ࡱ> 9 'bjbj EhhM]PPPPPddd8@d94@t P!$2!8888888$<b?l8Pp$ p$p$8PP48&&&p$PP8&p$8&&ri1Ti2رl$1}88091?%|?i2i2?P}2F!!r&X"\"F!F!F!88h&F!F!F!9p$p$p$p$?F!F!F!F!F!F!F!F!F!X :  STATE OF MAINE Department of Professional and Financial Regulation Bureau of Financial Institutions Restricted Term(s) Filing 9-B M.R.S. 241(9), 882 General Instructions This form is to be utilized by an individual, corporation, partnership or other entity to serve notice of, or request permission for, the use one or more of the following restricted terms or derivations thereof: savings bank credit union and/or trust. For corporate filers, please provide proof of incorporation in your home jurisdiction. If in process of incorporating, please indicate in process. The Bureau reserves the right to request additional information as it deems necessary to render a decision on your filing. It is especially important that a detailed response to questions 6 and 7 be provided to satisfy the criteria under 9-B M.R.S. 241(9)(B) . You may provide any information in addition to that requested by the Bureau which, in your opinion, might aid in the disposition of your request. Any such unsolicited information will be accepted for consideration with the express understanding that it may be made public unless designated confidential. 1. Name of Business Entity (Actual and/or proposed): Assumed Name or d/b/a (if any): Address (number and street): City or Town, State, and Zip Code Telephone: ( ) Fax: ( ) State of Incorporation Internet Address (if applicable): 2. Is the entity: A financial institution, financial institution holding company, subsidiary, or affiliate of a financial institution? Yes  FORMCHECKBOX  No  FORMCHECKBOX  If NO, please skip to question 5 If YES, please complete the following information: Financial Institution name: ______________________________ Address of registered or principal office in jurisdiction of incorporation:  3. If the entity is a financial institution, please specify the following: ( Bank ( Savings & Loan Association ( Credit Union ( Holding Company ( Other (specify) _______________________ ( State Charter ( Federal Charter ( Foreign Financial Institution with Domestic Charter 4. Does the entity have the authority under its charter to both make loans and solicit or accept deposits or shares as a regular course of business? Yes ( No ( 5. For corporate filers: Attach copy of name, address, and state of incorporation, and send a copy of its certificate of good standing from the Secretary of State of the state of domicile, if applicable. If in process of incorporation, please indicate in process below. Please indicate any assumed or trade names used by the entity, parent company, subsidiary, or affiliate, if applicable. 6. Description of corporate purpose and activities to be conducted under requested name: (please be as specific as possible) 7. Description of prospective customers, target market and advertising activities in fb88 of proposed entity: 8. Will an office be maintained in the State of fb88? Yes  FORMCHECKBOX  No  FORMCHECKBOX  If yes, please answer the following with respect to the office location: Address (number and street): City or Town and Zip code Telephone:  ( ) Fax: ( ) Internet Address (if applicable): 9. Certification. This section must be completed by a person authorized to sign on behalf of the entity making this filing: I, _____________________________________, (print name and title) by checking the designated box below, do hereby attest and certify to the following: 1. I am authorized to make this declaration to comply with the provisions of 9-B M.R.S. 241(9); 2. I also declare that this report has been prepared in conformity with the relevant instructions issued by State of fb88, Department of Professional and Financial Regulation, Bureau of Financial Institutions, in accordance with the policies and procedures of _____________________________; (Name of company requesting to use restricted term) 3. I also declare that the contents of this form have been examined by me in their entirety; and, finally 4. Based upon my knowledge, I do hereby declare that the information and related disclosures contained in this report are true and correct. Dated this _______day of _________, 20___.  FORMCHECKBOX  Certification box (check here) Entity Name:  Signature of Authorized Signatory : Telephone Number (___)__________________________________ Email ______________________________________ 10. Authroized agent. If the person completing this filing on behalf of the entity listed is an authorized agent (e.g. attorney, paralegal) to which additional questions may be addressed, please provide the information listed below: Name:  Title: Address: City: State:  ____________________________________ _____________ Zip:  Telephone: ( )  Fax: ( ) E-Mail: PLEASE SUBMIT THIS FORM AND SUPPORTING DOCUMENTATION TO: Bureau of Financial Institutions36 State House StationAugusta, ME 04333-0036(207) 624-8570 phone(207) 624-8590 fax 9-B M.R.S. 241 (9) Restrictions on the use of the terms savings, bank and derivatives of those terms. This subsection governs the use of the terms savings, bank and derivatives of those terms. A. A person, if duly authorized under the laws of this State, another state or the United States to conduct the business of banking, may use as a part of the name or title under which it conducts business in this State the terms saving, savings, savings bank, bank, banker, trust, trust company, banking or trust and banking company. The superintendent may require the filing of supporting documentation relating to this paragraph in the form and manner and containing such information as the superintendent may prescribe. B. Except as provided in paragraph A, a person, without prior written approval of the superintendent, may not use the terms saving, savings, savings bank, bank, banker, trust, trust company, banking or trust and banking company or any derivatives of those terms as part of the name or title under which business is conducted or as a designation of such business. In determining whether to grant written permission, the superintendent shall consider whether the business to be conducted is similar to the business of banking and whether using those terms or any derivatives of those terms could be deceptive or otherwise injurious to public interest. C. This subsection does not apply to out-of-state financial institutions, corporations or partnerships that, in the ordinary course of business, have to file with the Secretary of State in processing the routine disposition of assets acquired by legitimate business dealings. D. A person who violates any provision of this subsection is subject to a civil penalty of not more than $10,000 for each violation. E. This subsection does not prohibit the use of any name of a person who was duly qualified to do business as a foreign corporation in that name under Title 13-A, section 1201 on February 1, 1996. 9-B M.R.S. 882 Restriction on the use of the term Credit Union and derivatives of that term. No person, partnership or association and no corporation, except one incorporated under this Part or the corresponding provisions of earlier laws, may receive payments on shares from its members and nonmembers as provided in section 817 and loan such payment on shares and transact business under any name or title containing the words credit union without the prior written approval of the bank superintendent or unless organized under provisions of federal law. Whoever violates any provision of this section must be punished by a fine of not more than $10,000, and the Superior Court has jurisdiction to grant appropriate equitable relief to enforce this section.     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