N J DEPARTMENT OF BANKING AND INSURANCE
LICENSING SERVICES BUREAU
P O BOX 473
TRENTON, NJ 08625
BRANCH OFFICE INSTRUCTIONS
1. Indicate the type of branch license being requested in the space provided.
2. Type or print clearly all answers. Do not leave any questions unanswered. If a question is not
applicable or the answer is none, please type or print N/A or NONE.
3. Insert on line #1, the complete name of the corporation, limited liability company, partnership, or sole
proprietorship exactly as it appears in your incorporation/formation papers as filed with the N J
Division of Revenue or on your trade name certificate filed with your County Clerk’s office.
4. Application must be properly signed and dated. Signatures must be witnessed by a notary public or
attorney.
5. Send a company check or money order made payable to: Treasurer, State of New Jersey. The
check must be in the amount listed in the schedule below for the license type selected on the
application. Personal checks are not accepted.
LICENSE TYPE
FEE
Motor Vehicle Installment
Seller
Insurance Premium Finance
Company
NOTE: All fees submitted with an application are NON-REFUNDABLE.
Questions regarding an application may be directed to (609) 292-7272 – follow the prompts and select
option #3, then select option #2, and then select option #1 to be connected to Banking Licensing.
Send to: For Overnight delivery:
Licensing Services Bureau Licensing Services Bureau:
Dept. of Banking & Insurance Dept. of Banking & Insurance
P.O. Box 473 20 W. State St. – 8
th
Floor
Trenton, NJ 08625 Trenton, NJ 08608
GENBRINST811