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Federal R eserve Ba n k o f D allas
DALLAS, TEXAS

75222
Circular No. 80-227
November 25, 1980

R E G U L A T IO N
F o rm s F F IE C

0

003 and 004

TO TH E C H IE F EX E C U T IV E O F F IC E R
O F A L L M E M B E R B A N K S IN T H E
E L E V E N T H F E D E R A L R E SE R V E D IST R IC T :
On N o v em b er
21,
1979,
th e
Federal
R e s e r v e B oard p u b lish e d
a m e n d m e n ts to it s R e g u la tio n O to im p le m e n t th e r e p o r tin g r e q u ir e m e n ts o f
T i t l e s VIII a n d IX o f t h e F i n a n c i a l I n s t i t u t i o n s R e g u l a t o r y a n d I n t e r e s t R a t e
C o n tr o l A c t o f 1 9 7 8 (F IR A ).
T i t l e s VIII a n d IX a n d R e g u l a t i o n O r e q u i r e t w o
s e p a r a t e r e p o r t s : (1 ) a n a n n u a l r e p o r t t o b e s u b m i t t e d b y e x e c u t i v e o f f i c e r s a n d
p r in c ip a l sh a r e h o ld e r s o f m e m b e r b a n k s t o th e b o a rd s o f d ir e c t o r s o f th e ir b an k s
w ith r e s p e c t t o in d e b te d n e s s o f t h e e x e c u t i v e o f f i c e r s and p r in c ip a l s h a r e h o ld e r s
and th e ir r e la t e d in t e r e s t s t o t h e m e m b e r b a n k 's c o r r e s p o n d e n t b an k s; an d (2) a
r e p o r t t o b e s u b m it te d b y e a c h m e m b e r bank t o it s p r im a ry f e d e r a l bank
su p e r v is o r c o n c e r n in g t h e p r in c ip a l s h a r e h o ld e r s o f t h e r e p o r tin g bank and th e
in d e b te d n e ss o f it s e x e c u t iv e o f f ic e r s and p rin cip a l sh a r e h o ld e r s and th e ir
r e la te d in te r e s t s t o th e r e p o r tin g bank i t s e l f and to it s c o r r e sp o n d e n t banks.
T h e tw o fo r m s e n c l o s e d a re p ro v id e d fo r y o u r u se and t h e u s e o f yo u r
e x e c u t i v e o f f i c e r s and p r in c ip a l s h a r e h o ld e r s . F o r m s a r e b e in g p r o v id ed n a tio n a l
banks a t th e r e q u est o f th e C o m p tr o lle r o f th e C u rren cy .
B oth o f th e fo rm s
h a v e b e e n ap p ro v ed by th e F e d e r a l F in a n c ia l In stitu tio n s E x a m in a tio n C o u n cil
(F F IE C ) fo r u se by a ll f e d e r a lly in su r ed b an k s and by t h e ir e x e c u t i v e o f f i c e r s and
p r in c ip a l s h a r e h o ld e r s .
T h u s, a ll in su r ed b a n k s w ill b e u sin g u n ifo rm r e p o r t
f o r m s in c o m p l y i n g w i t h t h e r e p o r t i n g r e q u i r e m e n t s o f T i t l e s VIII a n d I X o f
F IR A .
M e m b e r b a n k s a r e r e q u ir ed u n d er R e g u la t io n O t o f ile a F o rm F F IE C
0 0 3 w i t h t h e a p p r o p r i a t e F e d e r a l R e s e r v e B a n k , in t h e c a s e o f S t a t e m e m b e r
b a n k s , o r t h e R e g i o n a l A d m i n i s t r a t o r , in t h e c a s e o f n a t i o n a l b a n k s . T h e r e p o r t
m u s t b e f i l e d b y M a r c h 31 o f e a c h y e a r a n d c o v e r s t h e p r e v i o u s c a l e n d a r y e a r .
T h e t i m e p e r io d c o v e r e d b y t h e 1 9 8 1 r e p o r t is J a n u a r y 1 t o D e c e m b e r 3 1 , 1 9 8 0 .
S o m e o f t h e in fo r m a tio n req u ir ed t o b e f ile d on F o rm F F IE C 0 0 3 w ill b e ta k e n
fr o m t h e F F IE C 0 0 4 (or s im il a r f o r m ) f o r m s s u b m i t t e d t o t h e m e m b e r b a n k s b y
th e ir e x e c u t iv e o f f ic e r s and p rin cip a l sh a r e h o ld e r s.
T h e o t h e r fo r m e n c lo s e d , F o rm F F IE C 0 0 4 , is p r o v id e d t o a s s is t
e x e c u t i v e o f f i c e r s a n d p r i n c i p a l s h a r e h o l d e r s o f m e m b e r b a n k s in m e e t i n g t h e i r
r e p o r t i n g r e q u i r e m e n t s u n d e r T i t l e VIII o f F I R A . Y o u r b a n k s h o u l d m a k e c o p i e s
o f t h e fo rm a v a ila b le t o y o u r e x e c u t iv e o f f i c e r s and p rin cip a l sh a r e h o ld e r s. T h e
e x e c u t i v e o f f i c e r s and p r in c ip a l s h a r e h o ld e r s m a y , if t h e y w ish , p r o v id e t h e
re q u ir e d in fo r m a tio n o n o t h e r fo r m s .

Banks and others are encouraged to use the following incoming W A T S numbers in contacting this Bank:
1-800-442-7140 (intrastate) and 1-800-527-9200 (interstate). F o r calls placed locally, please use 651 plus the
extension referred to above.

This publication was digitized and made available by the Federal Reserve Bank of Dallas' Historical Library (FedHistory@dal.frb.org)

- 2 -

S u b j e c t t o t h e r e p o r t i n g r e q u i r e m e n t s o f T i t l e VIII o f F I R A , r e p o r t s
o f in d e b t e d n e s s (an d in d e b t e d n e s s o f r e la t e d i n t e r e s t s ) t o c o r r e s p o n d e n t b a n k s o f
t h e m e m b e r bank w h ich h a s b e e n in cu rred by
e x e c u t i v e o f f i c e r s and p r in cip a l
sh a r e h o ld e r s m u st b e
file d w ith th e m e m b e r
b a n k 's b o a rd o f d ir e c t o r s b y
J a n u a r y 31 o f e a c h y e a r .
T h e 1 9 8 1 r e p o r t c o v e r s th e p erio d J a n u a ry 1 to
D ecem b er 31, 1980.
E a c h m e m b e r b an k sh o u ld n o t if y it s e x e c u t i v e o f f i c e r s an d p r in c ip a l
s h a r e h o l d e r s o f t h e r e p o r t i n g r e q u i r e m e n t s o f T i t l e VIII o f F I R A .
The persons
n o t if ie d sh o u ld in c lu d e a n y p e r s o n w h o w a s a n e x e c u t i v e o f f i c e r or p r in c ip a l
s h a r e h o ld e r o f t h e m e m b e r b an k d u r in g t h e p e r io d J a n u a r y 1 t o D e c e m b e r 3 1 ,
1 9 8 0 , s in c e a ll o f t h e s e p erso n s a r e su b je c t to r e p o r tin g r e q u ir e m e n ts if th e y
w e r e in d e b t e d t o a c o r r e s p o n d e n t b an k o f t h e m e m b e r b an k d u r in g th is p e r io d .
E a c h m e m b e r b an k is a ls o r e q u ir e d t o m a k e a v a ila b le t o it s e x e c u t i v e o f f i c e r s
an d p r in c ip a l s h a r e h o ld e r s a l i s t o f t h e m e m b e r b a n k 's c o r r e s p o n d e n t b a n k s. A
c o r r e s p o n d e n t b an k is d e f in e d a s a b an k t h a t
m a in ta in s o n e or m o re c o r r e ­
s p o n d e n t a c c o u n t s fo r a m e m b e r b an k d u r in g
t h e c a l e n d a r y e a r t h a t in t h e
a g g r e g a t e e x c e e d c e r t a i n a m o u n t s s p e c i f i e d in t h e r e g u l a t i o n .
F orm F F IE C 0 0 4 , or sim ila r fo r m , th a t is file d by e x e c u t iv e o f f ic e r s
and p r in c ip a l s h a r e h o ld e r s , m u st b e k e p t on f ile a t t h e m e m b e r b ank fo r a p erio d
o f th ree years.
T h e s e r e p o r ts a r e n o t r e q u ir ed t o b e m a d e a v a ila b le t o th e
p u b lic ; h o w e v e r , t h e r e p o r t s w ill b e r e v i e w e d b y e x a m in e r s d u r in g t h e c o u r s e o f
th e e x a m in a tio n o f th e m em b e r bank.
T h e r e p o r ts file d by e x e c u t iv e o f f ic e r s
and p r in c ip a l s h a r e h o ld e r s a r e n o t r e q u ir ed t o b e f ile d w ith t h e R e s e r v e B ank or
R e g io n a l A d m in istr a to r .
F o r m F F I E C 0 0 3 , w h i c h is f i l e d b y t h e m e m b e r b a n k w i t h t h e
R e s e r v e B an k or t h e R e g io n a l A d m in is t r a t o r , is s u b j e c t t o p u b lic d is c lo s u r e .
B o th t h e m e m b e r bank an d th e p rim a ry fe d e r a l bank su p e r v is o r a r e req u ir ed t o
m a k e a c o p y o f t h e r e p o r t a v a ila b le t o t h e p u b lic u p on r e q u e s t .

en clo sed

A n y c o m m e n ts th a t y ou m ig h t h a v e
fo r m s w ill be a p p r e c ia te d .

w ith r e s p e c t to th e u se o f th e

A ll q u e s t io n s or c o m m e n t s sh o u ld b e d i r e c t e d t o E a rl A n d e r so n ,
C h i e f E x a m i n e r , E x t . 6 6 6 5 o r M a r v in M c C o y , E x t . 6 6 5 7 , o f o u r B a n k S u p e r v i s i o n
and R e g u la tio n s D e p a r tm e n t.
S in c e r e ly yours,
R o b e r t H . B o y k in

First Vice President

Enclosures

*'

Board of Governors of the Federal Reserve System
C om ptroller of the Currency
Federal Deposit Insurance Corporation

*
Form F F IE C 003:
^
Approved by the Federal Financial Institutions
Examination Council - November 15, 19 79
Approval Expires - November 19 82

L

Name of Reporting Bank

Report on Ownership of the Reporting Bank and on
Indebtedness of its Executive Officers and
Principal Shareholders to the Reporting Bank and to its
Correspondent Banks

City

F o r t h e C a le n d a r Y e a r E n d in g D e c e m b e r 3 1 , 1 9

This report is required by law
(12 U.S.C. 1972 and 12 U.S.C. 1817<k))

State

Use a d d it io n a l page(s) i f a n y o f t h e lists c o n ta in s m o r e t h a n te n nam es

Part I

P a r t II

P rin c ip a l S h a r e h o ld e r s o f R e p o r t in g B a n k o n D e c e m b e r 3 1 o f th e C a le n d a r

L is t o f

Year

R e p o r t in g B a n k D u r in g t h e Y e a r w h o w a s , o r W h o se R e la te d In te re s ts w e r e .

R e p o r t in g B a n k t h a t F ile d w i t h t h e B o a rd o f D ir e c to r s o f t h e R e p o r tin g

P a rt I I I
E ach

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Each

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S h a r e h o ld e r o f t h e

Lis t o f

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S h a r e h o ld e r o f th e

In d e b t e d t o t h e R e p o r t in g B a n k a t a n y t i m e D u r in g t h e C a le n d a r Y e a r

B a n k a R e p o r t o n In d e b te d n e s s t o C o r r e s p o n d e n t B an ks

Nam e

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1.

1.

2.

2.

2.

3.

3.

4.

3.

4.

5.

4.

5.

6.

5.

6.

7.

6.

7.

8.

7.

8.

9.

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A G G R E G A T E A M O U N T O F IN D E B T E D N E S S :
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A G G R E G A T E A M O U N T O F IN D E B T E D N E S S :
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c a le n d a r

a n d s h a re h o ld e rs a n d o f e a c h o f t h e ir r e la te d in te re s ts .

a b o v e -lis te d

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Name and title of officer responsible fo r report
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s ,9nature o f officer responsible fo r report

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r e p o r t in g b a n k o n D e c e m b e r 31 o f t h e c a le n d a r y e a r f o r w h ic h th is r e p o r t

d i r e c t ly o r in d ir e c t ly , o w n s , c o n t r o ls , o r has t h e

f o r all lis te d pe rs ons . In d e t e r m i n in g t h e h ig h e s t a m o u n t o f in d e b te d n e s s

p o w e r t o v o te m o r e t h a n 1 0 p e r c e n t o f a n y class o f v o t in g s e c u ritie s o f
E v e r y n a tio n a l b a n k . S ta t e m e m b e r b a n k a n d in s u re d S ta t e n o n m e m b e r

o u ts t a n d in g a t m o n t h -e n d s . T h e o p t io n c h o se n m u s t be used c o n s is te n tly

o r fo r e ig n

B a n k s R e q u ir e d t o F ile R e p o r ts

o p t i o n , use e it h e r t h e in d e b te d n e s s o u ts t a n d in g d a i l y o r t h e in d e b te d n e s s

is fil e d . " P r in c ip a l s h a r e h o ld e r " m e a n s a n y p e rs o n ( o t h e r t h a n an in s u re d

R E P O R T IN G R E Q U IR E M E N T S

o u ts t a n d in g o f e a c h p r in c ip a l s h a r e h o ld e r, in d e b te d n e s s o f a n y m e m b e r o f

t h e r e p o r t in g b a n k .

t h e s h a r e h o ld e r's im m e d ia t e f a m i l y is t o be t r e a t e d as in d e b te d n e s s o f th e

bank)

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o u ts t a n d in g v o t in g shares. H o w e v e r , t h e r e g u la tio n p res u m es

p o lic y m a k in g f u n c t io n s o f t h e b a n k . C e r ta in c a te g o rie s o f b a n k o f fic e r s ,

c o n t r o l in s o m e cases w h e r e less t h a n 2 5 p e r c e n t o w n e r s h ip o r c o n tr o l

such as vice p r e s id e n ts , a re c o n s id e re d e x e c u tiv e o f fic e r s unless t h e y are

ex ists.

e x c lu d e d b y r e s o lu tio n o f t h e b o a r d o f d ir e c to r s o f t h e b a n k o r b y its

c o m p a n y 's

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a n d d o n o t p a r t ic ip a t e th e r e in .

o w n e d o r c o n t r o l le d b y a m e m b e r o f an in d iv id u a l's i m m e d ia t e f a m i l y are
S ta t e N o n m e m b e r B an ks: T o th e 'R e g io n a l D ir e c t o r o f t h e F e d e r a l D e p o s it
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t h e spouse o f an in d iv i d u a l, t h e in d iv id u a l's m in o r c h ild r e n , a n d a n y o t h e r
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W h e n R e p o r ts are t o b e F ile d

For

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I I , o n l y o n e in d iv id u a l in t h e im m e d ia t e f a m i l y

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re p o rt fo r

each

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T h e list o f p r in c ip a l s h a r e h o ld e rs s h o u ld in c lu d e t h e a c tu a l o w n e r r a th e r

b a n k in g a g e n c y b y M a r c h 31 o f t h e n e x t y e a r .

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in s u re d o r fo r e ig n

p o litic a l c o m m i t t e e , t h e fu n d s o r services o f w h ic h w ill b e n e f it a p e rs o n o r
t h a t is c o n t r o l le d b y t h e p e rs o n . T h e t e r m " c o n t r o l " is d e fin e d in s e c tio n
2 1 5 . 2 ( b ) o f R e g u la t io n O a n d , as discussed a b o v e , is g e n e r a lly o w n e r s h ip

T h e in d e b te d n e s s t h a t is r e p o r t a b le in t h e e n t r y f o r ag grega te a m o u n t o f

s ta te d in s e c tio n 2 1 5 . 3 o f R e g u la t io n 0 .

Availability of Reports
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in d e b te d n e s s in P a r t I I in c lu d e s a ll ty p e s o f c r e d i t e x c e p t t h e e x c lu s io n s

th a n t h e s t o c k h o ld e r o f r e c o r d , w h e r e th e s e d i f f e r .

C o p ie s o f th is

i n t e r e s t " m ean s a n y c o m p a n y

b a n k ) t h a t is c o n t r o l le d b y an in d iv id u a l o r c o m p a n y , a n d a n y c a m p a ig n o r

o r c o n t r o l o f 2 5 p e r c e n t o r m o r e o f a c o m p a n y 's v o tin g shares.

c o m p le t i n g Parts I a n d I I .
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b a n k in g ag encies a re also

r e q u ire d

b y la w t o m a k e th e s e

L is t

P art I I I

of

ea c h

e x e c u tiv e

o f f ic e r

and

each

p r in c ip a l

s h a r e h o ld e r o f th e

r e p o r t in g b a n k d u r i n g t h e y e a r w h o w as, o r w h o s e r e la t e d in te re s ts w e r e ,
in d e b te d t o t h e r e p o r t in g b a n k a t a n y t i m e d u r in g t h e c a le n d a r y e a r.

L is t

of

e a ch

e x e c u tiv e

o f f ic e r

and

e a ch

p r in c ip a l

s h a r e h o ld e r o f t h e

r e p o r t in g b a n k t h a t f il e d w it h t h e b o a r d o f d ir e c to r s o f t h e r e p o r t in g b a n k
a r e p o r t o n in d e b te d n e s s t o c o r r e s p o n d e n t b a n k s .

r e p o rts a v a ila b le t o t h e p u b lic u p o n re q u e s t.
P a rt I I consists o f a lis t b y n a m e o f each p e rs o n w h o a t a n y t i m e d u r in g

f o llo w in g

c o m p le t i n g th is

d e f in it io n s
re p o rt.

are

in t e n d e d

to

p r o v id e ge n eral g u id a n c e

in

C o r p o r a t io n 's

r e p o r t in g b a n k a n d w h o w as , o r w h o s e r e la te d in te re s ts w e r e , in d e b te d to
The

Under

t h e c a le n d a r y e a r w as an e x e c u tiv e o f f ic e r o r p r in c ip a l s h a r e h o ld e r o f th e

D E F IN IT IO N S

s h a r e h o ld e r

th e

P a r t II also

in te r e s t w as in d e b t e d , d u r in g a c a le n d a r y e a r t o a c o r r e s p o n d e n t b a n k o f

r e p o r t in g

bank

at any

tim e

d u r in g

th e

c a le n d a r y e a r.

s e c tio n

2 1 5 .2 2
R u le s a n d

of

an

of

R e g u la t io n

O

and

s e c tio n

3 4 9 .3

of

th e

R e g u la tio n s , e a ch e x e c u t iv e o f f ic e r o r p r in c ip a l

in s u re d

bank

who

w as

in d e b t e d , o r w h o s e

r e la te d

F o r prec ise d e f in it io n s , see th e F e d e r a l R eserve

re q u ire s t h e b a n k t o r e p o r t t h e aggregate a m o u n t o f t h e h ig h e s t a m o u n ts

such in s u r e d b a n k m u s t , b y J a n u a r y 31 o f t h e n e x t y e a r , m a k e a w r i t t e n

B o a rd 's R e g u la t io n O ( 1 2 C . F . R . P a rt 2 1 5 ) o r s e c tio n 3 0 4 . 4 a n d P a r t 3 4 9

o f in d e b te d n e s s o u ts t a n d in g t o t h e r e p o r t in g b a n k b y th e s e persons an d

rep o rt

o f t h e F e d e r a l D e p o s it In s u ra n c e C o r p o r a t io n 's R u le s an d R e g u la tio n s ( 1 2

t h e i r r e la te d in te re s ts . In c a lc u la tin g t h e aggregate a m o u n t o f in d e b te d n e s s

in d e b te d n e s s . P a r t I I I o f t h e f o r m co nsists o f ( 1 ) a lis t b y n a m e o f e a ch o f

f o r P a r t I I , t h e r e p o r t in g b a n k sh all ( 1 ) d e t e r m i n e

C . F . R . 3 0 4 . 4 a n d P a rt 3 4 9 ) .

e x e c u tiv e
th e ir

P art I

r e la te d

o u ts t a n d in g

P rin c ip a l s h a re h o ld e rs o f r e p o r t in g b a n k o n D e c e m b e r 31

separately f o r each o f
separately f o r each

o f fic e r s a n d p r in c ip a l s h a re h o ld e rs an d
in te r e s ts ,
to

th e

th e

h ig h e s t a m o u n t o f

r e p o r t in g

bank

d u r in g

r e p o r t a b le

th e

its

t h e e x e c u tiv e

of

who

in d e b te d n e s s

t h e c a le n d a r y e a r ; a n d

to

(2 )

b o ard

o f d ire c to r s o f such

o f fic e r s a n d

s u b m it t e d ,

by

in s u re d

bank

re g a rd in g t h a t

p r in c ip a l s h a r e h o ld e rs o f t h e r e p o r t in g b a n k

J a n u a ry

31

of

th e

year

in

w h ic h

th is

re p o rt

is

s u b m it t e d , a r e p o r t o n such in d e b te d n e s s t o c o r r e s p o n d e n t b a n k s f o r t h e
p re v io u s c a le n d a r y e a r ; a n d

(2 ) th e sum

o f th e m a x im u m

a m o u n ts o f

c a lc u la te a n d r e p o r t t h e t o t a l o f all o f th ese s e p a ra te h ig h e s t a m o u n ts . In
P a rt

I

consists

of

a

list

by

nam e

of

each

in d iv id u a l,

c o r p o r a t io n ,

p a rt n e r s h ip , t r u s t o r o t h e r e n t i t y t h a t was a p r in c ip a l s h a r e h o ld e r o f th e

in d e b te d n e s s o f th e s e e x e c u tiv e o f fic e r s a n d p r in c ip a l s h a re h o ld e rs a n d

t h is

t h e i r r e la t e d

d e te rm in a tio n

o u ts t a n d in g

d u rin g

of
th e

th e

s e p a ra te

c a le n d a r

h ig h e s t

y e a r, th e

a m o u n ts

r e p o r t in g

of
bank

in d e b te d n e s s
m ay, at

its

in te re s ts as r e p o r t e d

d ir e c to r s o f t h e r e p o r t in g b a n k .

in t h e i r su b m is s io n s t o t h e b o a r d o f

Board o f Governors of the Federal Reserve System
C om ptroller o f the Currency
Federal Deposit Insurance Corporation

Form F FI EW 0 0 4
^
%
J Approved by the Federal Financial Institutions
Examination Council - November 15, 1 9 7 9
Approval Expires November 19 82

Name of Executive O fficer or Principal Shareholder Subm itting Report

Report on Indebtedness of Executive Officers and
Principal Shareholders and their Related Interests
to Correspondent Banks

To be submitted by executive officers and princi­
pal shareholders of insured banks to the boards o f
directors of their banks in satisfaction o f the
reporting requirements of the Federal Reserve
Board's Regulation O (1 2 C .F .R . Part 2 1 5 ) and
Part 3 4 9 of the Federal Deposit Insurance Corpora­
tion's Rules and Regulations (12 C .F .R . Part 3 4 9 )
with respect to indebtedness to correspondent
banks.

Name of Bank to which R eport is Submitted

City

State

F o r t h e C a le n d a r Y e a r E n d in g D e c e m b e r 3 1 , 1 9 ____

S ta tu s o f R e p o r t in g P e rs o n :

A . M a x i m u m a m o u n t o f in d e b te d n e s s o u ts t a n d in g d u r in g t h e c a le n d a r y e a r:

D . T e rm s

an d

C o n d it io n s

of

each

e x te n s io n

of

c r e d it

in c lu d e d

as

in d e b te d n e s s in t h e a m o u n t r e p o r t e d in B o x A (see In s t r u c t io n 3 ) . Use
a d d it io n a l

______ E x e c u tiv e O f f ic e r

pages

if

in d e b te d n e s s

consists o f m o r e t h a n

a n d / o r m o r e space is n e e d e d t o r e p o r t te r m s a n d c o n d it io n s :
______ P rin c ip a l S h a r e h o ld e r

( I n th o u s a n d s o f d o lla r s ) $

I f t h e r e p o r t is s u b m it t e d f o r in d e b te d n e s s o f a r e la te d in te r e s t , n a m e an d
ad dress o f r e la t e d in te r e s t f o r w h ic h t h e r e p o r t is s u b m it t e d :

B.

M e t h o d used t o d e t e r m i n e m a x i m u m a m o u n t o f in d e b te d n e s s o u t s t a n d ­

L o a n 1:

in g (c h e c k o n e ) :

_____ i. h ig h e s t o u t s t a n d in g in d e b te d n e s s d u r in g t h e c a le n d a r y e a r

.ii.

h ig h e s t e n d o f th e m o n t h in d e b te d n e s s o u ts t a n d in g d u r i n g t h e
c a le n d a r y e a r

Nam e

an d ad dress o f t h e

c o rre s p o n d e n t b a n k t o

w h ic h

th e

e x e c u tiv e

o f f i c e r , p r in c ip a l s h a r e h o ld e r , o r r e la te d in te r e s t is in d e b te d :

L o a n 2:

C. A m o u n t o f in d e b te d n e s s o u ts t a n d in g 1 0 business d a y s p r io r t o t h e d a te
o f f il in g th is R e p o r t :

Lo an 3:

( I n th o u s a n d s o f d o lla r s ) $ .

I h e r e b y c e r t i f y t h a t in f o r m a t i o n g iven a b o v e is c o m p le t e , c o r r e c t ,
t r u e t o t h e b e st o f m y k n o w le d g e .

Signature of official responsible fo r report

Date Signed

th re e

loans

^General Instructions
1. Persons R e q u ir e d t o F ile R e p o r t

In

A R e p o r t o n In d e b te d n e s s t o C o r r e s p o n d e n t B a n ks ( F o r m F F I E C 0 0 4 ) ,
o r a s im ila r f o r m c o n t a in in g id e n t ic a l i n f o r m a t i o n , m u s t be c o m p le t e d
b y each e x e c u tiv e o f f i c e r a n d e a ch p r in c ip a l s h a r e h o ld e r o f an in s u re d
bank

who

w as

in d e b t e d , o r w h o s e

re la te d

in te re s ts w e r e

in d e b te d ,

d u r in g th e c a le n d a r y e a r f o r w h ic h t h e r e p o r t is b e in g s u b m it t e d t o a

d e t e r m i n in g t h e m a x i m u m

s h a r e h o ld e r ,
im m e d ia t e

th e
fa m ily

s h a r e h o ld e r .

a m o u n t o f in d e b te d n e s s o f a p r in c ip a l

in d e b te d n e s s

E ach

is t o

of

be tr e a t e d

m a x im u m

a

m em ber

of

th e

as in d e b te d n e s s o f t h e

am ount of

" Im m e d ia te

s h a re h o ld e r's

in d iv id u a l's

p r in c ip a l

in d e b te d n e s s r e p o r t e d

fa m ily "
m in o r

m ean s

th e

c h ild r e n , a n d

sp ou se
any

of

o f th e

an

in d iv id u a l,

th e

in d iv id u a l's c h ild r e n

(in c lu d in g a d u lt s ) resid in g in t h e in d iv id u a l's h o m e . F o r r e p o r t in g

m ay

p u rp o s e s , o n l y

one

in d iv id u a l

in t h e

im m e d ia t e

in c lu d e several s e p a ra te e x te n s io n s o f c r e d it . T h e r e p o r t in g p e rs o n m u s t

re p o rts ,

r e p o r t s e p a r a te ly t h e te r m s a n d c o n d itio n s o f e a ch o f th e s e e x te n s io n s

fa m ily

m u s t f ile

in d e b te d n e s s o f t h e in d iv id u a l's im m e d ia t e f a m i l y .

if

th a t

in d iv id u a l's

r e p o rts

in c lu d e

th e

in f o r m a t i o n

on

o f c r e d it .

c o r r e s p o n d e n t b a n k o f t h e i r b a n k . A l l in s u re d b a n k s a r e r e q u ir e d b y
la w

to

m ake

a v a ila b le

to

th e ir

e x e c u tiv e

o ffic e rs

and

p r in c ip a l

s h a re h o ld e rs a lis t o f t h e b a n k 's c o r r e s p o n d e n t b a n k s . " C o r r e s p o n d e n t
b a n k ” m ean s g e n e r a lly a b a n k t h a t m a in t a in s a c o r r e s p o n d e n t a c c o u n t
in excess o f a c e r ta in a m o u n t f o r t h e o f fic e r 's o r s h a r e h o ld e r's b a n k .

c.
E ach

rep o rt on

in d e b te d n e s s t o

each c o r r e s p o n d e n t b a n k m u s t also

in c lu d e t h e a m o u n t o f in d e b te d n e s s o u ts t a n d in g t o t h e c o r r e s p o n d e n t
bank

C o n t r o l o f a c o m p a n y is d e f in e d in s e c tio n 2 1 5 . 2 ( b ) o f R e g u la t io n O
as g e n e r a lly o w n e r s h ip o r c o n tr o l
c o m p a n y 's

1 0 business da y s b e fo r e t h e d a te t h e r e p o r t o n in d e b te d n e s s is

p re s u m e s

fil e d . I f t h e in f o r m a t i o n o n t h e a m o u n t o f in d e b te d n e s s o u ts t a n d in g t o

o u ts t a n d in g
c o n tro l

in

v o tin g

som e

of

25

shares.

cases

per cent o r m o re
H o w ever,

w h ere

less

th e

th a n

of a

r e g u la tio n

25

per

cent

o w n e r s h ip o r c o n t r o l exists.

a c o r r e s p o n d e n t b a n k 1 0 business d a y s b e fo r e t h e f il in g o f t h e r e p o r t is
The

e x e c u tiv e

o ffic e r

or

p r in c ip a l

s h a r e h o ld e r

m ust file

a s e p a ra te

r e p o r t c o n c e r n in g t h e in d e b te d n e s s o f t h e o f f ic e r o r s h a r e h o ld e r t o each
c o r r e s p o n d e n t b a n k a n d a s e p a ra te r e p o r t c o n c e r n in g t h e in d e b te d n e s s
o f each o f t h e r e la te d in te re s ts o f t h e o f f ic e r o r s h a r e h o ld e r t o each

n o t a v a ila b le o r c a n n o t be r e a d ily a s c e rta in e d b y t h e f il in g d a t e , an

d. " R e l a t e d in t e r e s t " m ean s a n y c o m p a n y c o n t r o l le d b y a p e rs o n a n d

e s tim a te o f t h e a m o u n t o f such in d e b te d n e s s m a y be f il e d , p r o v id e d

a n y p o lit ic a l o r c a m p a ig n c o m m i t t e e , t h e fu n d s o r services o f w h ic h

t h a t t h e a c tu a l a m o u n t o f such in d e b te d n e s s is s u b m it t e d t o t h e b a n k 's

w ill b e n e f it a p e rs o n o r t h a t is c o n t r o l le d b y a p e rs o n . H o w e v e r , a

b o a r d o f d ir e c to r s w i t h i n t h e n e x t 3 0 d a ys.

r e la t e d in te r e s t d o e s n o t in c lu d e a b a n k o r a fo r e ig n b a n k .

c o r r e s p o n d e n t b a n k . F o r e x a m p le , i f an e x e c u tiv e o f f ic e r is in d e b te d t o
tw o
each

c o r r e s p o n d e n t b a n k s , t h e o f f ic e r m u s t f i l e t w o r e p o r t s , o n e f o r
c o rre s p o n d e n t

bank.

If

th e

e x e c u tiv e o f f ic e r has t w o

r e la te d

4 . D e f i n it i o n s

e.

in terests t h a t w e r e also b o th in d e b te d t o t w o c o r r e s p o n d e n t b a n k s , th e

T h e f o l l o w i n g d e f in it io n s are in te n d e d t o p r o v id e g e n e ra l g u id a n c e in

o f f ic e r w o u ld f il e s ix r e p o r t s , t w o f o r t h e o f fic e r 's o w n in d e b te d n e s s

c o m p le t i n g th is r e p o r t . F o r prec ise d e f in it io n s , s e e t h e F e d e r a l Reserve

a n d f o u r f o r t h e in d e b te d n e s s o f t h e o f fic e r 's r e la t e d in te re s ts . I f t h e

B o a rd 's R e g u la t io n O

e x e c u tiv e o f f i c e r is n o t in d e b t e d t o a c o r r e s p o n d e n t b a n k , b u t a r e la te d

e x te n s io n

of

s e c tio n 2 1 5 . 3 o f R e g u la t io n 0 ) , b u t do es

" In d e b te d n e s s "

in c lu d e s

any

not

c r e d it

(as

d e fin e d

in

in c lu d e :

R u le s a n d R e g u la tio n s ( 1 2 C F R P a rt 3 4 9 ) .

in te r e s t

of

th e

o f f ic e r

is

in d e b te d

to

a co rresp o n d en t

bank,

i. c o m m e r c ia l p a p e r , b o n d s a n d d e b e n tu r e s issued in t h e o r d i n a r y

( 1 2 C F R P a rt 2 1 5 ) an d P art 3 4 9 o f th e F D lC 's

c o u rs e o f business; an d

th e

e x e c u tiv e o f f ic e r m u s t f il e a r e p o r t c o n c e rn in g t h e in d e b te d n e s s o f th e
o f fic e r 's r e la te d in te r e s t t o t h e c o r r e s p o n d e n t b a n k .

ii. c o n s u m e r c r e d it (as d e f in e d in s e c tio n 2 2 6 . 2 ( p ) o f R e g u la t io n Z )
a.

" E x e c u t i v e o f f i c e r " is d e fin e d in s e c tio n 2 1 5 . 2 o f R e g u la t io n O an d

to
2 . W h e r e a n d W h e n R e p o r t s a re t o b e F ile d

p a r t ic ip a t e

p o lic y m a k in g

T h e e x e c u tiv e o f f ic e r o r p r in c ip a l s h a r e h o ld e r m u s t s u b m it t h e r e p o r t
o n in d e b te d n e s s t o c o r r e s p o n d e n t b a n k s t o t h e b o a r d o f d ire c to r s o f
th e r e p o r t in g p e rs o n 's b a n k f o r each c a le n d a r y e a r b y J a n u a r y 3 1 o f th e
n e x t y e a r.

in an

m e a n s g e n e r a lly an in d iv id u a l w h o p a r t ic ip a te s o r w h o has a u t h o r i t y

(e.g.,

o f fic e r s

(o th e r th a n
f u n c t io n s

of

in t h e c a p a c ity o f a d i r e c t o r ) in m a jo r
th e

bank.

C e r ta in

c a te g o rie s o f

unless t h e y

are e x c lu d e d

by

r e s o lu tio n

f.

o f th e

h ig h e s t

s h o u ld

in d iv id u a l o r c o m p a n y ( o t h e r

ea ch c o r r e s p o n d e n t b a n k :

a m o u n t o f in d e b te d n e s s

o w n s , c o n tr o ls , o r has t h e p o w e r t o v o te m o r e t h a n 1 0 p e r c e n t o f

o u ts t a n d in g d u r i n g t h e c a le n d a r y e a r, a n d (b ) t h e te r m s a n d c o n d itio n s

a n y class o f v o tin g s e c u ritie s o f t h e b a n k . T h e t e r m in c lu d e s a p e rs on

each

e x te n s io n o f c r e d it in c lu d e d in t h e m a x i m u m a m o u n t r e p o r t e d .

T h e te rm s a n d c o n d it io n s t o be r e p o r t e d are: ( 1 ) t h e o r ig in a l a m o u n t

end

of

t h a t c o n tr o ls a p r in c ip a l s h a r e h o ld e r

(e.g.,

be

e it h e r

th e

(i) t h e

m o n th

c o n s is te n tly

c o rres p o n d en t

t h a n an in s u re d b a n k o r a fo r e ig n b a n k ) t h a t , d i r e c t ly o r in d ir e c t ly ,

of

a m o u n t o f in d e b te d n e s s " m e a n s , a t t h e o p t io n o f t h e
p e rs o n ,

c a le n d a r y e a r f o r w h ic h
S h a r e h o ld e r " m e a n s a n y

each c o rr e s ­

h ig h e s t o u ts t a n d in g

in d e b te d n e s s

d u r in g t h e c a le n d a r y e a r f o r w h ic h t h e r e p o r t is m a d e , o r ( ii ) th e

m a jo r p o lic y m a k in g fu n c t io n s o f t h e b a n k a n d d o n o t p a r t ic ip a te

T h e r e p o r t in g p e rs o n m u s t in c lu d e in e a ch r e p o r t o n in d e b te d n e s s t o
(a ) t h e m a x im u m

" M a x im u m
r e p o r t in g

b o a r d o f d ir e c to r s o f t h e b a n k o r b y its b y la w s f r o m p a r t ic ip a t io n in

b. " P r in c ip a l

less, f r o m

a re n o t m o r e fa v o r a b le t h a n th o s e o f f e r e d t h e ge n eral p u b lic .

t h e r e in .

3 . W h a t M u s t be R e p o r t e d

or

bank

v ic e p r e s id e n ts ) are p re s u m e d in R e g u la t io n 0 t o be

e x e c u tiv e o f fic e r s

ag gregate a m o u n t o f $ 5 , 0 0 0 ,

p o n d e n t b a n k , p r o v id e d th e c r e d it is in c u r r e d u n d e r te r m s t h a t

bank.

th e

in d e b te d n e s s

used

The

o u ts t a n d in g

d u r in g

th e

r e p o r t is m a d e . T h e m e t h o d c h o se n
fo r

ail

r e p o r t in g

in d e b te d n e s s

p e rs o n

to

th e

m u s t in d ic a te

sam e

on

th e

r e p o r t w h e t h e r t h e m a x im u m a m o u n t w as d e t e r m i n e d as o f t h e e n d
o f t h e m o n t h o r o n a d a ily basis.

a p e rs o n t h a t c o n tr o ls a
g.

b a n k h o ld in g c o m p a n y ) .

" C o rre s p o n d e n t b a n k ," " c o m p a n y ," and o th e r te rm s p e rtin e n t to
th is r e p o r t a re d e fin e d in t h e B o a rd 's R e g u la t io n O , 1 2 C F R P a rt

a n d d a te ; ( 2 ) t h e m a t u r i t y d a te ; ( 3 ) t h e p a y m e n t te r m s ; ( 4 ) t h e ra n g e o f
in te r e s t rates c h a rg e d d u r i n g t h e c a le n d a r y e a r; ( 5 ) w h e t h e r s e cu red o r

For

th e

p u rp o s e

u n s e c u re d ; ( 6 ) i f s e c u re d , a d e s c r ip t io n o f c o lla t e r a l a n d its v a lu e ; a n d

shares

( 7 ) a n y u n u s u al t e r m s o r c o n d itio n s .

im m e d ia t e f a m i l y a re p r e s u m e d t o be c o n t r o l le d b y t h e in d iv id u a l.

ow ned

or

o f d e t e r m i n in g w h o
c o n t r o l le d

by

a

is a p r in c ip a l

m em ber

of

th e

s h a r e h o ld e r,
in d iv id u a l's

215

(1 9 7 9 )

and

P art

349

of

th e

Federal

D e p o s it

C o r p o r a t io n 's R u le s an d R e g u la tio n s , 1 2 C F R P a r t 3 4 9 .

In s u ra n c e