DFI Forms - Master List (by number)

Notice to Individual - Use of Information

Form Number Title Revised Format
DFI 9 Citizen Complaint Form * Not to be used for Consumer Complaints against a DFI Licensee. 10-12 PDF
FDIC 3064-006 Interagency Biographical and Financial Report Form   PDF
HUD-GFE Good Faith Estimate Form (GFE). Available in the following languages: English; Chinese - 汉语; Korean Korean; Spanish - Español; Tagalog;  Vietnamese - Tính Từ. 06-10 PDF
DFI 2 Personal Financial Statement 09-12 PDF
DFI 3 Confidential Resume 08-12 PDF
DFI 10 Application for Authority to Organize Bank 09-12 PDF
DFI 14 Division 1.4 Management Certification 09-12 PDF
DFI 25 Uniform California Application/Notice (Word / PDF) 08-12 Word / PDF
DFI 55 Appointment of the Commissioner of Financial Institutions as Attorney for Service of Process (Foreign (Other State) Insured Bank Facility) 01-06 PDF
DFI 65 Appointment of the Commissioner of Financial Institutions as Attorney for Service of Process (Foreign (Other State) Non-Insured Bank Facility) 01-06 PDF
DFI 75 Appointment of the Commissioner of Financial Institutions as Attorney for Service of Process (Representative Office Application) 01-06 PDF
DFI 85 Appointment of the Commissioner of Financial Institutions as Attorney for Service of Process (Agency or Branch Application) 09-12 PDF
DFI 88 Application for Approval to Act as Approved Depository 02-07 PDF
DFI 90 Agreement of Approved Depository 02-07 PDF
DFI 93 Application for Approval for Withdrawal and Release of Eligible Assets 02-07 PDF
DFI 95 Report of Applicable Minimum 02-07  
DFI 301 Summary of Merger Approval Process - Credit Unions (Word | PDF) 04-13 PDF
DFI 310 Sample Form of Application - Credit Unions (Word | PDF) 04-13 PDF
DFI 320 Sample Form of Plan of Merger - Credit Unions (Word | PDF) 04-13 PDF
DFI 330 Sample Form of Notice of Merger - Credit Unions (Word | PDF) 04-13 PDF
DFI 340 Sample Form of Officers' Certificate Regarding Giving of Notice - Credit Unions (Word | PDF) 04-13 PDF
DFI 350 Sample Form of Certificate of Merger of Surviving Credit Union (Word | PDF) 04-13 PDF
DFI 360 Sample Form of Certificate of Merger of Disappearing Credit Union (Word | PDF) 04-13 PDF
DFI 370 Residential Mortgage Loan Report - Credit Unions 08-12 PDF
DFI 380 Credit Union Official - Questionnaire 01-06 PDF
DFI 390 Application for Approval to Form a Credit Union 10-08 PDF
DFI 391 Organizing a State Credit Union Information Booklet 08-08 PDF
DFI 502 Trust Company Report of Condition 03-10 Excel
DFI 502 Trust Company Report of Condition Instructions 03-10 PDF
DFI 505 Schedule T - Fiduciary and Related Services 09-10 Excel
DFI 506 Schedule U 02-03 Excel
DFI 507 Schedule S - discontinued 12/31/08    
DFI 507C Call Report Certification Page for State Chartered Banks 08-12 PDF
DFI 510 Depositaries 12-12 PDF
DFI 523 Report of Income for Foreign Banks 12-03 Excel
DFI 523C Call Report Certification Page for Foreign Banks 08-12 PDF
DFI 524 Trust Company Report of Income 03-10 Excel
DFI 525 Money Transmitter Call Report Excel
DFI 550 Emergency Contact Person Information 01-06 PDF
DFI 700 Application for Authorization to Invest in Corporation 08-12 PDF
DFI 704 Agreement to Comply with Regulations 08-12 PDF
DFI 706 Appointment of Commissioner of Financial Institutions as Agent for Service of Process 08-12 PDF
DFI 801 Consumer Complaint Form 11-10 PDF
DFI 801B Formulario para quejas del consumidor al DFI 04-09 Word
DFI 1004 Local Agency Security Program Collateral Transfer   PDF
DFI 1005 Local Agency Security Program Form   Word
DFI 1010 Application for License as Business and Industrial Development Corporation 02-07 PDF
DFI 1802 Stock Purchase Questionnaire 01-06 PDF
DFI 1815 Before the Department of Financial Institutions 01-06 PDF
DFI 1820 For Item 2(d) of the Premium Finance Company Application 06-06 PDF
DFI 1821 Customer Authorization of Disclosure of Financial Records 01-06 PDF
DFI 2110 Application for a License to Engage in the Business of Receiving Money for the Purpose of Transmitting the Same or its Equivalent 01-12 PDF
DFI 2118 Application for Approval to Acquire Control of Money Transmitter 01-12 PDF
DFI 2120 Complaint Regarding An Unlicensed Money Transmitter/Queja Con Respecto A Un Transmisor De Dinero No Authorizado 05-12 PDF
DFI 4025 Appointment of Commissioner of Financial Institutions as Agent for Service of Process (Payment Instruments) 02-07 PDF
DFI 4030 Authorization for Release of Information (Money Transmitters) 01-12 PDF
5010PI Application for License under Payment Instruments Law 02-07 PDF
5020PI Agreement of Applicant for License under Payment Instruments Law 02-07 PDF
DFI 5025 Appointment of Commissioner of Financial Institutions as Agent for Service of Process (Money Transmitters) 08-12 PDF