Each application for a license under the Nebraska Money Transmitters Act shall be made in writing and in a form prescribed by the director. Each application shall state or contain:

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(1) For all applicants:

(a) The exact name of the applicant, the applicant’s principal address, any fictitious or trade name used by the applicant in the conduct of its business, and the location of the applicant’s business records;

(b) The history of the applicant’s criminal convictions and material litigation for the five-year period before the date of the application;

(c) A description of the activities conducted by the applicant and a history of operations;

(d) A description of the business activities in which the applicant seeks to be engaged in this state;

(e) A list identifying the applicant’s proposed authorized delegates in this state, if any, at the time of the filing of the application;

(f) A sample authorized delegate contract, if applicable;

(g) A sample form of payment instrument, if applicable;

(h) The locations at which the applicant and its authorized delegates, if any, propose to conduct money transmission in this state; and

(i) The name, address, and account information of each clearing bank or banks, which shall be covered by federal deposit insurance, on which the applicant’s payment instruments and funds received for transmission or otherwise will be drawn or through which the payment instruments or other funds will be payable;

(2) If the applicant is a corporation, the applicant shall also provide:

(a) The date of the applicant’s incorporation and state of incorporation;

(b) A certificate of good standing from the state in which the applicant was incorporated;

(c) A certificate of authority from the Secretary of State to conduct business in this state;

(d) A description of the corporate structure of the applicant, including the identity of any parent or subsidiary of the applicant, and a disclosure of whether any parent or subsidiary is publicly traded on any stock exchange;

(e) The name, business and residence addresses, and employment history for the five-year period immediately before the date of the application of the applicant’s executive officers and the officers or managers who will be in charge of the applicant’s activities to be licensed under the act;

(f) The name, business and residence addresses, and employment history for the five-year period immediately before the date of the application and the most recent personal financial statement of any key shareholder of the applicant;

(g) The history of material litigation for the five-year period immediately before the date of the application of every executive officer or key shareholder of the applicant;

(h) Background checks as provided in section 8-2730 ;

(i) A copy of the applicant’s most recent audited financial statement including balance sheet, statement of income or loss, statement of changes in shareholder equity, and statement of changes in financial position and, if available, the applicant’s audited financial statements for the immediately preceding two-year period. However, if the applicant is a wholly owned subsidiary of another corporation, the applicant may submit either the parent corporation’s consolidated audited financial statements for the current year and for the immediately preceding two-year period or the parent corporation’s Form 10-K reports filed with the United States Securities and Exchange Commission for the prior three years in lieu of the applicant’s financial statements. If the applicant is a wholly owned subsidiary of a corporation having its principal place of business outside the United States, similar documentation filed with the parent corporation’s non-United States regulator may be submitted to satisfy this subdivision; and

(j) Copies of all filings, if any, made by the applicant with the United States Securities and Exchange Commission or with a similar regulator in a country other than the United States, within the year preceding the date of filing of the application; and

(3) If the applicant is not a corporation, the applicant shall also provide:

(a) The name, business and residence addresses, personal financial statement, and employment history, for the five-year period immediately before the date of the application, of each principal of the applicant and the name, business and residence addresses, and employment history for the five-year period immediately before the date of the application of any other person or persons who will be in charge of the applicant’s money transmission activities;

(b) A copy of the applicant’s registration or qualification to do business in this state;

(c) The history of material litigation for the five-year period immediately before the date of the application for each individual having any ownership interest in the applicant and each individual who exercises supervisory responsibility with respect to the applicant’s activities;

(d) Background checks as provided in section 8-2730 ; and

(e) Copies of the applicant’s audited financial statements including balance sheet, statement of income or loss, and statement of changes in financial position for the current year and, if available, for the immediately preceding two-year period.