New Mexico Regulation & Licensing Department FINANCIAL ...

New Mexico Regulation & Licensing Department

FINANCIAL INSTITUTIONS DIVISION

P.O. Box 25101 - 2550 Cerrillos Rd 3rd Floor ? Santa Fe, NM 87504 Phone: (505) 476-4885 - Fax: (505) 476-4670 - rld.state.nm.us/financialinstitutions

Small Loan Reporting Requirement Form (2017 Reporting Period)

In accordance with the provisions of ?58-15-10.1 NMSA 1978, this form must be submitted by all Small Loan Licensees who issued a loan with a disclosed annual interest rate (APR) greater

than one-hundred seventy-five percent (175%) as disclosed pursuant to 12 C.F.R. 226 ("Regulation Z") between January 1, 2016 and December 31, 2016.

ALL LOAN PRODUCT INFORMATION IS TO BE REPORTED FOR THE REPORTING PERIOD OF JANUARY 1 2016 THROUGH DECEMBER 31, 2016.

Please note this form does not apply to Payday Loan Information

INSTRUCTIONS

1) Fill out the Worksheet attached for each loan product of each location (excluding Payday Loans) with an annual interest rate (APR) greater than 175% as disclosed pursuant to "Regulation Z".

Enter Information in designated areas only. Please note, if using the PDF version, you must submit a separate form for each location.

2) Fill out, sign, and certify the "Signature of Certification".

3) Send the completed form and "Signature of Certification" Document to the Financial

Institutions Division via email at the following address no later than March 31, 2017.

You may email to the address below with any questions you may have regarding the

form.

SL.Reporting@state.nm.us

Failure by the licensee to file this report timely, accurately, or completely may result in the following Administrative Penalties ?58-15-10.1 (D) (1) and (2) NMSA 1978:

1) Fines in an amount not to exceed one-thousand five hundred dollars ($1,500) per day after the thirty-first day of March that a complete and accurate report is not filed.

2) Suspension of the licensee's required license under the New Mexico Small Loan Act of 1955 ?58-15-31 NMSA 1978.

Loan Products as defined by the Financial Institutions Division:

Title Loans:

Defined as "a loan secured by the borrower's vehicle title, which is structured to be a short term, fixed rate, closed end transaction usually

paid in one installment".

Installment Loans (Unsecured):

Defined as "a loan that is to be repaid in a minimum of four successive substantially equal payment amounts to pay off a loan in its entirety with a period of no less than one hundred twenty

days to maturity." This loan type has no collateral associated with this loan product.

Installment Loans (Vehicle Title Secured):

Defined as "a loan that is to be repaid in a minimum of four successive substantially equal payment amounts to pay off a loan in its entirety with a period of no less than one hundred twenty days to maturity." This loan type is secured by vehicle title that is clearly identified on the loan

documents.

Installment Loans (Secured):

Defined as "a loan that is to be repaid in a minimum of four successive substantially equal payment amounts to pay off a loan in its entirety with a period of no less than one hundred twenty days to maturity." This loan type is secured by

collateral other than Vehicle Titles.

Refund Anticipation Loans:

Defined as a loan that is secured by the proceeds from a consumer's anticipated income tax refund

or tax credit.

Other Loans:

Loans that do not fall within the defined guidelines of the various loan products. (i.e. Holiday Loans,

Convenience Check loans)

2017 SL Reporting Form

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SIGNATURE OF CERTIFICATION Company Name: License Number(s):

I PRINT NAME

certify under penalty of perjury that this report and the information.

contained herein is complete and accurate as of this 2017.

day of

,

I affirm that the information contained in this electronic filing is true, correct, and complete to the best of my knowledge and belief.

Print Name

Signature

Title

Email Address

2017 SL Reporting Form

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Small Loan Reporting Form (2017 Reporting Period)

TITLE LOANS

Defined as "a loan secured by the borrower's vehicle title, which is structured to be a short term, fixed rate, closed end transaction usually paid in one installment".

Section #1

Enter the following information.

Company Name

License Number for the reported licensed location A separate form must be submitted for each licensed location.

Section #2

Enter an "X" for all applicable fees associated with this loan product in boxes below.

Acquisition Fees Attorney Fees Documentation Fees Interest Fees NSF Fees Storage Fees Other (Provide a Description)

Application / Origination Fees Delinquency / Late Fees Electronic Filing Fees Title Lien Fees Repossession Fees Tax Prep Fees

Section #3

For Each Licensed location, enter the Minimum, Maximum and Average annual interest rate as disclosed pursuant to CFR 226 "Regulation Z for this loan product". ?58-15-10.1 (A) (1) (b) NMSA 1978

Minimum per licensed location Maximum per licensed location Average per licensed location

2017 SL Reporting Form

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Section #4

Enter the following information.

Frequency of Periodic Payments (?58-15-10.1(A) (1) (c) NMSA 1978) Enter an "X" for all applicable payment frequencies in the boxes below.

Single Pay- 14 to 15 Days Single Pay- Other Term Weekly Monthly Semi-Annually Other (Provide a Description) Term of the Loan Product. (?58-15-10.1(A) (1) (d) NMSA 1978) Enter an "X" for all applicable loan term in the boxes below.

Single Pay- 30 Days Daily

Bi-Weekly Bi-Monthly Annually

Less than 14 Days 15 Days 31 to 60 Days 91 Days to 5 Months 7 Months to 11 Months 13 Months to 17 Months 19 Months to 23 Months 2 to 5 Years

14 Days 16 to 30 Days

61 to 90 Days 6 Months 12 Months 18 Months 24 Months 5 Years or Greater

Any Other Standard Condition of this product. (?58-15-10.1(A) (1) (e) NMSA 1978)

2017 SL Reporting Form

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