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Forms for Existing Money Transmitter Licensees

Application for Change in Control of a Money Transmitter Licensee
Biographical Statement and Consent Form (MSB3)
Surety Bond Form
Fingerprint Processing
Other Department Forms and Guidance
FinCEN Forms and Guidance
Online Licensee Payments



UPGRADES/DOWNGRADES:  The Department requires a new application and licensing fee for all requests to upgrade or downgrade any license type.

A Money Transmission Licensee that would like to upgrade to a Seller-Issuer of Payment Instruments License will have to complete and submit to the Department a new application.


June 30, 2014
Application for Change in Control/Ownership of  Seller-Issuer of Payment Instruments or Money Transmitter Licensee:

This application must be filed by any/each person seeking to acquire 10% or more of the voting shares of a corporation or a 10% or more controlling interest in any other entity licensed to conduct business as a Seller-Issuer of Payment Instruments or Money Transmitter in Georgia.  There is a non-refundable application fee of 500 dollars.

Change in Officer or Director of a Licensee - Prior to taking position, any/each person seeking to be an officer or director of a seller-issuer of payment instruments or money transmitter licensee must provide certain documentation in order to be approved by this Department. This is similar to the process for one seeking to acquire 10% or more.

Note that a credit report will be pulled as permission is granted by the MSB3 Form. Issues including collections, charge-offs with balances, public records/liens, will need to be resolved prior to approval.


  1. One company buys or invests directly or indirectly in a licensee
  2. Individuals become owners of 10% or more
  3. New directors join the Board of Directors
  4. Officer changes occur, including the Compliance Officer

Please do not bind, hole punch or staple the completed application package.


June 30, 2014
Seller-Issuer of Payment Instruments and Money Transmitter Biographical Statement and Consent Form (MSB3):


May 23, 2014

Surety Bond form for Seller-Issuer of Payment Instruments and Money Transmitter Licensees

Surety Bond Form (fillable PDF)50.31 KB




Fingerprint Processing  - "GAPS"

June 9, 2014

For certain applicants and individuals, the Department requires background checks (criminal history record searches using fingerprints). Georgia Application Processing Services (GAPS) provides fixed office locations throughout the state of Georgia for fingerprint services in a non-criminal justice environment. Individuals that reside in Georgia are required to have their fingerprint background checks processed at a GAPS location but must first contact the Department to be registered to do so. In-state individuals, please see the Attachment below entitled, “GA DBF In-State GAPS Fingerprint Instructions.”

For out-of-state applicants, GAPS provides a procedure for fingerprint cards to be submitted directly to 3M Cogent. Out-of-state individuals, please see the Attachment below entitled, “GA DBF Out-of-State Fingerprint Instructions.”



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


Verification of Lawful Presence within the United States (MSBs):

The Georgia Department of Banking and Finance is required to verify the lawful presence of every individual, corporation, partnership, limited liability company or other business entity submitting a new or renewal application.


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




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



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