REGISTRATION TYPE

CERTIFIED CAPITAL COMPANIES

LICENSE TYPE

CAPCO

FEE: Department of Financial Services

$7500 Cashier's or certified check, or money order

APPLICATION FORM

Application for Certification as Certified Capital Company - FORM OFR-C-1-98

NET CAPITAL REQUIREMENT

$500,000

DEADLINE TO FILE

12/1/98

CONSENT TO SERVICE OF PROCESS

N/A

CORPORATE RESOLUTION

N/A

PROSPECTUS/OFFERING DOCUMENT

N/A

OTHER EXHIBITS

Exhibits

AUDITED FINANCIALS

(In accordance with GAAP)

Most recent FY audited

UNAUDITED FINANCIALS

(In accordance with GAAP)

If audited financials are not dated within 90 days of filing, submit unaudited financials as reviewed by a CPA, together with most recent audited statements. If in business for less than one year, submit unaudited financials as reviewed by a CPA.

APPLICABLE FLORIDA ADMINISTRATIVE CODE RULES

Chapter 69W-7 Florida Administrative Code

COMPLIANCE REQUIREMENTS

RENEWAL FEE (ANNUALLY)

$5000

RENEWAL DEADLINE

12/31 annually

FORM

N/A

TERMINATION

Terminates automatically upon failure to renew.

REINSTATEMENT FEE

No provision for reinstatement

REINSTATEMENT DEADLINE

No provision for reinstatement

REINSTATEMENT RETROACTIVE?

No provision for reinstatement

AMENDMENTS (To Report Changes)

Amended Form OFR-C-1-98 Chapter 69W-7