Information Regarding / Información acerca de Unlicensed Money Transmitter / Your Personal Information /

Transcription

1 STATE OF CALIFORNIA BUSINESS, TRANSPORTATION AND HOUSING AGENCY DEPARTMENT OF FINANCIAL INSTITUTIONS WILLIAM S. HARAF, Commissioner of Financial Institutions COMPLAINT REGARDING AN UNLICENSED MONEY TRANSMITTER / QUEJA CON RESPECTO A UN TRANSMISOR DE DINERO NO AUTHORIZADO Information Regarding / Información acerca de Unlicensed Money Transmitter / Your Personal Information / Transmisor de Dinero Sin Licencia Su Información Personal Name and Office Address / Your Name and Address / Nombre y Dirección de la Oficina Su Nombre y Dirección Telephone / Teléfono Your Address / Su Dirección de Correo Electrónico Contact Person / Persona de Contacto Your Telephone / Su Teléfono Your Fax Number / Su Número de Fax Your Employer / So Empleador How and when did you become aware of this money transmitter? Describe everything you personally observed about the conduct of its money transmission business. Submit copies of the following documents with this form: receipts, advertisements, photographs of money transmitter office(s), and brochures that show the person or company complained of are engaged in the business of money transmission. Cómo y cuándo usted se enteró de este transmisor de dinero? Describe todo lo que personalmente observó sobre la conducta de su negocio de envío de dinero. Envíe copias de los siguientes documentos con esta forma: recibos publicidad, fotografías de transmisor de dinero, y folletos que muestran la persona o la empresa denunciada está dedicado al negocio de transmisión de dinero. 45 Fremont Street, Suite 1700 San Francisco, CA (415) th Street Sacramento, CA (916) S. Spring Street, Suite Los Angeles, CA (213) Metropolitan Drive, Suite 108 San Diego, CA (619)

2 COMPLAINT REGARDING AN UNLICENSED MONEY TRANSMITTER / QUEJA CON RESPECTO A UN TRANSMISOR DE DINERO NO AUTHORIZADO Page / Pagina 2 Are you willing to appear in court to testify to the foregoing? Yes / Sí No / No Está usted dispuesto a comparecer ante el tribunal para dar testimonio de lo anterior? Your Signature / Su Firma Date / Fecha Please complete and mail or fax this form and related documents to the address below. Form 2120 (Rev ) Julio Prada Department of Financial Institutions 45 Fremont Street, Suite 1700 San Francisco, CA jprada@dfi.ca.gov Fax #: (415)

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