Browsers that can not handle javascript will not be able to access some features of this site.
Skip Navigation
LARA: Michigan Department of Licensing and Regulatory AffairsMichigan.gov: Official Web Site for the State of Michigan
Michigan.gov HomeLARA Home | Sitemap | Contacts | Online Services | Agencies
Printer Friendly Version Printer Friendly   Text Only Version Text Version  Share this page.
Consumer Financial Services Forms

• FIS 2053 PDF icon
Financial Statement Disclosure

• Fee Schedule Consumer Financial Services PDF icon

• FIS 1098 PDF icon
Consumer Financial Services Application

• Consumer Financial Services Application Packet PDF icon
Contains Forms: FIS 1098, FIS 2050, FIS 2051, FIS 2053, and FIS 2054

Credit Card Forms

• Fee Schedule Credit Card PDF icon

• FIS 1030 PDF icon
License Application - Application and Procedures

Debt Management

• FIS 0506 Debt Management Initial Application Packet PDF icon
Complete application packet except that applicants must also download and file either form FIS 0508 Surety Bond OR FIS 0509 Deposit of Cash or Securities. Read form instructions for details.

• Debt Management Schedule of Fees PDF icon

• FIS 0506 PDF icon
Application form only (additional forms are required to make application)

• FIS 0508 PDF icon
Bond for Licensee

• FIS 0509 PDF icon
Deposit of Cash or Securities in Lieu of Bond

• FIS 0510 PDF icon
Application for Consent to Service of Process

• FIS 0511 PDF icon
Employment List

• FIS 0512 PDF icon
Business History Form

• FIS 0513 PDF icon
Affidavit of Character

• FIS 0514 PDF icon
Financial Statement

• FIS 0515 PDF icon
Employment Notification

• FIS 0516 PDF icon
Termination Notification

• FIS 0517 PDF icon
Alternative Bond in Lieu of Michigan Based Trust Account

• FIS 0550 PDF icon
Debt Management Fee Processing Card

• Debt Management Examination Study Aid PDF icon

• FIS 0590 PDF icon
Debt Management Complaint Form

Deferred Presentment Service Providers

• Fee Schedule Deferred Presentment PDF icon

• Application forms packet for Deferred Presentment Service Providers (DPSPs) PDF icon
Forms to make application for initial license to transact business as a Deferred Presentment Services Provider in Michigan. Also see optional Substitute FIS 2041 Branch Offices List below.

• Substitute for form FIS 2041 Branch Office List for Deferred Presentment Service Providers (DPSPs) Excel icon
Excel compatible spreadsheet to file Branch Office data on a CD in lieu of paper form FIS 2041. For initial applications with four or more branch listings only.

Money Transmission Services Providers

• Fee Schedule Money Transmission PDF icon

• FIS 2060 and related forms PDF icon
Package to make application for a license to conduct business as a Money Transmission Services Provider in Michigan. All required forms for application except form FIS 2061 (use link below).

• FIS 2061 Excel icon
List of Authorized Delegates and Additional Locations. This filing can be made by enclosing a CD containing the completed file in an Excel compatible format.

Motor Vehicle Sales Fin. / Install. Seller Forms

• FIS 1028 PDF icon
Application, Procedures and Fees

Mortgage Loan Originator License Forms

• Nationwide Mortgage Licensing System (NMLS)

• FIS 2135 Surety Bond PDF icon
Bond - Mortgage Loan Originator - INDIVIDUAL

• FIS 2137 PDF icon
Bond - Mortgage Loan Originator - COMPANY

• Schedule of Fees for Mortgage Loan Originators PDF icon

Mortgage Broker, Lender, or Servicer Forms

• Fee Schedule First Mortgage PDF icon

• FIS 2053 PDF icon
Financial Statement Disclosure

• FIS 1140 MI Specific Forms for Mortgage Application PDF icon
Start with form FIS 1140 Michigan Specific Forms for Mortgage Application.

• Annual Report - First Mortgage
FIS 1077 Updated here after each annual mailing.

• FIS 1076 Financial Statement PDF icon

Premium Finance Company Forms

• FIS 0852 PDF icon
Instructions for Application for Licensure

• FIS 0853 PDF icon
Premium Finance Company License Fee Card

• FIS 0855 PDF icon
Premium Finance Company Balance Sheet

• FIS 0856 PDF icon
Application For Insurance Premium Finance Company License

• FIS 0857 PDF icon
Statement of Owners, Officers, and Directors of a Premium Finance Company

• FIS 0858 PDF icon
Insurance Premium Finance Company Corporate Surety Bond

Regulatory Loan Forms

• Fee Schedule Regulatory Loan PDF icon

• FIS 1026 PDF icon
Application and Procedures

Secondary Mortgage Forms

• Annual Report - Secondary Mortgage
FIS 1080 Updated here after each annual mailing.

• Fee Schedule Secondary Mortgage PDF icon

• FIS 1076 Financial Statement PDF icon


Quick Links
 •  How to File a Complaint
 •  Consumer Finance Bulletins
 •  Regulated Consumer Finance Entities

Michigan.gov Home | LARA Home | State Web Sites | Office of Regulatory Reinvention
Accessibility Policy | Link Policy | Privacy Policy | Security Policy | Michigan News | Michigan.gov Survey


Copyright © 2001-2012 State of Michigan