commissioner of Financial Institutions under delegated authority from the State Corporation Commission. In the event you wish to appeal either a determination made by the Bureau of Financial Institutions in the course of its investigation of your application or the Commissioner of Financial Institutions’ decision on your application, you may request a formal review by the State Corporation Commission in accordance with its Rules of Practice and Procedure.

The following are applications and related forms for new banks and for existing banks and bank holding companies, including applications for branch offices/relocations, conversion to a state bank charter, bank mergers, and acquisitions of banks. Each application form includes filing instructions. Some application types require the filing of supplemental forms. In each instance, the appropriate supplemental forms are listed directly following the application form. It is important to carefully read and follow all instructions and to provide full and complete responses. Investigation of the application may be delayed if the application is incomplete.

Establish a New Bank

  • CCB-1121 Application of a New Bank or a New Savings and Loan Association for a Certificate of Authority to Begin Business in Virginia
  • SUPPLEMENTAL FORMS
    • Bank Directors Responsibilities Bureau of Financial Institutions, State Corporation Commission, Commonwealth of Virginia
    • CCB-1117 Bank Directors Responsibilities Certification
    • CCB-1123 Personal Financial Report and Disclosure Statement
    • CCB-1140 Oath of Office of Organizing Directors of Financial Institutions
    • CCB-1147 Certification Form for Interagency Biographical and Financial Report
    • CCB-1150 Employment and Business Affiliation Disclosure Form

Conversion to a State Chartered Bank

  • CCB-1146 Application to Convert Pursuant to Title 6.2 of the Code of Virginia
  • SUPPLEMENTAL FORMS
    • Bank Directors Responsibilities Bureau of Financial Institutions, State Corporation Commission, Commonwealth of Virginia
    • CCB-1117 Bank Directors Responsibilities Certification
    • CCB-1123 Personal Financial Report and Disclosure Statement
    • CCB-1140 Oath of Office of Organizing Directors of Financial Institutions
    • CCB-1147 Certification Form for Interagency Biographical and Financial Report
    • CCB-1150 Employment and Business Affiliation Disclosure Form

Establish a Bank Branch

  • CCB-1125 Application to Establish a Branch

Change the Location of a Main Office or Bank Branch

  • CCB-1126 Application to Change the Location of a Main Office or Branch Pursuant to Title 6.2 of the Code of Virginia

Bank Merger

  • CCB-1128 Application for Approval of Merger Pursuant to Title 6.2 of the Code of Virginia
  • SUPPLEMENTAL FORMS
    • Bank Directors Responsibilities Bureau of Financial Institutions, State Corporation Commission, Commonwealth of Virginia
    • CCB-1117 Bank Directors Responsibilities Certification
    • CCB-1123 Personal Financial Report and Disclosure Statement
    • CCB-1140 Oath of Office of Organizing Directors of Financial Institutions
    • CCB-1147 Certification Form for Interagency Biographical and Financial Report
    • CCB-1150 Employment and Business Affiliation Disclosure Form

Interim Institution to Begin Business in Virginia

  • CCB-1131 Application of an Interim Institution to Begin Business in Virginia

Supplemental Forms

  • Bank Directors Responsibilities Bureau of Financial Institutions, State Corporation Commission, Commonwealth of Virginia
  • CCB-1117 Bank Directors Responsibilities Certification
  • CCB-1123 Personal Financial Report and Disclosure Statement
  • CCB-1140 Oath of Office of Organizing Directors of Financial Institutions
  • CCB-1147 Certification Form for Interagency Biographical and Financial Report
  • CCB-1150 Employment and Business Affiliation Disclosure Form

Permission To Acquire Voting Shares Of A Virginia Financial Institution By A Person Or A Virginia Financial Institution Holding Company

  • CCB-1137 Application for Permission to Acquire Voting Shares of a Virginia Financial Institution Pursuant to Section 6.2-704 A of the Code of Virginia

Supplemental Forms

  • CCB-1123 Personal Financial Report and Disclosure Statement
  • CCB-1137A Consent to Service of Process
  • CCB-1147 Certification Form for Interagency Biographical and Financial Report
  • CCB-1150 Employment and Business Affiliation Disclosure Form

Acquire A Virginia Bank Holding Company Or Virginia Bank By An Out-Of-State Bank Holding Company

  • CCB-1139 Application to Acquire a Virginia Bank Holding Company or Virginia Bank Pursuant to Section 6.2-704 C of the Code of Virginia

Supplemental Forms

  • CCB-1123 Personal Financial Report and Disclosure Statement
  • CCB-1137A Consent to Service of Process
  • CCB-1143 Limited Personal Financial Report and Disclosure Statement
  • CCB-1147 Certification Form for Interagency Biographical and Financial Report
  • CCB-1150 Employment and Business Affiliation Disclosure Form

Notice Of Intent To Acquire A Bank Outside Virginia

  • CCB-1138 Notice of Intent to Acquire a Bank Outside Virginia Pursuant to Section 6.2-715 of the Code of Virginia

Bank Holding Company To Acquire A Federal Savings Institution

  • CCB-1144 Application of a Bank Holding Company to Acquire a Federal Savings Institution Pursuant to Section 6.2-1146 of the Code of Virginia
  • SUPPLEMENTAL FORMS
    • CCB-1123 Personal Financial Report and Disclosure Statement

Establish A Subsidiary Trust Company

  • CCB-1129 Application of a Subsidiary Trust Company for a Certificate of Authority to Begin Business Pursuant to Title 6.2, Chapter 10, Article 3 of the Code of Virginia

Supplemental Forms

  • Bank Directors Responsibilities Bureau of Financial Institutions, State Corporation Commission, Commonwealth of Virginia
  • CCB-1117 Bank Directors Responsibilities Certification
  • CCB-1123 Personal Financial Report and Disclosure Statement
  • CCB-1140 Oath of Office of Organizing Directors of Financial Institutions
  • CCB-1147 Certification Form for Interagency Biographical and Financial Report
  • CCB-1150 Employment and Business Affiliation Disclosure Form

Bank To Engage In The Trust Business

  • CCB-1127 Application by a Bank To Engage in the Trust Business Pursuant to Title 6.2, Chapter 8, Article 3 of the Code of Virginia

Establish A Trust Office

  • CCB-9905 Application to Establish a Trust Office

CHECK CASHER REGISTRATION FORM

  • CCB-5510 Check Casher Registration Form

 

Following are applications and related forms for new consumer finance companies and for existing licensees, including applications for additional offices and office relocations, for the acquisition of licensees, and notices for other business to be conducted. Each application form includes filing instructions. Some application types require the filing of supplemental forms. In each instance, the appropriate supplemental forms are listed directly following the application form. It is important to carefully read and follow all instructions and to provide full and complete responses. Investigation of the application may be delayed if the application is incomplete.

Application Forms

  • NEW CONSUMER FINANCE LICENSE
    • CCB-4402 Application for a Consumer Finance License Pursuant to Chapter 15 of Title 6.2 of the Code of Virginia
      • SUPPLEMENTAL FORMS
        • CCB-1123 Personal Financial Report and Disclosure Statement
        • CCB-4409 Surety Bond Pursuant to Section 6.2-1523.3 of the Code of Virginia
        • CCB-1143 Limited Personal Financial Report and Disclosure Statement
        • CCB-1149 Depository Institution Authorization Form
        • CCB-1150 Employment and Business Affiliation Disclosure Form
    • CCB-4403 Notice to Conduct Consumer Finance Business and Other Business at Same Location
  • CHANGE THE LOCATION OF A CONSUMER FINANCE OFFICE
    • CCB-4406 Notice of Intent to Change the Location of a Consumer Finance Office
  • ADDITIONAL CONSUMER FINANCE OFFICE
    • CCB-4410 Application for an additional Consumer Finance office Pursuant to § 6.2-1508.1 of the code of Virginia.
  • ACQUIRE CONTROL OF A CONSUMER FINANCE LICENSEE
    • CCB-4408 Application for Permission to Acquire Control of a Consumer Finance Licensee Pursuant to Section 6.2-1510 of the Code of Virginia
      • SUPPLEMENTAL FORMS
        • CCB-1123 Personal Financial Report and Disclosure Statement
        • CCB-1143 Limited Personal Financial Report and Disclosure Statement
        • CCB-1149 Depository Institution Authorization Form
        • CCB-1150 Employment and Business Affiliation Disclosure Form

Following are applications and related forms for new credit counseling agencies and for existing licensees, including applications for additional offices and office relocations, and the acquisition of licensees. Each application form includes filing instructions. Some application types require the filing of supplemental forms. In each instance, the appropriate supplemental forms are listed directly following the application form. It is important to carefully read and follow all instructions and to provide full and complete responses. Investigation of the application may be delayed if the application is incomplete.

Application Forms

  • NEW CREDIT COUNSELING AGENCY
    • CCB-7700 Application to Engage in the Business of a Credit Counseling Agency Pursuant to Title 6.2, Chapter 20 of the Code of Virginia
      • SUPPLEMENTAL FORMS
        • CCB-1123 Personal Financial Report and Disclosure Statement
        • CCB-1148 Personal Information and Disclosure Statement for Directors of Credit Counseling Agencies
        • CCB-1149 Depository Institution Authorization Form
        • CCB-1150 Employment and Business Affiliation Disclosure Form
        • CCB-7703 Surety Bond Pursuant to Section 6.2-2003 of the Code of Virginia
  • ADDITIONAL LOCATION OR RELOCATION OF AN EXISTING OFFICE
    • CCB-7702 Application for an Additional Office or the Relocation of an Existing Office Pursuant Section 6.2-2006 of the Code of Virginia
  • ACQUIRE CONTROL OF A CREDIT COUNSELING LICENSEE
    • CCB-7704 Application for Permission to Acquire Control of a Credit Counseling Licensee Pursuant to Section 6.2-2007 of the Code of Virginia
      • SUPPLEMENTAL FORMS
        • CCB-1123 Personal Financial Report and Disclosure Statement
        • CCB-1148 Personal Information and Disclosure Statement for Directors of Credit Counseling Agencies
        • CCB-1149 Depository Institution Authorization Form
        • CCB-1150 Employment and Business Affiliation Disclosure Form

The following are applications and related forms for credit unions. Some application types require the filing of supplemental forms.  In each instance, the appropriate supplemental forms are listed directly following the application form. It is important to carefully read and follow all instructions and to provide full and complete responses. Investigation of the application may be delayed if the application is incomplete.

Application Forms

  • CREDIT UNION REQUEST FOR FIELD OF MEMBERSHIP EXPANSION
    • CCB-3308 Credit Union Request for Field of Membership Expansion Pursuant to Section 6.2-1328 of the Code of Virginia
  • CREDIT UNION REQUEST TO PROVIDE VIRTUAL CURRENCY CUSTODY SERVICES IN A FIDUCIARY CAPACITY 
    • CCB-3309 Credit Union Request to Provide Virtual Currency Custody Services in a Fiduciary Capacity Pursuant to Section 6.2-1302.1 of the Code of Virginia
  • ESTABLISH AND OPERATE A CREDIT UNION
    • CCB-3302 Application for Permission to Establish and Operate a Credit Union Pursuant to Section 6.2-1321 of the Code of Virginia
      • SUPPLEMENTAL FORMS
        • CCB-1123 Personal Financial Report and Disclosure Statement
        • CCB-1150 Employment and Business Affiliation Disclosure Form
  • OUT-OF-STATE CREDIT UNION TO CONDUCT BUSINESS IN VIRGINIA
    • CCB-3305 Application by an Out-of-State Credit Union to Conduct Business as a Credit Union in Virginia Pursuant to Section 6.2-1379 of the Code of Virginia
      • SUPPLEMENTAL FORMS
        • CCB-1137A Consent to Service of Process
        • CCB-3304 Consent to Service of Process (Insurer of Shares)
  • CREDIT UNION MERGER
    • CCB-3306 Application for Approval of Merger of Credit Unions Pursuant to Section 6.2-1344 of the Code of Virginia
  • CREDIT UNION TO ESTABLISH A SERVICE FACILITY
    • CCB-3307 Application of a Credit Union to Establish a Service Facility Pursuant to Section 6.2-1326 of the Code of Virginia

Effective July 1, 2021, no person shall engage in the business of providing or offering to provide debt settlement services to any consumer, whether or not the person has an office, facility, agent, or other physical presence in the Commonwealth, unless such person obtains a license from the State Corporation Commission.

Following are applications and related forms for new debt settlement service providers and for existing licensees. Each application form includes filing instructions. Some application types require the filing of supplemental forms. In each instance, the appropriate supplemental forms are listed directly following the application form. It is important to carefully read and follow all instructions and to provide full and complete responses. Investigation of the application may be delayed if the application is incomplete.

Application Forms

  • NEW DEBT SETTLEMENT SERVICE PROVIDER
    • CCB-11001 Application to Engage in the Business of Debt Settlement Services Pursuant to Chapter 20.1, Title 6.2 of the Code of Virginia
      • SUPPLEMENTAL FORMS
        • CCB-1123 Personal Financial Report and Disclosure Statement
        • CCB-1143 Limited Personal Financial Report and Disclosure Statement
        • CCB-1149 Depository Institution Authorization Form
        • CCB-1150 Employment and Business Affiliation Disclosure Form
        • CCB-11002 Surety Bond Pursuant to Section 6.2-2029 of the Code of Virginia
           
  • ADDITIONAL LOCATION OR RELOCATION OF AN EXISTING OFFICE
    • CCB-11003 Application for an Additional Office or the Relocation of an Existing Office Pursuant Section 6.2-2032 of the Code of Virginia                                                      
  • ACQUIRE CONTROL OF A DEBT SETTLEMENT SERVICES PROVIDER LICENSEE
    • CCB-11004 Application for Permission to Acquire Control of a Debt Settlement Services Provider Licensee Pursuant to Section 6.2-2033 of the Code of Virginia
      • SUPPLEMENTAL FORMS
        • CCB-1123 Personal Financial Report and Disclosure Statement
        • CCB-1143 Limited Personal Financial Report and Disclosure Statement
        • CCB-1149 Depository Institution Authorization Form
        • CCB-1150 Employment and Business Affiliation Disclosure Form

Applications for money transmitter licenses must be submitted through Nationwide Multistate Licensing System (NMLS). Applications for acquisition of control of existing licensees are not currently processed through NMLS and will continue to be submitted through the mail. Each application form includes filing instructions. The applications require the filing of supplemental forms. In each instance, the appropriate supplemental forms are listed directly following the application form. It is important to carefully read and follow all instructions and to provide full and complete responses. Investigation of the application may be delayed if the application is incomplete.

Application Forms

  • LICENSE TO ENGAGE IN THE MONEY TRANSMISSION AND/OR MONEY ORDER BUSINESS
  • ACQUIRE CONTROL OF A MONEY TRANSMITTER LICENSEE
    • CCB-5514 Application for Permission to Acquire Control of a Money Transmitter Licensee Pursuant to Section 6.2-1914 of the Code of Virginia
      • SUPPLEMENTAL FORMS
        • CCB-1123 Personal Financial Report and Disclosure Statement
        • CCB-1143 Limited Personal Financial Report and Disclosure Statement
        • CCB-1149 Depository Institution Authorization Form
        • CCB-1150 Employment and Business Affiliation Disclosure Form
        • CCB-5531 Criminal History Records Consent and Fingerprinting Instructions

Applicants for new mortgage lender/broker licenses and branches must submit their applications to Virginia through Nationwide Multistate Licensing System (NMLS). Applications for acquisition of control of licensees and for determination of a bona fide non-profit status are not currently processed through NMLS and will continue to be submitted through the mail. Each application form includes filing instructions.  When applicable, the appropriate supplemental forms are listed directly following the application form. It is important to carefully read and follow all instructions and to provide full and complete responses. Investigation of the application may be delayed if the application is incomplete.

Application Forms

  • ACQUIRE CONTROL OF A MORTGAGE LENDER AND/OR BROKER LICENSEE
    • CCB-8808 Application for Permission to Acquire Control of a Mortgage Lender and or Broker Licensee Pursuant to §6.2-1608 of the Code of Virginia
      • SUPPLEMENTAL FORMS
        • CCB-1123 Personal Financial Report and Disclosure Statement
        • CCB-1143 Limited Personal Financial Report and Disclosure Statement
        • CCB-1149 Depository Institution Authorization Form
        • CCB-1150 Employment and Business Affiliation Disclosure Form
        • CCB-8812 Criminal History Records Consent Form
    • CCB-8821 Application for Determination of a Bona Fide Non-Profit Status Pursuant to §6.2-1701.1 of the Code of Virginia
    • CCB-8823 Exclusive Agent Conditions of Licensure

Applications for a mortgage loan originator (MLO) license must be submitted through the Nationwide Multistate Licensing System (NMLS). The MLO application form is referred to as Form MU4. The MU4 application and the Virginia MLO application checklist with the required forms can be accessed on the NMLS website through the link below. 

Application Forms

  • Getting Started with the Nationwide Multistate Licensing System
    Reminder: Virginia jurisdiction-specific forms, available from the NMLS site, must be downloaded and submitted to the Bureau at the time the MU4 is electronically filed.
  • CCB-8821 Application for Determination of a Bona Fide Non-Profit Status Pursuant to §6.2-1701.1 of the Code of Virginia

The following are applications and related forms for motor vehicle title lenders, including applications for additional offices and office relocations, for other business to be conducted in a licensed office, and for the acquisition of licensees. Each application form includes filing instructions. Some application types require the filing of supplemental forms. In each instance, the appropriate supplemental forms are listed directly following the application form. It is important to carefully read and follow all instructions and to provide full and complete responses. Investigation of the application may be delayed if the application is incomplete.

Application Forms

  • MOTOR VEHICLE TITLE LENDER LICENSE
    • CCB-5523 Application for a Motor Vehicle Title Lender License Pursuant to Chapter 22 of Title 6.2 of the Code of Virginia
      • SUPPLEMENTAL FORMS
        • CCB-1123 Personal Financial Report and Disclosure Statement
        • CCB-1143 Limited Personal Financial Report and Disclosure Statement
        • CCB-5524 Surety Bond for Motor Vehicle Title Lender Pursuant to 6.2-2204 of the Code of Virginia
        • CCB-1149 Depository Institution Authorization Form
        • CCB-1150 Employment and Business Affiliation Disclosure Form
  • ADDITIONAL LOCATION OR RELOCATION OF AN EXISTING OFFICE
    • CCB-5525 Application for an Additional Office or Relocation of an Existing Office Pursuant to Chapter 22, Title 6.2 of the Code of Virginia.
  • ACQUIRE CONTROL OF A MOTOR VEHICLE TITLE LENDER LICENSEE
    • CCB-5526 Application for Permission to Acquire Control of a Motor Vehicle Title Lender Licensee Pursuant to Section 6.2-2208 of the Code of Virginia
      • SUPPLEMENTAL FORMS
        • CCB-1123 Personal Financial Report and Disclosure Statement
        • CCB-1143 Limited Personal Financial Report and Disclosure Statement
        • CCB-1149 Depository Institution Authorization Form
        • CCB-1150 Employment and Business Affiliation Disclosure Form
  • MOTOR VEHICLE TITLE LOAN BUSINESS AND OTHER BUSINESS AT SAME LOCATION
    • CCB-5527 Application to Conduct the Business of Motor Vehicle Title Lending and Other Business at Same Location.

SALES-BASED FINANCING REGISTRATION FORM

  • CCB-13001 Sales-Based Financing Registration Form

Following are applications and related forms for new short-term lenders and for existing licensees, including applications for additional offices and office relocations, for other business to be conducted in a licensed office, and for the acquisition of licensees.  Each application form includes filing instructions. Some application types require the filing of supplemental forms. In each instance, the appropriate supplemental forms are listed directly following the application form. It is important to carefully read and follow all instructions and to provide full and complete responses. Investigation of the application may be delayed if the application is incomplete.

Application Forms

  • SHORT-TERM LENDER LICENSE
    • CCB-5515 Application for a Short-Term Lender License Pursuant to Chapter 18 of Title 6.2 of the Code of Virginia
      • SUPPLEMENTAL FORMS
        • CCB-1123 Personal Financial Report and Disclosure Statement
        • CCB-1143 Limited Personal Financial Report and Disclosure Statement
        • CCB-5516 Surety Bond Pursuant to Section 6.2-1804 of the Code of Virginia
        • CCB-1149 Depository Institution Authorization Form
        • CCB-1150 Employment and Business Affiliation Disclosure Form
  • ADDITIONAL LOCATION OR RELOCATION OF AN EXISTING OFFICE
    • CCB-5517 Application for an Additional Office or Relocation of an Existing Office Pursuant Section 6.2-1807 of the Code of Virginia
  • ACQUIRE CONTROL OF A SHORT-TERM LENDER LICENSEE
    • CCB-5518 Application for Permission to Acquire Control of a Short-Term Lender Licensee Pursuant to Section 6.2-1808 of the Code of Virginia
      • SUPPLEMENTAL FORMS
        • CCB-1123 Personal Financial Report and Disclosure Statement
        • CCB-1143 Limited Personal Financial Report and Disclosure Statement
        • CCB-1149 Depository Institution Authorization Form
        • CCB-1150 Employment and Business Affiliation Disclosure Form
  • SHORT-TERM LOAN BUSINESS AND OTHER BUSINESS AT SAME LOCATION
    • CCB-5519 Application to Conduct the Business of Making Short-Term Loans and Other Business at the Same Location

The following are applications and related forms for savings institutions. Each application form includes filing instructions. For many application types, the filing of certain supplemental forms is also required. In each instance, the appropriate supplemental form(s) are listed directly following the application form and can be downloaded in the same manner as the application. It is important to carefully read and follow all instructions and to provide full and complete responses. Investigation of the application may be delayed if the application is incomplete.

Application Forms

  • ESTABLISH A NEW SAVINGS AND LOAN ASSOCIATION
    • CCB-1121 Application of a New Bank or a New Savings and Loan Association for a Certificate of Authority to Begin Business in Virginia
      • SUPPLEMENTAL FORMS
        • CCB-1123 Personal Financial Report and Disclosure Statement
        • CCB-1147 Certification Form for Interagency Biographical and Financial Report
        • CCB-1150 Employment and Business Affiliation Disclosure Form
        • CCB-2206 Savings Institution Directors Responsibilities Certification
  • CERTIFICATE OF AUTHORITY TO BEGIN BUSINESS AS A SAVINGS BANK
    • CCB-2215 Application for a Certificate of Authority to Begin Business as a Savings Bank Pursuant to Title 6.2, Chapter 11, Article 2 of the Code of Virginia
      • SUPPLEMENTAL FORMS
        • CCB-1123 Personal Financial Report and Disclosure Statement
        • CCB-1147 Certification Form for Interagency Biographical and Financial Report
        • CCB-1150 Employment and Business Affiliation Disclosure Form
        • CCB-2206 Savings Institution Directors Responsibilities Certification
  • CONVERSION TO A STATE CHARTERED SAVINGS INSTITUTION
    • CCB-1146 Application to Convert Pursuant to Title 6.2 of the Code of Virginia
      • SUPPLEMENTAL FORMS
        • CCB-1123 Personal Financial Report and Disclosure Statement
        • CCB-1140 Oath of Office of Organizing Directors of Financial Institutions
        • CCB-1147 Certification Form for Interagency Biographical and Financial Report
        • CCB-1150 Employment and Business Affiliation Disclosure Form
        • CCB-2206 Savings Institution Directors Responsibilities Certification
  • ESTABLISH A SAVINGS INSTITUTION BRANCH
    • CCB-2201 Application to Establish a Savings Institution Branch
  • RELOCATE A MAIN OFFICE OF SAVINGS INSTITUTION BRANCH
    • CCB-1126 Application to Change the Location of a Main Office or Branch Pursuant to Title 6.2 of the Code of Virginia
  • NOTICE OF PROPOSED CHANGE OF LOCATION (WITHIN ONE MILE) OF A MAIN OFFICE OR BRANCH OF A SAVINGS INSTITUTION
    • CCB-2212 Notice of Proposed Change of Location of a Main Office or Branch of a Savings Institution Pursuant to Title 6.2, Chapter 11 of the Code of Virginia
  • NOTICE OF INTENT TO ESTABLISH A NON-DEPOSITORY OFFICE BY A SAVINGS INSTITUTION
    • CCB-2213 Notice of Intent to Establish a Non-Depository Office by a Savings Institution Pursuant to Section 6.2-1133 of the Code of Virginia
  • SAVINGS INSTITUTION HOLDING COMPANY FOR ACQUISITION OF CONTROL
    • CCB-2207 Application of a Savings Institution Holding Company for Acquisition of Control Pursuant to Section 6.2-1147 of the Code of Virginia and 10 VAC 5-30-10, ET SEQ.
      • SUPPLEMENTAL FORMS
        • CCB-1123 Personal Financial Report and Disclosure Statement
        • CCB-1137A Consent to Service of Process
        • CCB-1147 Certification Form for Interagency Biographical and Financial Report
        • CCB-1150 Employment and Business Affiliation Disclosure Form
  • OUT-OF-STATE SAVINGS INSTITUTION TO TRANSACT A SAVINGS INSTITUTION BUSINESS IN VIRGINIA
    • CCB-2209 Application by an Out-of-State Savings Institution to Transact a Savings Institution Business in Virginia Pursuant to Title 6.2, Chapter 11, Article 5 of the Code of Virginia
      • SUPPLEMENTAL FORMS
        • CCB-1123 Personal Financial Report and Disclosure Statement
        • CCB-1147 Certification Form for Interagency Biographical and Financial Report
        • CCB-1150 Employment and Business Affiliation Disclosure Form
        • CCB-2206 Savings Institution Directors Responsibilities Certification
  • ACQUIRE A VIRGINIA SAVINGS INSTITUTION HOLDING COMPANY OR VIRGINIA SAVINGS INSTITUTION
    • CCB-2210 Application to Acquire a Virginia Savings Institution Holding Company or Virginia Savings Institution Pursuant to Title 6.2, Chapter 11, Article 5 of the Code of Virginia
      • SUPPLEMENTAL FORMS
        • CCB-1123 Personal Financial Report and Disclosure Statement
        • CCB-1143 Limited Personal Financial Report and Disclosure Statement
        • CCB-1150 Employment and Business Affiliation Disclosure Form
        • CCB-2206 Savings Institution Directors Responsibilities Certification
    • NOTICE OF INTENT TO ACQUIRE A SAVINGS INSTITUTION OUTSIDE VIRGINIA
      • CCB-2211 Notice of Intent to Acquire a Savings Institution Outside Virginia Pursuant to Section 6.2-1160 of the Code of Virginia

SETTLEMENT AGENT REGISTRATION FORM

  • CCB-10001 Settlement Agent Registration Form for a Financial Institution or its Affiliate or Subsidiary Pursuant to Section 55.1-1014 of the Code of Virginia

Applications for qualified education loan servicer licenses must be submitted through the Nationwide Multistate Licensing System (NMLS). Federal student loan servicing contractors who qualify for automatic issuance of a license pursuant to § 6.2-2602 of the Code of Virginia may also document their eligibility and request the license through NMLS.  

Applications for acquisition of control of existing licensees must be submitted outside of NMLS using form CCB-12003. The application may require the filing of one or more of the supplemental forms listed below. It is important to carefully read and follow all instructions and to provide full and complete responses. Investigation of the application may be delayed if the application is incomplete.

Application Forms

  • APPLICATION FOR PERMISSION TO ACQUIRE CONTROL OF A QUALIFIED EDUCATION LOAN SERVICER LICENSEE
    • CCB-12003  Application for permission to acquire control of a qualified education loan servicer licensee Pursuant to § 6.2-2609 of the Code of Virginia
      • SUPPLEMENTAL FORMS
        • CCB-1123 Personal Financial Report and Disclosure Statement
        • CCB-1143 Limited Personal Financial Report and Disclosure Statement
        • CCB-1149 Depository Institution Authorization Form
        • CCB-1150 Employment and Business Affiliation Disclosure Form
        • CCB-12004 Criminal history records consent and fingerprinting instructions

Application Forms

  • ESTABLISH AN INDEPENDENT TRUST COMPANY
    • CCB-9900 Application of a Trust Company for a Certificate of Authority to Begin Business Pursuant to Title 6.2, Chapter 10, Article 2 of the Code of Virginia
      • SUPPLEMENTAL FORMS
        • CCB-1123 Personal Financial Report and Disclosure Statement
        • CCB-1140 Oath of Office of Organizing Directors of Financial Institutions
        • CCB-1150 Employment and Business Affiliation Disclosure Form
        • CCB-9901 Certificate of a Control Person of a Trust Company Pursuant to Section 6.2-1024 of the Code of Virginia
        • CCB-9902 Bond of a Trust Company
        • CCB-9904 Dual Service Certificate Affiliated Trust Companies
  • ESTABLISH A TRUST OFFICE
    • CCB-9905 Application to establish a Trust Office
  • RELOCATION
    • CCB-9907 Application to Change the Location of a Main Office or Branch Pursuant to Section 6.2-1028 of the Code of Virginia
  • PERMISSION TO ACQUIRE VOTING SHARES OF A TRUST COMPANY
    • CCB-9906 Application for Permission to Acquire Voting Shares of a Trust Company Pursuant to Section 6.2-1023 of the Code of Virginia
      • SUPPLEMENTAL FORMS
        • CCB-1123 Personal Financial Report and Disclosure Statement
        • CCB-1150 Employment and Business Affiliation Disclosure Form
        • CCB-9901 Certificate of a Control Person of a Trust Company Pursuant to Section 6.2-1024 of the Code of Virginia
  • ESTABLISH A PRIVATE TRUST COMPANY
    • CCB-9908 Notice of Intent to Engage in Business as a Private Trust Company