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Forms for Existing Check Casher Licensees



Employee Criminal History Record Information Consent Form:

Each person employed shall complete an authorization for Criminal History Record Information Consent Form.  Prior to employment or not later than 30 days following employment the licensee shall cause a criminal background check to be performed on the person employed.



MSB Guide for Developing an Anti-Money Laundering (AML) Policy:


April 29, 2015
Verification of Lawful Presence for Mortgage and Money Services Applicants:

Pursuant to the Official Code of Georgia Annotated § 50-36-1, the Georgia Department of Banking and Finance (“Department”) is required to verify the lawful presence of every individual, corporation, partnership, limited liability company or other business entity submitting a new application.  Legal permanent residents, qualified aliens and non-immigrants are required to reverify their lawful presence annually at renewal.

Mortgage Loan Originators and Sole Proprietor Mortgage or Money Service Business applicants, seeking to obtain a license or registration in his or her own name will provide affidavit testimony regarding his or her legal presence in the United States using the attached Citizenship Affidavit.

For Mortgage Broker, Mortgage Lender, Check Casher, Money Transmitter and Seller of Payment Instrument company applicants (corporations, partnerships, limited liability companies or other business entities), only one individual, an owner or officer with the authority to act on behalf of the company, must complete and submit a signed, notarized affidavit.  The designated individual will be the “affiant,” providing affidavit testimony regarding his or her legal presence in the United States.

Please note that if the individual applicant, or the designated individual for a company, is not a United States citizen, this Department may be required by O.C.G.A. §50-36-1 to verify their immigration status through the Federal Systematic Alien Verification of Entitlement (SAVE) program.  Additional documentation may be requested.

Checklist for Completion

  • Print the Applicant or Licensee’s Name and NMLS (Nationwide Mortgage Licensing System) number.  This is the name in which the license is or will be held and its unique NMLS identifier.
  • Check only one of the boxes to indicate the affiant’s legal status (U.S. citizen, legal permanent resident, or qualified alien or non-immigrant).  A qualified alien or non-immigrant must also include his or her federally issued alien number along with a Foreign Passport and I-94, or an Employment Authorization Document that contains a photograph.
  • Check one of the secure and verifiable documents that will be submitted to verify the affiant’s legal status and attach a legible copy (front and back) to the affidavit. 
  • Print the city and state in which the document was executed.
  • Print the name of the Affiant and, for company applicants, his or her title for the company.
  • Affiant should sign the document in the presence of a notary who will affix his or her seal to the document.
  • Submit the original, signed, notarized affidavit along with a legible copy (front and back) of the secure and verifiable document selected to the Department.

Applications will not be processed without a complete and notarized affidavit.


MSB Report of Apparent Crime:

This form is for use in complying with Rule 80-3-1-.06(3) of the Department's Rules and Regulations pertaining to any criminal act or apparent criminal act by any officer, director, or employee of a licensee occurring in this state and relating to the business of the licensee.

MSB Report of Apparent Crime85.5 KB


May 23, 2014

Check Casher Surety Bond - Drafts Accepted for Collection with Payment Deferred

Check Casher Surety Bond73.26 KB



FinCEN Forms and Guidance (for compliance with applicable federal laws):