Technology provider application forms shall require:

1. (1) the type or types of authorization to which the application applies:

   1. (a) IPEN;
   2. (b) platform;
   3. (c) credential analysis;
   4. (d) identity proofing; or
   5. (e) custodian;

2. (2) contact information:

   1. (a) the information specified in Rule .0402(2) of this Section for the applicant;
   2. (b) the information specified in Rule .0402(3) of this Section for the registered agent of a business entity that is an applicant;

   3. (c) the information specified in Rule .0402(1) of this Section for:

      1. (i) the applicant's key individuals; and
      2. (ii) the applicant's compliance contact employee designated pursuant to Item (4)(b) of this Rule, except that the residential address shall not be required; and

3. (3) the following general information about the technology provider applicant and its business:

   1. (a) the type of business entity;
   2. (b) all states and nations in which the technology provider applicant has obtained a certificate of authority to do business, or its equivalent;
   3. (c) all assumed business names, trade names, or "doing business as" names used by the applicant in North Carolina, other states, or nations;
   4. (d) all fictitious or equivalent names registered with the Department or other states or nations because the business' legal name is not available. Note: An example would be a fictitious name registered with the Department pursuant to G.S. 55D-22(a)(6);
   5. (e) for legal actions, the information required by 18 NCAC 07J .0416;
   6. (f) for debarment involving the applicant or the applicant's key individuals, the information specified in 18 NCAC 07J .0414;
   7. (g) for disciplinary actions, the information specified in 18 NCAC 07J .0418;
   8. (h) for voluntary exclusion in lieu of debarment involving the applicant or the applicant's key individuals, the information specified in 18 NCAC 07J .0415;
   9. (i) for bankruptcy, the information required by 18 NCAC 07J .0420;
   10. (j) a summary of its most recent IT security audit as required by 18 NCAC 07J .0621;

4. (4) the following information related to the authorization that the applicant seeks:

   1. (a) the name of the product and the version number for which authorization is sought;
   2. (b) the full name of the compliance contact who meets the requirements of, and has the duties set forth in, 18 NCAC 07J .0406;
   3. (c) minimum hardware and software specifications as required by 18 NCAC 07J .0608;

5. (5) the following information regarding the applicant's provision of the same or similar notarial services in jurisdictions other than North Carolina:

   1. (a) the name of each state, tribe or nation; and
   2. (b) for each named jurisdiction, the information required by 18 NCAC 07J .0405;
6. (6) a URL link to the information that the applicant is required to provide pursuant to 18 NCAC 07J .0607;

7. (7) information regarding whether the applicant's services as a technology provider have within the preceding five years been the subject of:

   1. (a) a security breach; or
   2. (b) a ransomware attack, as defined at G.S. 143B-1320(a)(14a);
8. (8) identification and information for third-party vendors, supporting vendors, and businesses pursuant to 18 NCAC 07J .0408-.0411;

9. (9) the applicant's certifications, compliance reports, or equivalents by independent third-party entities with:

   1. (a) the information required by 18 NCAC 07J .0413; and

   2. (b) if the certifications, compliance reports, or equivalents have levels, grades, or annotations, those applicable to the applicant;

      Note: Examples of acceptable certifications are ISO 270001 and SOC2;

10. (10) the applicant's certification that it complies with the requirements to have and implement the plans required by 18 NCAC 07J Section .0600; and

11. (11) signature by a key individual employed by the technology provider applicant who has the authority to:

    1. (a) bind the applicant;
    2. (b) make certifications required by this Rule and the rules in 18 NCAC Subchapter 07J; and

    3. (c) declare under penalty of perjury that:

       1. (i) the information provided is true and complete to the best of the signer's knowledge and belief;
       2. (ii) the application was prepared under the signer's authority and supervision;
       3. (iii) the applicant agrees that representations, promises, and assurances of performance in the application are binding on it; and
    4. (d) the date on which the application was signed.

History Note: Authority G.S. 10B-4; 10B-126(d); 10B-134.19; 10B-134.21; 10B-134.23(b);
Eff. July 1, 2025.