Form FinCEN Form 107 FinCEN Form 107 Registration of Money Services Business

Bank Secrecy Act
Registration of Money Services Business (RMSB)

FinCEN Report 107
BSA E-File Only

Part I

Always complete entire report.
See instructions for items marked with an asterisk ( * ).

OMB No.1506-0013

Filing Information

1 Indicate the type of filing by checking a, b, or d below (Check only one). If filing a correction, check c and either a, b, or d.
a
e

Initial registration

b

Renewal

c

Correct/amend a prior report

d

Re-registration

Enter MSB registration (BSA ID) number if 1b, 1c, or 1d is checked

2 If you checked item 1d, please indicate the reason(s). Check all that apply.
a

Re-registered under state law

Part II

b

More than 10 percent transfer of equity interest

c

More than 50 percent increase in agents

Registrant Information
a

*3 Individual’s last name, or entity’s legal name

If entity

*4 First name

6 Alternate name, e.g., AKA - individual or DBA - entity *7 Address

*10 ZIP/Postal Code

15 Telephone number

*9 State

*8 City
*13 TIN a
type b
c

*12 TIN

*11 Country
code

5 Middle initial

15 a Ext.

EIN
SSN/ITIN
Foreign

14 Date of birth
____ / ___ /_______
MM

DD

YYYY

16 E-mail address (If available)

17 Website address (URL) (If available)
18 Name of compliance contact person for this registered MSB

Part III

19 Compliance telephone number

19 a Ext.

Owner or Controlling Person
a

20 Individual’s last name, or entity’s legal name
24 City

23 Address
28 TIN

32 Website address (URL) (If available)

21 First name
25 State

29 TIN a
type b
c

Part IV

Entity

EIN
SSN/ITIN
Foreign

22 Middle initial

26 ZIP/Postal Code

30 Date of birth

27 Country
code

31 E-mail address (If available)

____ / ___ /_______
MM

DD

YYYY

33 a Ext.

33 Telephone number

Money Services and Product Information

*34 U.S. States and/or territories where the registrant, its agents or branches are physically located and/or providing MSB activities. Note: At
least one box in item 34 must be checked. Check box a, b, or c as appropriate (Check only one). If box a, b, or c does not apply, check
as many state/territory boxes as appropriate. If MSB engages in activities on tribal lands, mark the box for the state, territory or district in
which the tribal lands are located. In addition, check box “d” if the MSB engages in activities in foreign locations (non-U.S. and US Territories).
a

All States & Territories

b

All States c

All Territories

d

Foreign location(s)

Alabama (AL)

Georgia (GA)

Maryland (MD)

New York (NY)

South Dakota (SD)

Alaska (AK)

Guam (GU)

Massachusetts (MA)

North Carolina (NC)

Tennessee (TN)

American Samoa (AS)

Hawaii (HI)

Michigan (MI)

North Dakota (ND)

Texas (TX)

Arizona (AZ)

Idaho (ID)

Minnesota (MN)

N. Mariana Isls. (MP)

Utah (UT)

Arkansas (AR)

Illinois (IL)

Mississippi (MS)

Ohio (OH)

Vermont (VT)

California (CA)

Indiana (IN)

Missouri (MO)

Oklahoma (OK)

Virgin Islands (VI)

Colorado (CO)

Iowa (IA)

Montana (MT)

Oregon (OR)

Virginia (VA)

Connecticut (CT)

Kansas (KS)

Nebraska (NE)

Palau (PW)

Washington (WA)

Delaware (DE)

Kentucky (KY)

Nevada (NV)

Pennsylvania (PA)

West Virginia (WV)

District of Columbia (DC)

Louisiana (LA)

New Hampshire (NH)

Puerto Rico (PR)

Wisconsin (WI)

FS of Micronesia (FM)

Maine (ME)

New Jersey (NJ)

Rhode Island (RI)

Wyoming (WY)

Florida (FL)

Marshall Islands (MH)

New Mexico (NM)

South Carolina (SC)

Catalog Number 39578N

Rev. 21.5 (2-3-12)

Part IV

(continued)

2

35 Enter the number of U.S. branches of the registrant. Reminder: do not separately register each branch.
See instructions for an explanation of the term “branch.”
*36 Money services business activities of the registrant in the U.S. Check as many as apply. See instructions for an explanation of the terms.
d
Seller of money orders
a
Issuer of traveler’s checks
g
Check casher (Including traveler’s and money orders)
b

Seller of traveler’s checks

e

Dealer in foreign exchange

h

Seller of prepaid access

c

Issuer of money orders

f

Money transmitter

i

Provider of prepaid access (If checked, complete 38-43)

37 If you are providing financial services in addition to those checked in item 36 please briefly describe.
If item “36i” is checked, provide the following information (items 38 to 43) to identify each prepaid program for which the registrant is the provider
of prepaid access (Information for up to 999 programs may be entered).
39 IIN (BIN) of this program
38 Name of prepaid program
40 Name of primary transaction processor
(First six digits mandatory)
42 Contact phone number

41 Name of compliance contact person for this program
43 Is this prepaid program useable internationally?

Yes

42a Ext.

No

44 Is any part of the registrant’s U.S. money services business an informal value transfer system?
a
See the explanation of “money transmitter” and “ informal value transfer system” in the instructions.

Yes

b

No

a

Yes

b

No

45 Is any part of the registrant’s U.S. money services business conducted as a mobile operation?

46 Enter the number of U.S. agents authorized to conduct each money services business activity. Do not include US branches, or persons who
are solely employees. See instructions for an explanation of the term “agent.”
d Number of US agents conducting
a Number of US agents selling
money transmission
traveler’s checks
b Number of US agents selling
money orders

e Number of US agents engaged in
check cashing (Including traveler’s
checks and money orders)

c Number of US agents involved
as a dealer in foreign exchange

f Number of US agents selling
prepaid access

Part V

Primary Transaction Account for MSB Activities

NOTE:

See instructions for an explanation of the term “transaction account.” The registrant’s primary transaction account is the account that has
the greatest annual dollar amount of money services business activity. In items 47 through 56 enter information about the registrant’s
primary transaction account for money services business activities.
56 Type of financial institution where the primary transaction account is held (NOTE: If box “a” is checked, items 48 and 49
are required. If box “c” is checked, item 50 is required).
a
Depository institution
b
Non-depository institution
c
Foreign
47 Name of financial institution where the primary transaction account is held
49 Primary account number
51 Address

Part VI

48 Depository financial institution routing number

50 Depository financial institution IBAN (If foreign)
52 City

53 State 54 ZIP/Postal Code

55 Country
code

U.S. Location of Supporting Documentation/Address of Agent for Service of Process

If the supporting documentation is kept at the U.S. location reported in Part II check here
and continue to Part VII. If not, provide the U.S.
location of where the supporting documentation is kept here in Part VI. If the MSB is located outside of the U. S., enter U.S. location of the U.S.
agent for service of legal process. Do not enter a non-U.S. address
57

Address

Part VII

59 State

58 City

60 ZIP Code

Authorized Signature/Signature of Agent for Service of Process

I am authorized to file this form on behalf of the money services business listed in Part II. I declare that the information provided is true, correct
and complete. I understand that the money services business listed in Part II is subject to the Bank Secrecy Act and its implementing regulations.
The money services business listed in Part II maintains a current list of all agents, an estimate of its business volume in the coming year, and all
other information required to comply with 31 U.S.C. 5330 and the regulations thereunder. The signature of the owner, controlling person,
authorized corporate officer, or U.S. agent for service of legal process is mandatory.
*62 Signature

63 Print name

64 Title

65 Date of signature

______ / _____ / _______
MM
DD
YYYY

Rev. 12/21

Registration of Money Services Business Instructions for FinCEN Form 107
General Information
Who Must Register
Generally money services businesses (MSBs) must
register with the Department of the Treasury, using
this report, FinCEN 107, Registration of Money
Services Business (RMSB). However, not all MSBs
are required to register. For example, if you are an
MSB solely because you are an agent of another
MSB, you are not required to register. The
discussion below will help you determine whether
or not you are an MSB that is required to register.
For more information visit http://www.fincen.gov/
financial_institutions/msb/.
The term “money services business” includes:
1. Dealer in foreign exchange who transacts in an
amount greater than $1,000 for any one customer
on any day, whether or not for same day delivery.
2. Check casher who accepts checks or other
monetary instruments in an amount greater than
$1,000 in return for currency or a combination of
currency and other monetary instruments for any
one customer on any day.
3. Issuer or seller of traveler’s checks or money
orders who issues or sells more than $1,000 in
traveler’s checks or money orders for any one
customer on any day. “Issuer” is defined or
determined by virtue of the amount at which its
monetary instruments or traveler’s checks are sold,
as opposed to the amounts at which they are issued.
For example, the amount of the sale includes the
face value of the monetary instruments plus any
fees.

The following are not required to register:
1. A business that is an MSB solely because it serves
as an agent of another MSB. An agent is a person
authorized to represent the principal and to transact business on its behalf with third parties. See
further discussion of “agent” below. For example,
a supermarket corporation that sells money orders for an issuer of money orders is not required
to register. This is true even if the supermarket
corporation serves as an agent for two or more
issuers. However, an MSB that serves as an agent
of another MSB and engages in MSB activities on
its own behalf must register. For example, a supermarket corporation must register if, in addition to acting as an agent of the money order
issuer, it also provides check cashing or currency
exchange services on its own behalf in an amount
greater than $1,000 for any one person on any
day.
2. The United States Postal Service, any agency
of the United States, of any state, or of any political
subdivision of any state.
3. A seller of prepaid access is any person that
receives funds or the value of funds in exchange
for an initial loading or subsequent loading of
prepaid access, if that person: (1) sells prepaid
access offered under a prepaid program that can be
used before verification of customer identification;
or (2) sells prepaid access, including closed loop
prepaid access, in excess of $10,000 to any person
on any one day and has not implemented policies
and procedures reasonably adapted to prevent such
a sale..
For the regulatory definition of “money services
business” see 31 CFR 1010.100 (ff).
The following terms are used to describe an MSB:

4. Provider of prepaid access who agrees to be the
provider with respect to a prepaid access program
or is determined to have principal oversight and
control over the prepaid access program. The
provider serves as the principal conduit for access
to information from its fellow program participants. Considerations for a provider determination include whether a party organizes the program; sets the terms and conditions of the prepaid
program and determines that the terms have not
been exceeded; determines the other businesses
that will participate in the prepaid program, which
may include the issuing bank, the payment processor, or the distributor; controls or directs the
appropriate party to initiate, freeze, or terminate
prepaid access; and engages in activity that demonstrates oversight and control of the prepaid
program.
5. Money transmitter.
6. U.S. Postal Service.
7. Seller of prepaid access. A seller is an MSB,
however, as stated below, such an MSB is not
required to register.

1. An “agent” is a separate business entity from
the issuer that the issuer authorizes, through written
agreement or otherwise, to sell its instruments,
products or services, or, in the case of funds
transmission, to sell its money transmission
services. A person who is solely an employee of
the MSB is not an agent of that MSB. A branch is
not a separate business entity and is therefore not
an agent.
2. A “branch” is an owned location of either an
issuer or agent at which financial services are
provided. An MSB should not separately register
each of its branches. A mobile operation owned by
an MSB (i.e., conducting MSB services from a
vehicle) is considered to be a branch of that MSB.
The MSB’s headquarters is not a branch. If the
MSB has only one location, that location is not a
branch.

1

3. A “check casher” is a person that accepts checks
(as defined in the Uniform Commercial Code), or
monetary instruments (as defined at §
1010.100(dd)(1)(ii), (iii), (iv), and (v)) in return
for currency or a combination of currency and
other monetary instruments or other instruments
(e.g., money orders, traveler ’s checks), in an
amount greater than $1,000 for any person on
any day in one or more transactions.
4. A “dealer in foreign exchange” is a person that
accepts the currency, or other monetary
instruments, funds, or other instruments
denominated in the currency, of one or more
countries in exchange for the currency, or other
monetary instruments, funds, or other instruments
denominated in the currency, of one or more other
countries in an amount greater than $1,000 for
any other person on any day in one or more
transactions, whether or not for same day delivery.
5. “Informal value transfer system.”
See
explanation of the term money transmitter.
6. An “issuer” is the business that is ultimately
responsible for payment of money orders or
travelers checks as the drawer of such instruments,
or a money transmitter that has the obligation to
guarantee payment of a money transfer.
7. A “money transmitter” is (A) a person that
provides money transmission services. The term
‘‘money transmission services’’ means the
acceptance of currency, funds, or other value that
substitutes for currency from one person and the
transmission of currency, funds, or other value
that substitutes for currency to another location
or person by any means. ‘‘Any means’’ includes,
but is not limited to, through a financial agency or
institution; a Federal Reserve Bank or other facility
of one or more Federal Reserve Banks, the Board
of Governors of the Federal Reserve System, or
both; an electronic funds transfer network; or an
informal value transfer system; or (B) Any other
person engaged in the transfer of funds.
An “informal value transfer system” is a kind of
money transmitter. An informal value transfer
system includes any person who engages as a
business in an informal money transfer system or
any network of people who engage as a business in
facilitating the transfer of money domestically or
internationally outside of the conventional
financial institutions system.
8. A “person” is an individual, a corporation, a
partnership, a trust or estate, a joint stock
company, an association, a syndicate, joint venture,
or other unincorporated organization or group, an
Indian Tribe (as that term is defined in the Indian
Gaming Regulatory Act), and all entities cognizable
as legal personalities.

Registration of Money Services Business Instructions for FinCEN Form 107
9. A “seller” is a business that issuers or providers
authorize, through written agreement or otherwise,
to sell their instruments, services, or products or
their money transmission services.

De-registration: There is no formal process for
removing or ceasing the registered status of an
MSB. See FinCEN Guidance FIN-2006-G006
(February 3, 2006), titled “Registration and DeRegistration of Money Services Businesses”

10. A “transaction account” is a deposit or account
on which the depositor or account holder is
permitted to make withdrawals by negotiable or
transferable instrument, payment orders of
withdrawal, telephone transfers, or other similar
items for the purpose of making payments or
transfers to third persons or others. Such term
includes demand deposits, negotiable order of
withdrawal accounts, savings deposits subject to
automatic transfers, and share draft accounts. See
12 USC 461(b)(1)(c).

http://www.fincen.gov/financial_institutions/msb/
pdf/msbregistration_de_registration.pdf

Where and When to Register
Where to Register:
Go to the BSA E-Filing Home Page; http://
bsaefiling.fincen.treas.gov/main.html and if
not registered click on “Become a BSA EFiler” button to establish and set up your
account. If you are already registered, log
into your account.
When to Register:
Initial registration: File the report within 180
days after the date the business is established.
Renewal: Each MSB must renew its registration
every two years, on or before December 31. See
31 CFR 1022.380(b)(2). For example, if an MSB
registered on October 15, 2003, it must file a
renewal by December 31, 2004, and then every 24
months thereafter (on or before December 31,
2006, then December 31, 2008, etc.). Renewals
must be submitted on a new FinCEN Report
107. Photocopies of previously submitted
forms/reports or facsimiles will not be
accepted for renewal purposes
Special Actions:
Correct/amend a prior report: Log in to the BSA
E-File website, and complete all Parts of a new
FinCEN Report 107.
Re-registration: Refile a new registration report
when one of the following events occurs:
1. a change in ownership requiring re-registration
under state registration law;
2. more than 10 percent of voting power or equity
interest is transferred (except certain publiclytraded companies) or;
3. the number of agents increases by more than 50
percent.

The Financial Crimes Enforcement Network
(FinCEN) will immediately send a confirmation
message of receipt of filing upon submission. An
acknowledgment that the registration has been
accepted, processed, and recorded will be available
on the E-Filing System status page in
approximately two business days. The listing will
be published on FinCEN’s official MSB registration
list (URL TBD) in approximately two weeks. If
you have general questions about MSB regulatory
requirements, please contact FinCEN’s Regulatory
Helpline at 800-949-2732, Option 1. If you have
electronic filing questions, please contact the BSA
E-Filing Help Desk at 866-346-9478, Option 1.
General Instructions
NOTE: All items on FinCEN Report 107
should be completed fully and accurately.
Items marked with an asterisk (*) must be
completed for the registration to be accepted,
processed, and recorded.
1. This report is available on the FinCEN’s BSA EFiling web site at http://bsaefiling.fincen.treas.gov/
main.html.
2. Unless there is a specific instruction to the
contrary, leave blank any items that do not apply
or for which information is not available.
3. Complete the report by providing as much
information as possible.
4. Do not include supporting documents with this
report.
5. Enter all dates in MM / DD / YYYY format
where MM=month, DD=day, and YYYY=year.
Precede any single number with a zero, i.e., 01,
02, etc.
6. List all U.S. telephone numbers with area code
first and then the seven-digit phone number, using
the format (XXX) XXX-XXXX.
7. Always enter an individual’s name as last name,
first name, and middle initial (if known). If a legal
entity is listed, enter its name in the last name
field.
8. Enter identifying numbers starting from left to
right. Do not include spaces, dashes, or other
punctuation. Identifying numbers include social
security number (SSN), employer identification
number (EIN), individual taxpayer identification
number (ITIN), alien registration number, driver’s

2

license/state identification, foreign national
identification, and passport number.
9. Enter all Post Office ZIP Codes from left to
right with at least the first five numbers, or with
all nine (ZIP + 4) if known.
10. Addresses: Enter the US permanent street
address, city, two-letter state or territory
abbreviation used by the U.S. Postal Service and
ZIP Code (ZIP+4 if known) of the individual or
entity. A post office box number should not be
used for an individual, unless no other address is
available. For an individual, also enter any
apartment number, suite number, or road or route
number. If a P.O. Box is used for an entity, enter
the street name, suite number, and road or route
number.
If the address of the individual or entity in PART
II or III is in a foreign country, enter the city,
province or state, postal code and the name of the
country. Complete any part of the address that is
known, even if the entire address is not known.
Specific Instructions
Part I

Filing Information

See “When to Register” in the General
Information part of these instructions.
Item 1— Check either box a, b, or d (only one)
for the type of filing. If this report corrects an
earlier filing, check box c and either box a, b, or d
and enter the RMSB registration (BSA ID) number
in the space provided in e.
Item 2— If you checked box 1d, please indicate
the reason by checking boxes a, b, or c (check all
that apply).
Part II

Registrant Information

Enter information for the US State or Territory
operating location.
Items *3, *4, and 5— Individual’s last name,
or entity’s legal name, First name, and
Middle initial. If a sole proprietorship, enter
the last name of the proprietor in item *3,
followed by the first name and middle initial in
items *4 and 5, respectively. If an entity, enter
the full legal name of the registrant money services
business as it is shown on the charter or other
document creating the entity in item *3 and check
the “If entity” box in the upper right hand corner.
Leave items *4 and 5 blank. For example, enter
“Good Hope Enterprises, Inc.” when the money
services business is Good Hope Enterprises, Inc.
Item 6— Alternate name, e.g., AKA individual or DBA - entity. If applicable, enter
any alternate name of the registrant, such as a
separate Doing Business As name. For example, if
Good Hope Enterprises, Inc., is doing business as

Registration of Money Services Business Instructions for FinCEN Form 107
“Joe’s Check Cashing” enter in item 6, “Joe’s
Check Cashing.”
Items *7, *8, *9, *10, and *11— Address. Enter
the permanent address of the registrant that is
being registered. If the permanent address is not
located in the United States, enter the country
code in item *11 and as much of the information
in items *9 and *10 as possible. Country codes
can be found in the BSA e-filing drop-down list.
Item *12— TIN (Tax Identification Number).
If the registrant is an entity, enter its employer
identification number (EIN). If the registrant is
an individual and a U. S. Citizen or an alien with a
social security number, enter his/her SSN. If the
registrant is an individual who is an alien and has
an individual taxpayer identification number, enter
his/her ITIN.
Item *13— TIN type. Indicate what type of
identification number was entered into item *12,
SSN/ITIN or EIN. If the entity does not have a
SSN, ITIN or EIN and is located outside of the
United States, indicate that the entity is foreign.
If foreign is checked, *12 maybe left blank.
Item 14— Date of Birth. Indicate the date of
birth of the individual or sole proprietor registrant
identified in item *3. If item *3 is an entity, leave
Item 14, Date of Birth, blank.
Item 15— Telephone number. Enter the
telephone number of the MSB listed in item 3,
including any extension where applicable.
Item 16— E-mail address (If available). If the
MSB has an e-mail address please enter it here. An
e-mail address may be used to contact the MSB
should questions arise regarding its registration.
Item 17— Website address (URL) (If
available). If the MSB has a website, please enter
the URL here. The website may be used to confirm
any details of the registration that are unclear or
incomplete.
Item 18— Name of compliance contact person
for this registered MSB. Enter name “if entity”
is checked or if a different individual from the
individual listed in item 3.
Item 19— Compliance telephone number.
Item19a— Extension (if applicable).
Part III

Owner or Controlling Person

General: Any person who owns or controls an
MSB, or is an authorized agent in the United States,
is responsible for registering the MSB. Only one
registration report is required for any business in
any registration period.
If more than one person owns or controls the
business, they may enter into an agreement
designating one of them to register the business.
The designated owner or controlling person must
complete Part III and provide the requested
information. In addition, that person must sign
and date the form as indicated in Part VII. Failure

by the designated person to register the business
does not relieve any other person who owns or
controls the business of the liability for failure to
register the business.
An “Owner or Controlling Person” includes the
following:
Registrant Business

Owner or Controlling
Person

Sole Proprietorship.........the individual who
owns the business
Partnership......................a general partner
Trust...............................a trustee
Corporation.....................the largest single
shareholder
If two or more persons own equal numbers of
shares of a corporation, those persons may
enter into an agreement as explained above that
one of those persons may register the business.
If the owner or controlling person is a
corporation, a duly authorized officer of the
owner-corporation may execute the form on
behalf of the owner-corporation.
Items 20 to 33—Enter the applicable information
for the owner or controlling person. The
individual’s home address and phone number should
not be used, unless a business address and phone
number are unavailable.
Items 23, 24, 25, 26, and 27— Address. Enter
the permanent address of the owner or controlling
person. If the permanent address is not located in
the United States, enter the country code in item
27 and as much of the information in items 25 and
26 as possible. Country codes can be found in the
BSA e-filing drop-down list.
Item 28—TIN. If the owner or controlling person
is an entity, enter its employer identification
number (EIN). If the owner or controlling person
is an individual and a U. S. Citizen or an alien with
a social security number, enter his/her SSN. If the
owner or controlling person is an individual who is
an alien and has an individual taxpayer
identification number, enter his/her ITIN.
Item 29— TIN type. Indicate what type of
identification number was entered into item 28,
SSN/ITIN or EIN. If the entity does not have a
SSN, ITIN or EIN and is located outside of the
United States, indicate that the entity is foreign.
If foreign is checked, 26 maybe left blank.
Item 30— Date of Birth. Indicate the date of
birth of the individual or sole proprietor registrant
identified in Item 20. If item 20 is an entity, leave
blank.
Item 31— E-mail address (If available). If the
individual or entity listed in item 20 has an e-mail
address, please enter it here. An e-mail address

3

may be used should questions arise regarding this
registration.
Item 32— Website address (URL) (If
available). If the individual or entity listed in
item 20 has a website, please enter the URL here.
The website may be used to confirm any details of
the registration that are unclear or incomplete.
Item 33 and 33a— Telephone number and
Extension (if any). Enter the telephone number
of the individual or entity listed in item 20,
including any extension where applicable.
Part IV
Money Services and Product
Information
Item *34 —US States and/or territories where
the registrant, its agents or branches are
physically located and/or providing MSB
activities (At least one box must be chacked).
Check box “a” for All States and Territories, “b”for
All States, or “c” for All Territories (Check only
one) as appropriate. If box a, b, or c does not
apply, check as many state/territory boxes as
appropriate. If MSB engages in activitiees on tribal
lands, mark the box for the state, territory or
district in which the tribal lands are located. In
addition, check box “d” if the MSB engages in
activities in foreign lacations (non-US and US
Territories).
Item 35 —Enter the number of branches of
the registrant. Enter the number of branches of
the money services business at which one or more
MSB activities are offered. If there are no branches,
enter zero. See the General Information for an
explanation of the term “branch.”
Item *36 —MSB activities of the registrant
(At least one box must be checked). Items
36a through 36i are MSB activities. Check the
box of each MSB activity conducted by the
registrant at its branches. See the General
Information for an explanation of the terms
“issuer,” “seller,” “dealer in foreign exchange,”
“check casher,” “provider of prepaid access,”
“seller of prepaid access,” and “money
transmitter.” An MSB that is a seller of prepaid
access, or whose only activity is as a seller of
other MSB’s products, is an agent MSB and has no
requirement to register. However, a principal MSB
also engaging in selling activities must indicate
those activities in this part.
Item *36i— A Provider of prepaid access is required
to “identify each prepaid program for which it is
the provider of prepaid access.” What constitutes
a separate prepaid program is left to the business
judgment of the provider of prepaid access;
however, the information required in items 38 43 is illustrative of the factors that should be
considered. Items 38 to 43 may be repeated up to
999 times. For example, where programs have
separate names, different issuing banks or Issuer
Identification Numbers (IIN), or where one
program can be used internationally and another
not, the programs should be identified separately.

Registration of Money Services Business Instructions for FinCEN Form 107
Item 37— If you are providing financial services
in addition to those checked in item 34 please
briefly describe.
Item
38—
Prepaid Access
Program
Identification. If item 36i (Provider of Prepaid
Access) is checked, the Provider must “identify
each prepaid program for which the registrant is
the provider of prepaid access. . . . .” Item 38
allows space to identify the name(s) of the
program(s) for which the registrant is a provider.
A “program” for item 38 may be ascertained by
the services offered or geographical areas served
or by some other manner determined by the
provider. Or, a Provider may want to identify
similar prepaid programs with a description such
as “payroll programs,” “loyalty/awards/promotion
programs,” or “business-to-business programs.”
Item 39— IIN/ BIN. List the Issuer Identification
Number (“IIN”) or the bank identification number
(“BIN), if any (First six digits are mandatory).
Item 40— Name of primary transaction
processor. Provide the name of the primary
transaction processor with whom the Provider
contracts for its particular prepaid access
program(s). The particular processor sought in
this response is the entity capable of reconstructing
transactions (e.g., loads, re-loads, transfers,
transaction sites, dollar amounts) and prepaid
access activity generally. There is no need to list
multiple processors or sub-processors in this item’s
response.
Items 41, 42, and 42a— Name and telephone
number of compliance contact person for this
program. (Complete only if different than
PART II items 18, 19, and 19a) Provide the
name and telephone number of a person with
knowledge of the program and who can be a
meaningful contact for law enforcement. Such a
person may be one with day-to-day knowledge of
the program.
Item
43—Is
this
program
useable
internationally? A program may be useable
internationally if funds or the value of funds are
accessible, by any means, outside of the United
States. Accordingly, if for example, the program
allows for ATM usage or point of sale transactions
in countries outside of the United States, it is
useable internationally.
Item 44 —Informal value transfer system. If
any part of the registrant’s money services business
is an informal value transfer system, check yes.
An informal value transfer system is a kind of
money transmitter. See the General Information
explanation of the term “money transmitter.”
Item 45 —Mobile operation/Conducting MSB
services from a vehicle. If any part of the
registrant’s money services business is conducted
as a mobile operation, check yes. A mobile
operation is one based in a vehicle. For example, a

check cashing service offered from a truck is a
mobile operation. For purposes of item 35, each
mobile operation should be counted as a separate
branch.
Item 46 —Number of agents. Enter the number
of agents that the registrant has authorized to sell
or distribute its MSB services. Do not count the
MSB headquarters, branches or any person who is
solely an employee of the MSB. A bank is not an
agent for this purpose.
See the General
Information for an explanation of the term
“agent.”
Part V Primary Transaction Account for
MSB Activities
Items 47, 48 and 49—Name of the financial
institution where the primary transaction
account is held, routing number and account
number. Enter the name of the bank or other
financial institution where the registrant has its
primary transaction account. Provide the routing
number (the digits on the lower left side of a check)
and the account number (the digits centered on
the bottom of a check) for the primary transaction
account. See the General Information for an
explanation of the term “transaction account.”
Item 50—Depository financial institution
IBAN (international bank account number,
if foreign). If the transaction account is
maintained at a financial institution located outside
of the United States (Item 55 is other than US),
enter the account’s international bank account
number.
Items 51 to 54—Enter the address for the
financial institution where the transaction account
is maintained.
Item 55 –Country code. If the permanent
address is not located in the United States, enter
the country code in item 55. Country codes can be
found in the BSA e-filing drop-down list.
Item 56—Type of financial institution where
the primary transaction account is held.
Check box “a” if the primary account is held at a
bank, thrift or credit union, or check box “b” if
the primary account is held at a financial institution
other than a bank. In addition to box “a” or “b,”
check box “c” if the depository institution or non-

4

depository institution is located outside of the
United States. For example, box “a” and box “c”
may be checked if the primary transaction account
is held at a bank located outside of the United
States.
Part VI
US Location of Supporting
Documentation/ Address of Agent for Service
of Process
Designation of Agent for Service of Process
A foreign located MSB is required by 31 CFR
1022.380(2) to “designate the name and address
of a person who resides in the United States and is
authorized, and has agreed, to be an agent to accept
service of legal process . . . .” Designation of such
an agent is accomplished by entering the agent’s
information in Part VI, Location of Supporting
Documentation/Address of Agent for Service of
Process, and having the agent sign the document
on behalf of the MSB in Part VII, Authorized
Signature/Signature of Agent for Service of Process.
The agent is required to hold the supporting
documentation and agent list described in Part VI
at the listed location on behalf of the foreign
located MSB.
The agent signing on behalf of the foreign located
MSB in Part VII certifies as follows: “I am
authorized to file this form on behalf of the money
services business listed in Part II. I declare that
the information provided is true, correct and
complete. I understand that the money services
business listed in Part II is subject to the Bank
Secrecy Act and its implementing regulations. The
money services business listed in Part II maintains
a current list of all agents, an estimate of its business
volume in the coming year, and all other
information required to comply with 31 U.S.C.
5330 and the regulations thereunder.”
General: The U.S. located registrant or the
foreign located registrant’s U.S. agent for service
of legal process must retain for five (5) years
certain information at a location within the United
States. That information includes:
Documents supporting the MSB’s existence may
include:
1. A copy of the registration form.
2. Annual estimate of the volume of the registrant’s
business in the coming year.
3. The following information regarding ownership
or control of the business: the name and address
of any shareholder holding more than 5% of the
registrant’s stock, any general partner, any trustee,
and/or any director or officer of the business.

Registration of Money Services Business Instructions for FinCEN Form 107
4. An agent list.
If the registrant has agents, it must prepare and
maintain a list of its agents. That agent list must
be updated annually and retained by the business
at the location in the United States reported on
this registration form in Part II or Part VI. The
agent list should not be filed with this
registration form.
The agent list must include:
a. Each agent’s name,
b. Each agent’s address,
c. Each agent’s telephone number,
d. The type of service(s) provided by each
agent on behalf of the registrant,
e. A listing of the months in the immediately
preceding 12 months in which the gross
transaction amount of each agent with respect
to financial products/services issued by the
registrant exceeds $100,000,
f. The name and address of any depository
institution at which each agent maintains a
transaction account for the money services
business activities conducted by the agent on
behalf of the registrant,
g. The year in which each agent first became
an agent of the registrant, and
h. The number of branches or subagents of
each agent.
Items 57 to 60—If the supporting
documentation is retained at a U.S. location other
than the U.S. address listed in Part II, enter the
location information in items 57 through 60. If
the registrant is a foreign located MSB, enter
the location of the registrant’s U.S. agent for
service of legal process where the supporting
documentation must be maintained. Do not enter
a non-US address.

Part VII Authorized Signature/Signature
of Agent for Service of Process
Items *62 to 65—The U.S. owner or controlling
person listed in Part III, or, in the case of a
foreign located MSB, the U.S. agent for service
of legal process, must sign and date the form as
indicated in Part VII. If the owner or controlling
person is a corporation, a duly authorized officer
of the corporation must execute the form on
behalf of the corporation. Enter the date this
document was signed.
Penalties for failure to comply: Any person
who fails to comply with the requirements to
register, keep records, and/or maintain agent lists
pursuant to 31 CFR 1022.380 may be liable for
civil penalties of up to $5,000 for each violation.
Failure to comply also may subject a person to
criminal penalties, which may include
imprisonment for up to five (5) years and
criminal fines. See 18 USC 1960. Note: This
registration does not satisfy any state or
local
licensing
or
registration
requirements.
Paperwork Reduction Act Notice.
The purposes of this form are to provide an
effective and consistent means for money
services businesses to register with the Financial
Crimes Enforcement Network, and to assure
maintenance of reports or records where such
reports or records have a high degree of usefulness
in criminal, tax, or regulatory investigations or
proceedings. This report is required by law,
pursuant to authority contained in Public Law
103-305; 31 USC 5330; 5 USC 301; 31 CFR
Chapter X. The information collected may be
provided to those officers and employees of any
constituent unit of the Department of the
Treasury who have a need for the records in the
performance of their duties. The records may be
referred to any other department or agency of
the United States, to any State, or Tribal
Government.
Public
reporting
and
recordkeeping burden for this information

5

collection is estimated to average 45 minutes
per response, and includes time to gather and
maintain data for the required report, review the
instructions, and complete the information
collection. Send comments regarding this burden
estimate, including suggestions for reducing the
burden, to the Office of Management and Budget
Paperwork Reduction Project, Washington, DC
20503 and to the Paperwork Reduction Act;
Department of the Treasury, Financial Crimes
Enforcement Network, P.O. Box 39, Vienna, VA
22183-0039. The agency may not conduct or
sponsor, and an organization (or a person) is not
required to respond to, a collection of
information unless it displays a currently valid
OMB control number.
Privacy Act Notice.
Pursuant to the requirements of Public Law 93579 (Privacy Act of 1974), notice is hereby
given that, in accordance with 5 U.S.C. 552a(e),
the authority to collect information on FinCEN
Report 107 is Public Law 103-305; 31 USC
5330; 5 USC 301; 31 CFR Chapter X. The
Department of the Treasury may use and share
the information with any other department or
agency of the United States, to any State, or
Tribal Government, or part thereof, upon the
request of the head of such department or agency,
or authorized State or Tribal Government official
for use in a criminal, tax, or regulatory
investigation or proceeding, and to foreign
governments in accordance with an agreement,
or a treaty. Disclosure of this information is
mandatory. Civil and criminal penalties, including
in certain circumstances a fine of not more than
$5,000 per day and imprisonment of not more
than five years, are provided for failure to file
the form, supply information requested by the
form, and for filing a false or fraudulent form.
Disclosure of the social security number or
taxpayer identification number is mandatory.
The authority to collect is 31 CFR Chapter X.
The
social
security
number/taxpayer
identification number will be used as a means to
identify the individual or entity who files the
report.