§ 1059.6. Required application information.
(a) SA-1 form. The SA-1 is a multipurpose form intended for use in the sale of different transferable rights and shall be completed by the broker or attorneys, or both, in a manner consistent with the intentions of the sale.
(b) Required information. The completed SA-1 must include all of the information required by the Authority:
(1) The certificate numbers.
(2) The name of the proposed buyer and contact information, including a telephone number, an email address and a facsimile number.
(3) If the proposed buyer is a nonindividual person and is not already a certificate holder:
(i) The articles of incorporation, operating agreement, formation documents or other applicable organizing documents for the applicant.
(ii) A certificate of good standing for the applicant from the Bureau of Corporations and Charitable Organizations.
(iii) A copy of the Department of State’s entity page for the applicant.
(4) The name of any holding company as defined in § 1051.2 (relating to definitions) having an interest in the proposed buyer and a contemporaneous certificate of good standing for the holding company from the Bureau of Corporations and Charitable Organizations, or similarly authorized entity in another jurisdiction in the United States.
(5) The trade name, if any, of the proposed buyer and a copy of the trade name registration certificate, if applicable.
(6) The mailing address and physical address of the proposed buyer.
(7) A copy of the proposed buyer’s business plan.
(8) A list of current corporate officers, directors, stockholders, key employees and persons with controlling interests as defined in § 1051.2, if applicable with an indication of each individual’s title.
(9) A list of all Authority, PUC and Federal common carrier rights held by the proposed buyer and any of the persons listed in response to paragraph (8), including taxicab medallions.
(10) The name, address, telephone number, facsimile number and email address of any attorney assisting the proposed buyer with the application process, together with an acknowledgement that § 1061.1(b) (relating to broker registration) has been reviewed by the proposed buyer.
(11) A criminal history report, issued within 30 days of the filing of the application, from any jurisdiction in which the following persons have lived in the preceding 5 years through the date of application:
(i) An individual proposed buyer.
(ii) Any individual with a controlling interest in the proposed buyer.
(iii) Any individual with a controlling interest in the holding company of a proposed buyer.
(iv) A key employee.
(12) A verified statement indicating that the persons identified in paragraph (11) have not been subject to a conviction as defined in § 1001.10 (relating to definitions) and that the proposed buyer has read and understands the prohibitions of ownership as provided in § 1051.5 (relating to ineligibility due to conviction or arrest).
(13) Verified statements from the owner and proposed buyer confirming that each are in compliance with § 1051.6 (relating to payment of outstanding fines, fees and penalties).
(14) The Federal Tax Identification number for the owner and proposed buyer.
Authority The provisions of this § 1059.6 temporarily amended under 53 Pa.C.S. § 57B02.
Source The provisions of this § 1059.6 temporarily amended May 5, 2017, effective February 25, 2017, expire upon promulgation of final-form regulations or on November 5, 2018, whichever is later, as set forth in 53 Pa.C.S. § 57B02(b), 47 Pa.B. 2558. Immediately preceding text appears at serial pages (373583) to (373584).
Cross References This section cited in 52 Pa. Code § 1059.8 (relating to financial fitness generally).
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