Hawaii Digital Currency Innovation Lab

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Hawaii Digital Currency Innovation Lab Application

Administered by Hawaii Technology Development Corporation (HTDC)
& Division of Financial Institutions (DFI) of Department of Commerce & Consumer Affairs (DCCA)

GENERAL INFORMATION
Application Information & Process
To facilitate the ease of completing this application, we recommend referring to the .pdf format of this application to learn more about the documents and information we need from your company.
(Link to .pdf copy of application form hosted on HTDC website under "Application & Admission")

Applicants are welcome to save and resume the application process.

The application deadline is 05-01-2020 (end of day, Hawaii time). 

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Application & Participation Fees

For assistance, please email fintech@htdc.org and we will get back to you.
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Please note that this information should be consistent with the information currently on record with the Business Registration Division of the State of Hawaii Department of Commerce and Consumer Affairs, including a Hawaii address for the agent.
COMPANY INFORMATION: BASIC

All items with are required.






NMLS - Nationwide Multistate Licensing System
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Applicant's Legal Name









Street Address
Street Address Line 2
City
State
Postal/Zip Code
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Designated Contact (if different from Applicant)








COMPANY INFORMATION: REGISTERED AGENT












Street Address
Street Address Line 2
City
Postal/Zip Code
COMPANY INFORMATION: CERTIFICATE OF GOOD STANDING

All items with are required.

To participate in the Hawaii Digital Currency Innovation Lab, your company needs to provide a Certificate of Good Standing issued by the Business Registration Division of the State of Hawaii Department of Commerce and Consumer Affairs. Please note that the certificate must be dated not more than 60 days prior to the filing of an application through NMLS.

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For assistance, please email fintech@htdc.org and we will get back to you.
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FINANCIAL INFORMATION: BANK ACCOUNT(S)
Provide the legal name and address of the clearing bank or banks that will be used in the Hawaii Digital Currency Innovation Lab. Each clearing bank must be a U.S. financial institution whose deposits are insured by the Federal Deposit Insurance Corporation. Funds designated as permissible investments must be held in trust or "FBO" account(s).






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FINANCIAL INFORMATION: HAWAII OFFICE/BRANCH/STORE LOCATION(S)
a) Provide a list of proposed Hawaii office/branch/store location(s), if any, through which your company intends to conduct business activities in the State of Hawaii. In this list, include:
(i) the name designated by your company for each office/branch
(ii) the address of each location

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b) If applicable, provide a list of proposed Hawaii office/branch location(s) where your company intends to use company-owned ATM terminals to provide your products/services. In this list, include:
(i) the name designated by your company for each office/branch
(ii) the address of each location

FINANCIAL INFORMATION: AUTHORIZED AGENT(S) / DELEGATE(S) LOCATION(S)
Provide a list of authorized agent(s). Parties who own ATMs through which your company will provide its money transmittal services are considered to be authorized delegates and must be included in the agent listing.

FINANCIAL INFORMATION: FINANCIAL STATEMENTS
Note: A licensee must have a net worth of no less than $1,000, at all times. Financial statements for the Applicant must be prepared in accordance with U.S. Generally Accepted Accounting Principles (U.S. GAAP).





For assistance, please email fintech@htdc.org and we will get back to you.
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BUSINESS INFORMATION
a) BUSINESS PLAN
Provide a business plan with sections describing the following:

1. Background
  • Business activities conducted by your company and a history of its operations (if applicable)
2. Products and Services
  • Business activities in which your company seeks to be engaged in or introduce to the State of Hawaii
  • The innovative product or service your company plans to deploy 
3. Target Market(s)
  • Your target audience (demographics, attributes etc.)
  • Product/Service benefits for your target markets 
  • Risks to consumers who purchase or use your product or service, and how an injured consumer will be made whole
4. Operating Structure
  • The operating structure that your company intends to employ
5. Future Plans
  • How participating in this pilot program would enable a successful test of your product or service

For assistance, please email fintech@htdc.org and we will get back to you.
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BUSINESS INFORMATION
b) ORGANIZATIONAL DESCRIPTION & CHART 
In your document:
i) Describe the corporate structure, including the identity of any parent or subsidiary of your company
ii) Give a brief description of the activity of the parent(s) (ultimate and immediate) or subsidiaries
iii) Indicate whether any parent or subsidiary is publicly traded on any stock exchange 
iv) Identify all shareholders of the direct or indirect owners that control 25% or more of any voting class of stock and their respective percentage of ownership
v) Include an organizational chart if your company is owned by another entity or entities or person, or has subsidiaries or affiliated entities

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c) MANAGEMENT CHART 
Provide a document containing an organization management chart showing your company's divisions, officers, and managers.

Audit Information
a) Anti-Money Laundering Program (AML) / Office of Foreign Assets Control (OFAC) Policy: 


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b) Information Technology Security 
Submit a copy of your company's most recent independent information technology security audit

Payment Instruments
DOCUMENT SAMPLE 
Provide a sample form of all payment instruments to be used in your company's business, if applicable (check, draft, money order, traveler's check, or order (electronic or written) or receipt (electronic or written) for the transmission of money or monetary value identifying the sender, recipient of the transmitted funds, date monies received, amount to be transmitted, fee(s), exchange rate, and total amount received from the sender).

For assistance, please email fintech@htdc.org and we will get back to you.
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Reporting Guidelines

Pilot Program Survey

Project Conclusion
Describe procedures for wind-down activities as the pilot program concludes and if your company decides to withdraw from the pilot program before it ends.                                           
For instance, please include specifics on:
i) The time you will start notifying customers about the termination of your product/service
ii) Contact details for customers if they have questions after the pilot program ends

Disclaimers

1. No acceptance of application shall be perceived as, or constitute any endorsement of an applicant. No denial shall be perceived as, nor constitute any repudiation of an applicant. Applications which have potentially predatory, unfair, or deceptive features, pose undue risks to consumers, or institutions, or are inconsistent with the policies of this program, will not be permitted into the program. HTDC does not approve, endorse, nor prioritize any particular applicant within this program.  

2. Application approval is at HTDC’s discretion. Applicants do not have any rights or privileges. HTDC has the full discretion to accept or reject applications and there is no right to due process in this program. There is no contested case or appeals process, and no contractual rights or contractual remedies.

3. HTDC has the authority to suspend, revoke, and/or terminate any application or participation in the program on any, or even no, basis. No explanation is required.  HTDC is not subject to any prior precedent, reliance, or guarantee.

4. Data, Privacy, Confidentiality and Limitation of Liability. This application form is provided for government-authorized use only. Unauthorized or improper use of the system the application form resides on may result in civil and criminal penalties. By submitting this application form, the PARTICIPANT understands and consents to the following:

A) The PARTICIPANT has no reasonable expectation of privacy regarding any communications or data transiting or stored on this information system; and is hereby notified that any information provided could become publicly available data.

B) HTDC is a government entity and subject to applicable Freedom of Information Act and Uniform Information Practices Act provisions. Therefore, it might be required to disclose documents if requested; and it may disclose information to other government agencies, as provided by law. However, any documents or data made or received by any member or employee of the corporation shall not be a public record to the extent that the material or data: (1) Consists of trade secrets; (2) Consists of commercial or financial information regarding the operation of any business conducted by the applicant for, or recipient of, any form of assistance HTDC is empowered to render; or (3) Relates to the competitive position of that applicant in a particular field of endeavor.

C) Limitation on Liability. Chapters 661, HRS, or any other law to the contrary notwithstanding, the PARTICIPANT does not have any obligation, debt, claim, cause of action, claim for relief, charge, or any liability of any kind whatsoever in favor or any person or entity, against the State, HTDC, its board members, or its officers or employees, without regard to whether that person or entity receives any benefits under this chapter. The State, HTDC, and its officers and employees shall not be liable for the results of any investment, purchase of securities, loan, transaction or other assistance provided pursuant to HTDC's actions. 

For assistance, please email fintech@htdc.org and we will get back to you.
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Thank you for applying to participate in Hawaii's first Digital Currency Innovation Lab.                      We look forward to reviewing your application!
                                                                                                                                                  By submission of this application, you agree that all information provided is accurate to the best of my knowledge. I understand that false information can disqualify the company from participating in the program.

To save a copy of this application, follow the instructions to "Save as .Pdf" or Print after you press the "Submit" button below.
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Authorized Representative






Important
The Authorized Representative listed above must complete an electronic signature form before we will review the application. Once you hit the submit button, you will be directed to the form.
For assistance, please email fintech@htdc.org and we will get back to you.
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