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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 E x e c u tiv e O ffic e r and Each P rin c ip a l S h a r e h o ld e r o f t h e Lis t o f E ach E x e c u tiv e O ffic e r and E ach P rin c ip a l 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 Nam e Nam e 1. 1. 1. 2. 2. 2. 3. 3. 4. 3. 4. 5. 4. 5. 6. 5. 6. 7. 6. 7. 8. 7. 8. 9. 8. 9. 10. 9. 10. 10. 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 : The sum of th e h ig h e s t am ount of in d e b te d n e s s 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 : o u ts t a n d in g c a le n d a r a b o v e -lis te d Name and title of officer responsible fo r report t h a t th is r e p o r t has be en s ,9nature o f officer responsible fo r report p r e p a r e d in c o n f o r m a n c e w i t h t h e in s tr u c tio n s issued a n d is t r u e t o t h e _________________________________________ be st o f m y k n o w le d g e . bank do h e re b y d e c la re T h e s u m o f t h 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 ts t a n d in g d u r in g t h e r e p o r t in g b a n k d u r i n g th e c a le n d a r y e a r o f e a ch o f t h e a b o v e -lis te d o ffic e r s I,____________________________ a b o v e -n a m e d th e 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 . ( I n th o u s a n d s o f d o lla r s ) $ o f th e to Date s '8nod in te rests. year to co rre s p o n d e n t o f fic e r s and banks s h a re h o ld e rs as an d rep o rted fo r each ( I n t h o i K a n r k n f d o lla r s ) $ fo r ea c h of of t h e ir re la te d th e General Instructions R E P O R T IN G R E Q U IR E M E N T S B a n k s R e q u ir e d t o F ile R e p o r ts 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 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 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 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 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 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) th a t, s h a r e h o ld e r. b a n k is re q u ire d t o file th is r e p o r t . The te rm p r in c ip a l W h e r e R e p o r ts a re t o be S e n t " p r in c i p a l g e n e r a lly " C o n tro l" to S ta t e M e m b e r B an ks: T o t h e F e d e r a l R ese rv e B a n k o f th e D is t r ic t in w h ic h be a p e rs on is d e f in e d o w n e r s h ip or in c lu d e s a p e rs o n th a t c o n tr o ls th a t c o n tr o ls a bank in s e c tio n 2 1 5 .2 (b ) of R e g u la t io n c o n tro l of 25 per cent or a h o ld in g 0 m o re o f a T h e t e r m " e x e c u t i v e o f f i c e r " is d e f in e d in s e c tio n 2 1 5 . 2 ( d ) o f t h e B o a rd 's R e g u la t io n 0 m eans g e n e r a lly a p e rs o n who p a rtic ip a te s o r has 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 b y la w s f r o m t h e m e m b e r b a n k is lo c a te d . and a u t h o r i t y t o p a r t ic ip a t e ( o t h e r th a n in t h e c a p a c it y o f a d i r e c t o r ) in m a jo r 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 c o m p a n y 's r e p o r t in g b a n k is lo c a te d . (e.g., s h a r e h o ld e r c o m p a n y ). N a tio n a l B an ks: T o t h e R e g io n a l A d m i n i s t r a t o r o f t h e R e g io n in w h ic h t h e s h a r e h o ld e r " F o r th e p u rp o s e s o f d e t e r m i n in g w h o is a p r in c ip a l s h a r e h o ld e r , shares p a r t ic ip a t io n in m a jo r 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 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 In s u ra n c e C o r p o r a t io n of th e R e g io n in w h ic h th e r e p o r t in g bank is lo c a te d . p resum ed to be c o n t r o l le d b y t h e in d iv id u a l. " I m m e d i a t e f a m i l y " m ean s 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 o f t h e in d iv id u a l's c h ild r e n (in c lu d in g a d u lts ) re s id in g in t h e in d iv id u a l's hom e. W h e n R e p o r ts are t o b e F ile d For P arts I a n d 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 needs t o be lis te d p r o v id e d t h a t in d iv id u a l's n a m e is used c o n s is te n tly in re p o rt fo r each c a le n d a r y e a r m u s t b e f ile d w it h t h e a p p r o p r ia t e 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 . P art II r e q u ir e d by la w t o re q u e s t. T h e m ust be r e ta in e d b y t h e r e p o r t in g b a n k a n d are b e m a d e a v a ila b le b y t h e b a n k t o t h e p u b lic u p o n 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 D E F IN IT IO N S f o llo w in g c o m p le t i n g th is 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 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. 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 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. The in s u re d o r fo r e ig n 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 rep o rt ( e x c e p t an 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 . The " R e la te d 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 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 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 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 P a rt I consists of a list by nam e of each in d iv id u a l, 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 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 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 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 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 fa m ily th e m u s t f ile 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 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, 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 . any of not c r e d it (as d e fin e d in in c lu d e : 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 " 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 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 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 (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 e it h e r (i) t h e 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 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., 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 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 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 , 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 . each c o rr e s 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 , end of th e m o n th 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 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 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 " M a x im u m r e p o r t in g 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 S h a r e h o ld e r " m e a n s a n y 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 . 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 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 t h e r e in . 3 . W h a t M u s t be R e p o r t e d each in c lu d e s 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. 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 of " In d e b te d n e s s " 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 (a ) t h e m a x im u m e x te n s io n 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 be c o n s is te n tly c o rres p o n d en 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 . 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@FedFRASER