Fill Out a Valid Georgia C 15 Template Edit Georgia C 15 Here

Fill Out a Valid Georgia C 15 Template

The Georgia C-15 form serves a critical role within the state's regulatory framework, acting as an official report and itemized list of all unserviced preneed funeral contracts as of December 31 of the reporting year. Mandated by O.C.G.A. 10-14-12(g), it requires funeral homes to document detailed information, including the total number of unserviced contracts, amounts paid, and the status of escrow accounts for these contracts. This form ensures transparency and compliance within the funeral services sector, safeguarding consumer interests.

Edit Georgia C 15 Here

When it comes to managing preneed funeral contracts in Georgia, the Form C-15 plays a crucial role in ensuring transparency and compliance with state regulations. Mandated by the O.C.G.A. 10-14-12(g), this form serves as an annual report, providing an itemized list of all unserviced preneed funeral contracts as of December 31st of the year reported. This documentation, required by the Georgia Department of Securities and Business Regulation, serves not only to protect consumers but also to ensure that funeral homes are maintaining the necessary funds in escrow for future services. The form itself is thorough, asking for detailed information about each contract, including the name of the contract holder, the total amount of the contract, how much has been paid to date, and the balance remaining on deposit. This rigorous accounting helps keep the funeral services industry in Georgia transparent and accountable, ensuring that individuals who have prepaid for services will have their needs met when the time comes. By certifying the accuracy of the information under penalty of perjury, the signatory confirms that all required funds are appropriately deposited, further safeguarding the interests of all parties involved.

Form Example

 

 

 

 

STATE OF GEORGIA

 

 

 

Brian P. Kemp

 

SECURITIES AND BUSINESS REGULATION

 

Robert D. Terry

 

Secretary of State

 

 

2 Martin Luther King Jr. Drive, S.E.

 

Division Director

 

 

 

 

 

Suite 802 West Tower

 

 

 

 

 

 

 

Atlanta, Georgia 30334

 

 

 

 

 

 

 

(404) 656-3920

 

 

 

 

 

REPORT AND ITEMIZED LIST OF ALL UNSERVICED PRENEED FUNERAL CONTRACTS

 

 

 

 

 

 

 

AS OF 12/31/200__

 

 

 

This report is mandated by O.C.G.A. 10-14-12(g).

 

 

 

 

 

Please read instructions accompanying this form.

 

 

 

 

 

PART 1 - GENERAL

 

 

 

Registration Number

 

 

Total number of unserviced

 

Phone Number

 

 

 

 

 

contracts as of 12-31-200__

 

 

 

 

Name of Registrant/Funeral Home

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Mailing Address

 

 

 

 

 

 

City

State

Zip Code

 

 

 

 

 

 

 

 

 

 

Location of Records

 

 

 

 

 

 

City

State

Zip Code

 

 

 

 

 

 

 

 

Name and phone number of contact person regarding this report:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PART II - UNSERVICED PRENEED FUNERAL CONTRACTS

 

 

 

 

 

 

 

 

 

 

 

 

Contract Holder Name and

Depository

 

Date of

 

Contract

Total Amount

Amount

Total Amount

 

Bank Account Number

 

 

Contract

 

Number

of Contract

Paid to Date

on Deposit

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TOTAL (Page 1)

 

 

 

 

 

 

 

 

 

TOTAL (Page 2)

 

 

 

 

 

 

 

 

 

TOTAL OF ALL PAGES

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Attach additional pages, as necessary, with complete information as above on every contract holder.

Form C-15 Jan 2010

page 1

PART II - UNSERVICED PRENEED FUNERAL CONTRACTS

Contract Holder Name and

Depository

Date of

Contract

Total Amount

 

Amount

Total Amount

Bank Account Number

 

Contract

Number

of Contract

 

Paid to Date

on Deposit

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TOTAL (Page 2)

 

 

 

 

 

 

 

Attach additional pages, as necessary, with complete information as above on every contract holder.

 

 

 

 

PART III - CERTIFICATION

 

 

 

 

 

 

 

 

 

 

I hereby certify, under penalties of perjury, that the information contained in this Annual Report and the supporting documents attached hereto are true and correct to the best of my knowledge and belief. I further certify that all required deposits have been made

to the preneed escrow account. I am authorized to sign this document on behalf of the individual or corporate owner.

Signature:

Print Name:

 

 

Title

Date

 

 

Form C-15 Jan 2010

page 2

Document Details

Fact Name Description
Document Title The document is titled "Report and Itemized List of All Unserviced Preneed Funeral Contracts as of 12/31/200__".
Governing Law This form is mandated by the Official Code of Georgia Annotated (O.C.G.A.) 10-14-12(g).
Issuing Authority The form is issued by the Georgia Secretary of State, Securities and Business Regulation Division.
Location The division is located at 2 Martin Luther King Jr. Drive, S.E., Suite 802 West Tower, Atlanta, Georgia 30334.
Contact Information Contact number for inquiries is (404) 656-3920.
Purpose The purpose of the form is to report unserviced preneed funeral contracts as of December 31 of the reported year.
Content Requirement Registrants must provide details such as the total number of unserviced contracts, contract holder name, contract and depository details, and the amount paid to date.
Certification The form requires a certification by the submitter under penalties of perjury that the information provided is accurate and that all required deposits have been made to the preneed escrow account.

Detailed Guide for Using Georgia C 15

The process of completing the Georgia C-15 form, a crucial document for reporting unserviced preneed funeral contracts, demands careful attention to detail and accuracy. This form plays a vital role in maintaining transparency within the funeral services sector, ensuring that preneed contracts are managed according to state laws. It is essential for entities involved to submit accurate and up-to-date information to the Georgia Secretary of State, Securities and Business Regulation Division. Below are the steps necessary for filling out this form.

  1. Enter the current year at the top of the form where it reads "12/31/200__" by filling in the appropriate year.
  2. In PART 1 - GENERAL, provide the registration number associated with your funeral home or service.
  3. Indicate the "Total number of unserviced contracts as of 12-31-200__" by entering the precise number of contracts that have not been fulfilled.
  4. Fill in the contact details of the registrant or funeral home, including the name, mailing address, city, state, and zip code.
  5. Specify the location where the records are kept, including the city, state, and zip code.
  6. Provide the name and phone number of the contact person responsible for this report.
  7. In PART II - UNSERVICED PRENEED FUNERAL CONTRACTS, list each contract holder's name and the depository bank's name.
  8. For each contract, include the date of the contract, the contract number, the total amount of the contract, the amount paid to date, and the total amount on deposit.
  9. Ensure that you attach additional pages if necessary, following the same format provided on the form for every contract holder.
  10. After listing all unserviced preneed funeral contracts, calculate and enter the totals for page 1 and page 2, and the overall total of all pages at the end of PART II.
  11. In PART III - CERTIFICATION, certify the accuracy of the information and the compliance with required deposit into the preneed escrow account by signing and printing your name, indicating your title, and dating the document.

Once the form is fully completed and all supporting documents are prepared, it should be submitted to the office of the Georgia Secretary of State, Securities and Business Regulation Division by the designated deadline. The act of submission not only complies with state regulations but also contributes to the integrity and trustworthiness of the funeral services industry in Georgia. Accurate and timely reporting ensures that the rights and interests of all parties involved, especially those of the contract holders, are protected and respected.

More About Georgia C 15

Frequently Asked Questions about Georgia Form C-15

  1. What is Georgia Form C-15?
  2. Form C-15 is a required document issued by the State of Georgia's Secretary of State, specifically from the Securities and Business Regulation Division. It mandates the reporting and itemized listing of all unserviced preneed funeral contracts as of December 31st of any given year. This form ensures compliance with the O.C.G.A. 10-14-12(g), contributing to the oversight of preneed funeral arrangements.

  3. Who needs to fill out this form?
  4. Any registrant or funeral home in Georgia holding unserviced preneed funeral contracts is required to complete and submit Form C-15. The form helps in the administration and monitoring of these contracts to ensure they are managed correctly and in accordance with state laws.

  5. What are unserviced preneed funeral contracts?
  6. Unserviced preneed funeral contracts are agreements made in advance for funeral services and merchandise that have not yet been provided or used. These contracts are made between an individual, the contract holder, and a funeral service provider, detailing the services and/or merchandise to be provided in the future, typically upon the death of the contract holder.

  7. What information is required on Form C-15?
    • General information about the registrant/funeral home, including name, registration number, and contact details.
    • Total number of unserviced contracts as of December 31st of the reporting year.
    • Itemized list of all unserviced preneed funeral contracts, including details such as contract holder's name, contract date, total amount, amount paid to date, and account details.
    • Certification by the authorized individual affirming the accuracy of the information provided and compliance with escrow account deposit requirements.
  8. What is the significance of the certification part in Part III?
  9. The certification section in Part III serves as a legal affirmation by the signer that the information contained in the report is accurate and truthful to the best of their knowledge. It also certifies that all required deposits into the preneed escrow account have been made, ensuring compliance with state laws. Failing to truthfully complete this certification can lead to penalties under perjury laws.

  10. How and when should Form C-15 be submitted?
  11. Form C-15 must be completed annually and submitted to the Securities and Business Regulation Division of the Georgia Secretary of State. The specific deadline is as of December 31st of each year, with the completed form reflecting information up to this date. The submission process can be done by mail or electronically, if available, according to the instructions provided with the form.

  12. What happens if a funeral home fails to submit Form C-15?
  13. Failing to submit Form C-15 can result in various consequences. The state may impose penalties, fines, or legal actions against the non-compliant funeral home. Moreover, it can lead to a loss of licensure or the right to sell preneed funeral contracts within Georgia. It’s crucial for all registrants to comply with this requirement to avoid such penalties and to ensure trust and reliability in preneed funeral arrangements.

Common mistakes

  1. Failing to provide the full Registration Number: Every funeral home must include their specific registration number that identifies them with the state's regulatory body. Skipping or inaccurately filling this section can result in processing delays or the form being returned.

  2. Not listing the total number of unserviced contracts accurately as of December 31st: It's crucial to provide an exact count of all contracts that have not yet been serviced to maintain transparency and compliance.

  3. Omitting the funeral home's contact information, including the phone number and the name of a direct contact person: This information is essential for any follow-up or clarification by regulatory bodies.

  4. Leaving the Location of Records section incomplete: This specifies where the funeral home keeps the illustrated records, which is important for accountability and potential audits.

  5. Incorrectly reporting the Total Amount Paid to Date and the Total Amount on Deposit for contracts: Accurate financial records are vital for ensuring that funds are properly managed and protected.

  6. Skipping the bank account number associated with the preneed contracts: This number is critical for verifying where the consumers' funds are held.

  7. Forgetting to include the Date of Contract for each listed agreement: This date is necessary to determine the contract's age and compliance with financial obligations.

  8. Omitting contract numbers: Each preneed funeral contract should have a distinct number for identification and tracking purposes.

  9. Neglecting to attach additional pages when necessary: If there are more contracts than the form allows, additional sheets must be attached with complete information for each unserviced contract.

  10. Failing to sign and date the Certification section: The form must be signed by someone with the authority to represent the funeral home, certifying the information's accuracy under penalties of perjury.

Mistakes on the Georgia C-15 form can lead to serious consequences, including regulatory scrutiny, potential fines, or administrative action by the state. Ensuring accuracy and completeness in this documentation is crucial for compliance with state laws governing preneed funeral contracts. By avoiding these common errors, funeral homes can maintain good standing and foster trust within the communities they serve.

Documents used along the form

When working with the Georgia C-15 form, which is crucial for reporting and providing an itemized list of all unserviced preneed funeral contracts as of a specified date, there are several other forms and documents that tend to be used alongside it. These additional materials are important for ensuring that all aspects of preneed funeral contract obligations are thoroughly documented and in compliance with Georgia's regulatory requirements.

  • O.C.G.A. 10-14-12(g) Excerpt: This specific section of the Official Code of Georgia Annotated outlines the legal requirements that must be adhered to in relation to preneed funeral contracts. It provides critical context for the C-15 form's purpose and the legal background that governs preneed funeral arrangements in Georgia.
  • Preneed Escrow Account Agreement: Since the C-15 form requires certification that all required deposits have been made into a preneed escrow account, the agreement or contract establishing this escrow account is a key document. It sets forth the terms and conditions under which the funds are held and managed.
  • Annual Financial Statement: This document provides a comprehensive overview of the funeral home's financial situation, including assets, liabilities, and a detailed account of the preneed trust funds. It's vital for proving that the funeral home is financially stable and capable of fulfilling its preneed agreements.
  • Contract Holder Records: Detailed records of each contract holder, including the contract agreement, payment history, and correspondence, are necessary to support the information reported on the C-15 form. These records are crucial for verifying the total amount paid and the amount on deposit for each unserviced preneed funeral contract.
  • Bank Statements for Preneed Escrow Accounts: These are monthly or quarterly statements from the financial institution where the preneed escrow accounts are held. They provide a third-party verification of the amounts reported on the C-15 form as being on deposit for each unserviced preneed funeral contract.

Together, these documents ensure that the funeral home is fully transparent and in compliance with Georgia's laws regarding preneed funeral contracts. By meticulously maintaining and submitting these forms and supporting documents, funeral homes demonstrate their accountability and commitment to upholding their prearranged funeral service agreements.

Similar forms

The Georgia C-15 form is similar to other regulatory filings that require detailed accounting and reporting for specific business activities. These documents share a common goal of transparency and regulatory compliance. For instance, the similarities can be observed with the Federal Form 5500, bank audit reports, and insurance solvency documents, each serving a sector-specific oversight function.

Federal Form 5500 is required annually for employers who offer pension or health plans to their employees. Similar to the Georgia C-15 form, Form 5500 calls for detailed information about the plan's financial condition, investments, and operations. Both documents aim to ensure that entities are operating in compliance with applicable laws and that they are solvent, thus protecting the interests of participants and beneficiaries. Where the Georgia C-15 focuses on preneed funeral contracts, Form 5500 encompasses a broader scope of employee benefit plans. Nonetheless, the thematic goal of accountability and safeguarding stakeholders' interests runs parallel in both reports.

Bank Audit Reports, typically required by regulatory bodies such as the Federal Reserve or the Federal Deposit Insurance Corporation (FDIC), are another document similar to the Georgia C-15 form. These reports provide a comprehensive overview of a bank's financial health, including the status of deposits and loan portfolios. Similar to the section in the C-15 form detailing unserviced preneed funeral contracts, bank audit reports require detailed itemization of assets and liabilities. The underlying principle of these documents is to ensure financial stability and compliance with banking laws and regulations, protecting depositors and maintaining public confidence in the financial system.

Insurance Solvency Documents are submitted to state regulators to demonstrate an insurance company’s ability to meet its long-term obligations to policyholders. Like the C-15 form, these documents require detailed financial information, including liabilities, assets, and capital adequacy. The focus on ensuring that companies have enough reserves to cover future claims is similar to the C-15’s focus on ensuring funeral homes have sufficient funds set aside for preneed funeral contracts. Both sets of documents serve to protect consumers by ensuring that companies are financially solvent and able to fulfill their commitments.

Dos and Don'ts

Completing the Georgia C 15 form, a crucial document for reporting unserviced preneed funeral contracts, demands attentiveness and precision. Presented below are guidelines structured to assist in accurately filling out this form.

Do's:

  • Read the instructions accompanying the form carefully before beginning to ensure thorough understanding and compliance with state requirements.
  • Ensure that the registration number and total number of unserviced contracts are accurately reported, reflecting the exact figures as of December 31st of the reporting year.
  • Confirm the funeral home's mailing address and the location of records are current and correct, to avoid miscommunication or delays in correspondence.
  • Provide the name and phone number of a designated contact person who can answer queries regarding the report, enhancing the department's ability to clarify or follow up as needed.
  • Accurately list each unserviced preneed funeral contract, including all requested details such as the holder's name, the depository, contract number, and amounts relating to the contract.
  • Attach additional pages if necessary, ensuring that each added sheet mirrors the format provided on the form and includes comprehensive information on every contract holder.
  • Review the form for completeness and accuracy before submission, verifying all numerical and textual information.
  • Sign and date the form under Part III - Certification, acknowledging the veracity of the furnished data and the compliance with deposit requirements.

Don'ts:

  • Avoid hurrying through the form filling process, as errors or omissions can result in processing delays or legal issues.
  • Do not leave any required fields blank; if a section does not apply, consider marking it as "N/A" or "None" to indicate awareness and intentional omission.
  • Resist the temptation to estimate or guess figures; all amounts relating to the contracts must be exact and verifiable.
  • Do not use incomplete or vague contact information Accurate details facilitate efficient communication, crucial for clarifying potential discrepancies.
  • Refrain from submitting the form without attaching the necessary additional pages for contracts exceeding the space provided, as this can lead to incomplete reporting.

Misconceptions

When it comes to managing preneed funeral contracts, the Georgia C-15 form is a crucial document that funeral homes must handle with utmost care. Despite its importance, there are several misconceptions surrounding its purpose and requirements. Here are four common misunderstandings:

  • It's not mandatory for all funeral homes.
  • This is incorrect. In Georgia, every funeral home that offers preneed contracts is required to file a C-15 form. This mandate is set forth under O.C.G.A. 10-14-12(g), ensuring that all unserviced preneed funeral contracts are reported annually to the Secretary of State. The goal is to maintain transparency and protect consumer interests.

  • The form is only about financial details.
  • While financial details, including the total amount of each contract and the total amount paid to date, are certainly key components of the form, it encompasses more than just finances. The C-15 form also requires information on the registrant, such as contact information, the location of records, and a certification that ensures all provided data is accurate and that all required deposits have been made to the preneed escrow account. Thus, it's a comprehensive document that covers administrative, operational, and financial reporting.

  • Any staff member can sign the form.
  • Actually, not just anyone at the funeral home can sign the C-15 form. The document requires a signature from an individual authorized to sign on behalf of the corporate or individual owner of the funeral home. This requirement is critical for legal accountability, ensuring that the information submitted is verified and attested to by someone with the authority to make such assertions.

  • Past due contracts don’t need to be reported.
  • This misconception could lead to significant compliance issues. The form requires an itemized list of all unserviced preneed funeral contracts as of December 31st of the reporting year, regardless of their payment status. This includes contracts that are fully paid, partially paid, or even past due. The aim is to provide a complete picture of the funeral home's obligations to its clients, ensuring the state can monitor compliance with applicable laws and regulations effectively.

Understanding these misconceptions about the Georgia C-15 form helps ensure that funeral homes remain in compliance and continue to serve their communities with high standards of transparency and accountability.

Key takeaways

When it comes to filling out and using the Georgia C-15 form, it's essential to grasp its significance and requirements to ensure compliance with state laws. Here are key takeaways that should help guide anyone tasked with this responsibility:

  • The Georgia C-15 form is a report that focuses on unserviced preneed funeral contracts as of December 31st of the reported year. It plays a critical role in maintaining transparency and compliance within the funeral services sector.
  • It is mandated by O.C.G.A. 10-14-12(g), highlighting its legal requirement. Ignoring or failing to accurately complete this form can have legal ramifications for the registrant or funeral home.
  • Part I of the form collects general information about the registrant or funeral home, including registration number, contact details, and the location where records are kept. This part serves as the basic identifier for the entity reporting the unserviced contracts.
  • Part II requires detailed information on each unserviced preneed funeral contract, including the contract holder's name, contract date, amounts paid and on deposit, and the depositary bank information. This section ensures that unserviced contracts are properly accounted for and that funds are adequately protected and managed.
  • The form allows for attachment of additional pages if the space provided is not sufficient to list all unserviced preneed funeral contracts, ensuring that comprehensive data is captured and reported.
  • Part III contains a certification section where the individual responsible for the report must certify, under penalties of perjury, the accuracy and truthfulness of the information provided. This certification ensures accountability and legal compliance.
  • Filling out the Georgia C-15 form accurately is crucial for funeral homes operating within the state. It's not just about compliance; it's also about ensuring that funds meant to prepay for funeral services are responsibly and transparently managed. By keeping these key takeaways in mind, funeral homes can better navigate the complexities of state regulations and uphold the trust placed in them by their clients.

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