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P.O Box 10970 Santa Ana CA 92711
(1) 800 640-4042
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AGENTS PORTAL
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Registration form
Please complete the form below:
Are you a new agent, existing agent or employee?
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New agent
Existing agent
Agent Employee
Continental Employee
If you're human leave this blank:
User role
Select Role
New agent
Existing agent
Continental Employee
Agent Employee
Select your agent type
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Agent
Agent group
Enter your agent number
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User role agent
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Agent
Agent group
Agents Legal Name
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Agents DBA Names
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Address
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City
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State
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Zip Code
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Business Phone Number
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Your Phone Number
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Your Email
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Your Full Name
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Owner's Full Name
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Owner Cell Phone
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Owner's Email Address
Compliance Officer Name
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Compliance Officer's Phone
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Compliance Officer's Email Address
Department name
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Accounting
Compliance
Customer Services
Credit
IT Department
Manager
Sales Representative
Shipping Department
Trust
Do you have any Employee Acknowledgements?
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Yes
No
What is the number of Employee Acknowledgements you have?
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Prior to conducting money order transactions, the following employees have received training on Bank Secrecy Act reporting and recordkeeping requirements, USA Patriot Act and OFAC regulations including the reporting of suspicious activity and CEMO’s internal Policies and Procedures.
Employee name
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Date
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Employee name
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Date
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Employee name
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Date
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Employee name
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Date
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Employee name
*
Date
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Employee name
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Date
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Select a type of business
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Check Cashing
Grocery Store
Convenience Store (including liquor store)
Other (Please specify)
Other info...
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Does your company have more than one store offering CEMO’s service?
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Yes
No
How many?
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Store name
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Store name
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Store name
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Store name
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Store name
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Cash checks for more than $1,000
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N/A
Own Internal Policy
Adopted Provider's Policy
Provider's name
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Accept or exchange currency for more than $1,000
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N/A
Own Internal Policy
Adopted Provider's Policy
Provider's name
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Sell stored value card drawn on your account
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N/A
Own Internal Policy
Adopted Provider's Policy
Provider's name
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Provide money transfer services
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N/A
Own Internal Policy
Adopted Provider's Policy
Provider's name
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Password
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Confirm Password
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By checking this box I certify that the above information is true and correct. I understand that providing false or misleading information to avoid regulatory requirements can result in termination of agent relationship.
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I have read and accept the
privacy policy
and allow "Continental Express Money Order Company Inc." to collect and store the data I submit through this form.
*
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