27 NCAC 01E .0315 registration amendment form

Registration Amendment Form for Prepaid Legal Services Plan

 

A prepaid legal services plan shall file a registration amendment form with the secretary of the North Carolina State Bar no later than 30 days after a change in the information provided by the plan in its initial registration statement or in its last registration renewal form. Changes to the operation of the plan or to the governing documents of the plan that are inconsistent with the information contained in the plan's initial registration statement or in the plan's last registration renewal form may not be implemented until they are registered with the State Bar.

 

The plan owner shall provide complete responses to items 2 5 if he or she would like to amend the plan's current registration information. There is no need to complete items 2 5 if they have not changed. The plan owner shall provide complete responses to item 1 and items 6 11.

 

1. Current Registration Information

a. Plan Name:

b. Plan Number:

 

2. New Name of Plan:

 

3. New Owner of Plan

a. Name:

b. Title:

 

4. New Principal North Carolina Address for Plan

a. Address:

b. City:

c. State:

d. Zip Code:

 

5. New Contact Information for Plan Representative

a. Name:

b. Address:

c. City:

d. State:

e. Zip Code:

f. Telephone Number:

g. Email Address:

 

6. Is the plan still offered by a person or entity not authorized to engage in the practice of law? [Yes] [No]

 

7. Does the plan, in exchange for any valuable consideration, still offer to arrange the provision of specified legal services that are paid for in advance of any immediate need for the specified legal service ("covered services")? [Yes] [No]

 

8. Are the legal services the plan offers to arrange still provided by North Carolina licensed attorneys who are not employees, directors, or owners of the plan? [Yes] [No]

 

9. Do the covered services the plan offers to arrange still extend beyond the sale of an identified, limited legal service, such as drafting a will, for a fixed, one-time fee? [Yes] [No]

 

10. After reading the foregoing form in its entirety, does the plan owner signing below certify that all statements made in this form are true and correct to the best of his or her knowledge? [Yes] [No]

 

11. Does the plan owner signing below understand that the amendments to this plan may not be implemented until the registration amendment form is registered with the North Carolina State Bar in accordance with 27 N.C.A.C. 1E .0313 through .0315 of the North Carolina State Bar Regulations for Organizations Practicing Law? [Yes] [No]

 

________________

Date

__________________________________

Signature of Plan Owner

__________________________________

Typed Name of Plan Owner

 

History Note: Authority G.S. 84-23; 84-23.1;

Adopted by the Supreme Court: September 25, 2020.