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Circular No. 29. *ti *-*0 os it* t x FEDERAL RESERVE BANK O F NEW YORK 62 CEDAR STREET JULY 15, 1915. To THE CASHIER: SIR: Copies 1. For 2. For 3. For 4. For are enclosed of four statement forms, as follows: corporations, firms, farmers or live stock dealers, merchants, manufacturers or other individuals. These forms are designed to assist member banks to assemble and maintain credit files relating to borrowers. Statements made on these forms will show clearly the relation of quick assets to current liabilities. Only such supplementary information is called for as seems essential to a full understanding of a borrower's position. On the back of each form space is provided for additional questions or records. A supply of the forms has been prepared for distribution, without charge, to member banks desiring to use them. As explained in Circular No. 25 of this bank the regulation of the Federal Reserve Board which becomes effective to-day does not require a member bank, in applying for rediscounts, to certify that it has on file statements of those of its depositors the aggregate of whose paper actually rediscounted or offered for rediscount by it does not exceed $5,000. or 10% of its paid in capital. This ruling serves to exempt those borrowers of country banks who are not accustomed to make statements but whose character and circumstances are known personally to the officers of the banks. For the present at least, neither the regulations of the Federal Reserve Board nor the practice of this bank require a statement to accompany each note offered for rediscount. Statements will be asked for only in particular cases when the circumstances seem to require them. The enclosed forms therefore have been prepared not primarily for this bank, but rather to assist its member banks to assemble credit information. The present is a particularly opportune time for member banks to undertake this work. Since the establishment of the Federal Reserve System it has been generally understood that statements are to be required in connection with the rediscount of paper, and the use of the "Federal Reserve Bank of New York Statement Form" will, in most cases, be a sufficient explanation to borrowers. It is unnecessary here to refer to the obvious advantages to both borrowers and lenders of regular signed statements. As a matter of sound practice this bank would like to see the custom extended to embrace practically all borrowers. Cordial cooperation in the development of credit files is anticipated and the officers of this bank will be glad whenever requested to advise or aid in the work. Member banks may prefer to use their own or other forms of statements but those banks which wish to use the Federal reserve bank forms are requested to advise the number of each required. Suggestions for the improvement of the forms will be gladly received. Respectfully, BENJ. STRONG, JR., Governor. 52f Federal Reserve Bank of New York Statement Form. INDIVIDUAL CR-12 FARMER OR LIVE STOCK DEALER. STATEMENT O F . . ADDRESS . BUSINESS To BANK OF I make the following statement of all my assets and liabilities as at the close of business on and give other material information for the purpose of obtaining advances on notes and bills bearing my signature or indorsement and for obtaining credit generally upon present and future applications. (PLEASE ANSWER ALL QUESTIONS AND FILL IN ALL BLANKS) LIABILITIES ASSETS Cash on hand and in bank Accounts owed by me Accounts due to me—Good Notes owed by me without security. .. Unsecured loans due to me—Good. Notes owed by me with security other than real estate Secured loans due to me Notes or mortgages owed by me with real estate as security Mortgage loans due to me Farm products on hand Live stock on hand Notes owed by me with chattel mortgage as security Farm land (See schedule) Other indebtedness (Itemize) Buildings Farm implements and machinery. . Other property (Itemize) Total Liabilities Net Worth. TOTAL TOTAL Location of Land Owned Acres L Title. Estimated Value Assessed at Mtgd. for Insured for J The legal and equitable title to all pieces of above described real estate is in my name solely, except as follows: Buildings. State general character. Contingent Liability. Ever destroyed by fire?. Implements. State general character of those listed as assets. As guarantor 5 As indorser $ As bondsman for others $ Accounts and Notes Payable. If any are past due state amounts and reasons Growing Crops. Outlay to date is a3 follows: Cost of seed " " " fertilizer " labor Other costs—(Itemize) Total Insurance. Fire $ $. Maximum Debt. $. was at a maximum ($ $. at a minimum ($ :....?. During last calendar year, my total indebtedness ) on and ) on Other Liens. If any other liens on assets, state am't and circumstances $. Life $. Who is beneficiarv? Age. My Age is Married or Single. I hereby certify that the figures and statements contained on both sides of this sheet are true and give a correct showing of my financial condition. Signedforthis day of Digitized FRASER (OVER) 191.... Name State character of Accounts, Notes and Mortgages listed as assets ? If any leased land used, state acreage, nature, use and terms of rental (The balance of this space may be used for printing any questions desired to be asked amplifying statement of condition as shown on opposite page). *A Federal Reserve Bank of New York Statement Form INDIVIDUAL STATEMENT OF. MERCHANT, MANUFACTURER, ETC. BUSINESS ADDRESS. To BANK OF I make the following statement of all my assets and liabilities at the close of business on and give other material information for the purpose of obtaining advances on notes and bills bearing my signature or indorsement, and for obtaining credit generally upon present and future applications. (PLEASE ANSWER ALL QUESTIONS AND FILL IN ALL BLANKS) ASSETS LIABILITIES Cash on Hand and in Bank. . Accounts Payable Accounts Receivable Notes Payable to Banks Notes Receivable Notes Payable to Others Merchandise Other Current Liabilities (Itemize) Other Quick Assets (Itemize). Quick Assets Current Liabilities I Land and Buildings (See schedule on back).. . Mortgages Machinery and Fixtures Other Liabilities (Itemize) Other Assets (Itemize) Current and Deferred Liabilities Net Worth TOTAL Merchandise. TOTALi On what basis valued, cost or market?. Finished $ Unfinished $ Raw $ If any goods on consignment, state Contingent Liability. As indorser $ $ No accounts have been sold or assigned ex- As guarantor cept as follows: amount and circumstances Accounts and Notes Payable. Do you take advantage of all trade discounts? Sales and Profits Last Fiscal Year. If any are past due state amount and circumstances. Net sales $ Net profits $ Accounts and Notes Receivable. If any are past due or doubtful, Current Liabilities. During last fiscal year, current liabilities were at a maximum ($ state amount and circumstances ) on and at a minimum ($ ) on Mortgages and O t h e r L i e n s . State due date of mortgages and on what assets a lien If any are due from employees, relatives or similar sources, are Is mortgage a lien on any current assets^* . . included in assets, state amount and circumstances If any other liens on assets, state amount and circumstances. Bonds and Stocks. State general character and if readily salable at values stated Insurance. Life $ Age. • Fire, on Buildings $ My Age is Audits. Merchandise $ Date started present business..., Are books audited by a certified public accountant?. Give date of last audit. Who is beneficiary? I hereby certify that the foregoing figures are taken from my books and that they and the statements contained on both sides of this sheet are true and give a correct showing of my financial condition. .day of. Signed this. (OVER) 191 Name. Proprietor Location of Land Owned : Acres Value*** ; ! ' \ ' | Assessed at Mtgd. for L | .... Title. The legal and equitable title to all pieces of above described real estate is in ray name solelv. exrent as (The balance of this space may be used for printing any questions desired to be asked amplifying statement of condition as shown on opposite page). ; I .i Insured for Federal Reserve Bank of New York Statement Form FIRM CR-14 STATEMENT OF . . ADDRESS . BUSINESS BANK OF To We make the following statement of all the assets and liabilities of our firm at the close of business on and give other material information for the purpose of obtaining advances on notes and bills bearing our signature or indorsement, and for obtaining credit generally on present and future applications. (PLEASE ANSWER ALL QUESTIONS AND FILL IN ALL BLANKS) ASSETS LIABILITIES Cash on Hand and in Banks. Accounts Payable Accounts Receivable Notes Payable to Banks Notes Receivable Notes Payable to Others , Merchandise Deposits , Other Quick Assets (Itemize). Other Current Liabilities (Itemize). Quick Assets. Current Liabilities. Land and Buildings Mortgages Machinery and Fixtures. Other Deferred Liabilities (Itemize) Other Assets (Itemize) . Current and Deferred Liabilities. Net Worth TOTAL Merchandise. TOTAL On what basis valued, cost or market Finished $ Unfinished $ C o n t i n g e n t Liability. Raw $ Asindorser$. As guarantor $ If any goods are on consignment, state amount and circumstances. No accounts have been sold or assigned except as follows: Accounts and Notes Payable. If any are past due state amount and circumstances Sales and Profits Last Fiscal Year. Net sales $. Net profits $ During last Accounts and Notes Receivable. If any past due or doubtful state amount and circumstances. fiscal year ($> ) on ($ ) on current were at maximum and at a minimum Mortgages and Other Liens. If any amounts are due from members of the firm, employees, liabilities State due date of mortgages and on what assets a lien branches or similar sources, state amounts and circumstances Is mortgage a lien on any current assets ? If any other liens on assets, state amount and circumstances Bonds and Stocks. State general character and if readily salable at value stated Insurance. dise $ Reserves and Depreciation. Fire, on Buildings $ State what provision is made. Merchan- Life, in favor of firm $. We hereby certify that the foregoing figures are taken from the books of our firm and that they and the statements contained on both sides of this sheet are true and give a correct showing of our financial condition. Signed this day of (OVER) 191 Firm Name ""Membarofipinn DATE OF PARTNERSHIP DATE OF EXPIRATION SPECIAL PARTNERS GENERAL PARTNERS Amount Contributed. NAME Net Worth Outside this Business. Amount Contributed. NAME Partner Until if the firm has any branch offices state location and how accounts are handled II the firm or any member is connected with any other business, state nature of the business and extent to which interested What is the practise of the firm in regard to trade discounts? Are books audited by a certified public accountant? Location and Description of Land Owned Title. Give date of last audit, Estimated Value Assessed at Mtgd. for The legal and equitable title to all pieces of above described real estate is in my name solely, except as follows: (The balance of this space may be used for printing any questions desired to be asked amplifying statement of condition as shown on opposite page). Insured for •2. 7 Federal Reserve Bank of New York Statement Form. CORPORATION. CR-15 STATEMKMT O F . BUSINESS ADDRESS . To BANK OF We make the following statement of all the assets and liabilities of this companyat the close of business on and give other material information for the puroose of obtaining advances on notes and bills bearing our signature or indorsement, and for obtaining credit generally on present and future applications. (PLEASE ANSWER ALL QUESTIONS AND FILL I N ALL BLANKS.) LIABILITIES ASSETS Cash on Hand and in Banks. . Accounts Payable Accounts Receivable Notes Payable to Banks Notes Receivable Notes Payable to Others Merchandise Deposits Other Quick Assets (Itemize)., Other Current Liabilities (Itemize), Quick Assets. L Current Liabilities. Land and Buildings Mortgages Machinery and Fixtures. Bonded Debt , , Other Assets (Itemize) . Other Liabilities (Itemize) , Current and Deferred Liabilities. Capital Stock Preferred Capital Stock Common Surplus and Undivided Profits TOTAL Merchandise. TOTAL Contingent Liability. On what basis valued, cost or market?. Finished $ Unfinished $ Raw $ As indorser $ As guarantor $ If any goods are on consignment, state amount and circumstances. No accounts have been sold or assigned except as follows: Accounts and Notes Payable. Sales and Profits Last Fiscal Year. Net profits $ If any are past due state amount and circumstances Net sales $ Dividends paid $ Accounts and Notes Receivable. If any are past due or doubtful During last fiscal year current ($ state amount and circumstances liabilities were at a maximum )on and at a minimum ($ ) on Mortgages and Bonds. State due dates of mortgages and on what If any amounts are due from directors, officers, employees, subsidiaries, assets a lien branches, or similar sources, state amounts and circumstances State due date of bonds and on what assets a lien Bonds and Stocks. State general character and whether readily If any other liens on assets, state amount and circumstances... . salable at value stated Insurance. Fire, on Buildings $ chandise $ Are mortgages or bonds a lien on any current assets?. Mer- Reserves and Depreciation. State what p r o v i s ion is made. Life, in favor of company $ We hereby certify that the foregoing figures are taken from the books of this company and that they and the statements contained on both sides of this sheet are true and give a correct showing of the financial condition of the company. Signed this day of. (OVER) .191. Name.. By. (State official title) DIK1 < -Prcst. Secret) In what state incorporated? If company has any subsidiaries or branch offices state location anil how account^ are hatulled What is practice of company in regard to trade discounts?. Are books audited by a certified public accountant? Gfe >f last audit .N.J. 191 . Federal Reserve Bank of Philadelphia, Philadelphia, Pa. Dear Sirs:— In accordance with resolution of the Federal Reserve Board, dated May 4, 1915, transferring this bank from District No. 3 to District No. 2, and with the resolutions of the Board of Directors of this bank, dated _ 1915, this bank has applied for cancellation of its _ shares of the stock of the Federal Reserve Bank of Philadelphia and has applied for shares of the stock of the Federal Reserve Bank of New York. To facilitate these transactions you are hereby authorized and requested to pay to the Federal Reserve Bank of New York, on account of our subscription to the capital stock of that bank, $ subscription to representing the net amount paid by us on account of our _ shares of your capital stock. Yours very truly, President or Cashier. At a meeting of the Board of Directors of the of duly called and held on the day of 191 , the following resolution was offered and duly adopted: " W H E R E A S , This Bank has subscribed to _ shares of the capital stock of the Federal Reserve Bank of Philadelphia, pursuant to a resolution adopted by its Board of Directors on the day of _ 1914, in accordance with the provisions of the Act of Congress approved December 23rd, 1913, and known as the Federal Reserve Act, and has paid on account thereof in instalments the sum of $ said sum being 50 per cent, of the par value of said shares; " A N D W H E R E A S , According to the certificate filed April 2nd, 1914, by the Reserve Bank Organization Committee with the Comptroller of the Currency, designating the several Federal Reserve cities and defining the geographical limits of the districts to be respectively served by the Federal Reserve Banks located in said cities, this Association was at that time located in District No. 3, which district is served by the Federal Reserve Bank of Philadelphia; " A N D W H E R E A S , The Federal Reserve Board, under the authority granted to it by Section 2 of the said Federal Reserve Act, has by resolution adopted May 4th, 1915, ordered that Federal Reserve District No. 2 shall be modified and extended so as to include, on and after July 1st, 1915, the counties of Monmouth, Middlesex, Hunterdon, Somerset, Union, Essex, Passaic, Hudson, Bergen, Morris, Sussex and Warren, in the State of New Jersey, which said counties have heretofore been included in Federal Reserve District No. 3 ; " A N D W H E R E A S , This Association is located in the County of _ in the State of New Jersey, said county being one of the twelve counties transferred by said resolution and order from District No. 3 to District No. 2 ; "Nozv, therefore, be it resolved, That the President or Vice-President and Cashier of this Association be and they are hereby authorized, empowered and directed to make application to the said Federal Reserve Bank of Philadelphia for the cancellation of said _ shares of stock heretofore allotted to this Bank and for the refund of all payments made thereon; "And be it further resolved, That the President or Vice-President and Cashier of this Association be and they are hereby authorized, empowered and directed to make application for and to subscribe to shares of the par value of $100 each of the capital stock of the Federal Reserve Bank of New York, to pay for such stock in accordance with the provisions of the said Federal Reserve Act, and to take any other action necessary or desirable to the accomplishment of the said readjustment." Pursuant to the foregoing resolution, the of hereby makes application for the cancellation of „ _ shares of stock of the Federal Reserve Bank of Philadelphia heretofore allotted to it, and for the refund of such cash payments as this Bank may be entitled to under the provisions of Section 5 of the Federal Reserve Act. Pursuant to foregoing resolution, the of hereby subscribes to and makes application for _ shares of the capital stock of the Federal Reserve Bank of New York of the par value of $100 each, amounting to $ and agrees to pay for same in accordance with the provisions of the Federal Reserve Act. of (SEAL) By ; President. Cashier. We, the undersigned, hereby certify that this $ Bank and surplus of $ of business on the has an unimpaired capital of as shown by its books at the close day of 1915. ( T o be signed by three or more directors) Directors. LOCATION O F A P P L Y I N G BANK (Please fill in) City or town County State CERTIFICATE OF FEDERAL RESERVE AGENT The foregoing application for the surrender of stock in the Federal Reserve Bank of Philadelphia has been examined and the statement of the number of shares allotted to the applying bank has been verified. I recommend that shares of stock be accepted for cancellation and that the cash subscriptions already paid for this surrendered stock be returned. Federal Reserve Agent, Federal Reserve Bank of Philadelphia. CERTIFICATE OF FEDERAL RESERVE AGENT The foregoing application for. shares of stock in the Federal Reserve Bank of New York has been examined and checked. The amount of stock applied for is equal to 6 per cent, of the capital and surplus of the applying bank, as shown by certified statement of Directors. I recommend t h a t Federal Reserve Board. shares of stock be allotted to it by the Federal Reserve Agent, Federal Reserve Bank of New York. CERTIFICATE OF APPROVAL The foregoing application for the surrender of shares of stock in the Federal Reserve Bank of Philadelphia, and for the allotment of shares of stock in the Federal Reserve Bank of New York has been approved by the Federal Reserve Board. Secretary, Federal Reserve Board. RECORD O F ENTRY The foregoing application has been duly entered on the records of the Federal Reserve Board. Bookkeeper. .191 .
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