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FEDERAL RESERVE BANK
OF N E W YORK

ftT C igft 7
July 2 3 , 19 7 6

REGULATION U
Revised F.R. Form U-l
To All Bunks, a n d Others Concerned,
in the Second Federal Reserx’e District

T h e B o a rd o f G o v e r n o r s o f th e F ed era l R e serv e S y stem h a s a d o p te d a rev ised F e d e r a l R eserv e F orm

U-l e n title d , “ S ta te m e n t o f P u r p o se o f a S to c k -S e c u r e d E x te n sio n o f C red it by a B a n k ,” effective
S e p te m b e r 1, 1976. In a d o p tin g th e n ew fo r m , th e B o a rd o f G o v ern o rs su b m itte d th e fo llo w in g sta te m e n t
for p u b lic a tio n in th e Federal Register:

Pursuant to the authority of Section 7 of the Securities Exchange Act of 1934 (15 U.S.C. 78g), the Board of
Governors has adopted a revised Federal Reserve Form U-l, “Statement of Purpose of a Stock-Secured Exten­
sion of Credit by a Bank,” effective September 1, 1976.1 This form is for use by banks in fulfilling certain
requirements of Part 221 of Title 12 (Regulation U).
On February 7, 1968 the Board published a notice in the Federal Register (33 F. R. 2702) announcing, inter
ahu, that, effective March 11, 1968, Section 221.3(a) of Regulation U is amended to add a requirement that a
bank shall obtain and keep for a prescribed period in connection with any stock-secured loan, on a form
prescribed by the Board, a statement relating to the purpose of the loan by (i) the customer and (ii) the officer
extending the credit. The Board commented that the changes in Section 221.3(a) of Regulation U were designed
to make uniform the evidentiary requirements of such section.
Pursuant to and simultaneously with the notice of amendment to Section 221.3(a), the Board published in
the Federal Register on February 7, 1968 (33 F. R. 2721), a notice of adoption, effective March 11. 1968, of , inter
alia. Federal Reserve Form U-l, “Statement of Purpose of the Proceeds of a Stock-Secured Extension of Credit
by a Bank,” for use by banks in implementing and fulfilling the requirements of that Section.
In 1969, the Board adopted an amendment to Section 221.3(a), effective July 8, 1969, to reduce the time
required for retaining Federal Reserve Form U-l (34 F. R. 9203, June 11, 1969) and adopted a revised Form U-l
to reflect such change (34 F. R. 12330).
Since the last revision of Federal Reserve Form U-l in 1969, substantial experience has been gained by
banks, law enforcement agencies and System staff in the use of the form. Such experience leads to the conclu­
sion that certain revisions of Form U-l are necessary and appropriate, if it is to continue to serve as a useful
evidentiary tool in maintaining compliance with provisions of Regulation U.
Generally, the revised Form U-l will embody the following changes:
(1) The addition of caveats and definitional aids to prospective borrowers respecting their potential criminal
liability under various statutes and the provisions of the Board’s Regulation X. The purpose of Regula­
tion X. which was adopted by the Board on November 1, 1971, is to prevent infusion into United States
securities markets of unregulated credit obtained in circumvention of the provisions of the Board’s
margin regulations, or by borrowers falsely certifying the purpose of a loan, or otherwise willfully and
intentionally evading the provisions of those regulations.
1 A copy o f the Federal Reserve Form U-l is filed as a part o f the original document. Copies are available
on request to the Board of Governors o f the Federal Reserve System or any Federal Reserve Bank.




(O ver)

(2) A revision of the format to provide increased assistance to law enforcement agencies and bank examiners
by requiring, inter alia, a borrower to specifically state whether or not a proposed stock-secured exten­
sion of credit is for the purpose of purchasing or carrying margin stock.
(3) Inclusion of a requirement for affirmative representation by borrowers respecting the integrity of the
collateral offered as security for an extension of credit, and a requirement that a duly authorized officer
of the lending bank shall undertake, in addition to other required procedures, an examination of the
physical aspects of the securities offered as collateral and perform such validation procedures with
respect thereto as are mandated by bank policy and governmental regulations.
Because the revisions to Form U-l are designed to make uniform evidentiary requirements pursuant to
Section 221.3(a) and are procedural in nature the Board concluded that the notice and public procedure con­
templated by Section 553 of Title 5. United States Code, was unnecessary with respect to such changes.
Enclosed is a copy of the revised Form U -l, which should be reproduced as needed. A limited number
of additional copies of the form are available upon request from our Securities Regulations Division. Any
questions regarding the form mav be directed to that Division.




Paul A. Volcker,
President.

F.R. Form U-l
Rev. 5/76
Fxp. 5/79

BOARD OF GOVERNORS OF THE FEDERAL RESERVE SYSTEM
STATEMENT OF PURPOSE OF A STOCK-SECURED EXTENSION OF CREDIT BY

(Name o f Bank)

(FEDERAL RESERVE FORM U-l)
T I T I J M S 0 S F r T m N N7S ffT
I T . f N ™ ' S F ° R M M A Y B E P U N IS H A B L E B Y F IN E O R IM P R IS O N M E N T ( U S . C O D E
T I T L E 15, S E C T I O N 78ff A N D T I T L E 18, S E C T I O N S 1001, 1005 A N D 1014). A B O R R O W E R W H O F A L S E L Y C E R T I F I F S
THE

PU RPO SE

OF

A

C R E D IT

P R O V IS IO N S O F R E G U L A T IO N

ON

T H IS

FO RM

OR

O T H E R W IS E

W IL L F U L L Y

OR

IN T E N T IO N A L L Y

U W IL L A L S O V IO L A T E F E D E R A L R E S E R V E R E G U L A T IO N X , “ R U L E S G O V E R N IN G
B O R R O W E R S W H O O B T A IN S E C U R IT IE S C R E D IT ” .

In s tru c tio n s :

(1) Section 221.3(a) of Regulation U requires that a statement of purpose must be obtained in connection with any extension of
credrt by a bank secured directly or indirectly by any stock. The term “stock” is defined in section 221 3
nd nclud s anv
security commonly known as a stock; any voting trust certificate and any security convertible, with or without I n sideration
f7) P rt u t
u Z ' ° \ CT yr7 ^ Warram °r nght t0 SUbSCnbe t0 °r pUrchase such a ^ u n ty ; or any such warrant or right
( ) a t I (3) and (4) need be filled in only it the purpose of the credit described in Part I (1) is other than to purchase or carry
margin stock. The term margin stock” is defined in section 221.3(v) and generally means (1) stocks that are registered on a
national securities exchange and stocks that are on the Federal Reserve Board’s List of OTC Margin Stocks, (2) debt securities
(bonds) that are convertible into such stocks and (3) shares of most mutual funds
jouln'L
"eed ^ fi"ed ^ °nly if SUCh S0Ur°e " ° ,her than regular]y Published info™atio„ in a
(4) Part II, except for the certification by the officer of the bank, need not be completed in the case of a credit of $5 000 or less
winch is not lor the purpose of purchasing or carrying margin stock. However, in such cases. Part I must be completed
(5) Please print or type (it space is inadequate attach separate sheet).
completed.

PART I To be completed by borrower(s)
NO

1) Is this credit in the amount of $......................................... or any part thereof, for the purpose of
purchasing or carrying margin stock?
Jf “ no”, describe the specific purpose............................................................

YhS
| i
^

□

2) In addition to this credit, do you have any other outstanding credit that has been extended by
this bank, or has this bank agreed to extend additional credit to you?

□

Q

Is any of the collateral listed in Part II to be delivered, or has any such collateral been delivered
from a bank, broker, dealer or person other than you?
’

[~|

Q

If “yes”, from whom? ............................................................................. Against payment to deliverer?

□

□

Q

| |

5)

-) Has any of the collateral listed in Part II been owned less than 30 days?
l e u n d e r sig n e d h as (h a v e ) read th is fo r m an d a n y a tta c h m e n ts th e r e to a n d h e r e b y c e r tifie s a n d
e b e st o f m y (o u r ) k n o w le d g e an d b e lie f th e in fo r m a tio n c o n ta in e d th e r e in is tr u e , a c c u r a te
ir th e r m o r e , o th e b e st o f m y (o u r ) k n o w le d g e , th e se c u r itie s liste d a s c o lla te r a l in Part II are
ne, u n a lte r e d , a n d n o t s t o le n , fo r g e d or c o u n te r fe it.

GNED................ y-.............................................................
(Borrower s signature)
(Date)
(Print or type name)

SIGNED
(Borrower’ s signature)

(Print or type name)

T H IS FORM SH O U L D N O T BE SIG N ED IN BLANK



a ffir m s th a t to
and co n
ete
a u th e n ic e e n
a u m e n iic , g en -

(Date)

PA R T II To b e c o m p l e t e d b y b a n k

This form is in connection with note num ber.................................... dated
(1) Collateral consisting of stock, other than debt securities convertible into margin stock. The maximum loan
value of such stock under the current Supplement to Regulation U is.......... per cent of its current market value.
Issue

No. o f shares

Market price
per share

Date and source o f
valuation

Total market value
per issue

(2) Collateral consisting of debt securities convertible into margin stock. The maximum loan value of such
debt securities under the current Supplement to Regulation U is.......... per cent of the current market value.
Principal
amount

Issue

Market price

Date and source o f
valuation

Total market value
per issue

Market price

Source o f valuation

G ood faith
loan value

(3) Other collateral.
Describe briefly

T h e u n d e r sig n e d , a d u ly a u th o r iz e d o ffic e r o f th e b a n k , (i) is a w a re th a t th is sto c k -se c u r e d c r e d it m a y b e su b je c t
to th e c r e d it r e str ic tio n s o f R e g u la tio n U , (ii) h as read th is fo r m a n d a n y a tta c h m e n ts th e r e to , (iii) h as a c c e p te d
th e c u s to m e r ’s s ta te m e n t in Part I in g o o d fa ith as req u ired b y R e g u la tio n U * , (iv ) h as e x a m in e d th e p h y sic a l
a sp e c ts o f th e se c u r itie s d e sc r ib e d a b o v e th a t d ir e c tly se c u r e th e c r e d it, p e r fo r m e d su c h v a lid a tio n p r o c e d u r e s as
are req u ired b y b a n k p o lic y a n d b y g o v e r n m e n t r e g u la tio n s p r o m u lg a te d u n d e r s e c tio n 1 7 ( f ) o f th e S ecu rities
E x c h a n g e A c t o f 1 9 3 4 , as a m e n d e d , (v ) has e x a m in e d th e w r itte n c o n s e n t o f th e tru e o w n e r to p le d g e or o th e r ­
w ise e n c u m b e r th e c o lla te r a l d e sc r ib e d a b o v e , i f th e s e c u r itie s are n o t reg istered in th e n a m e o f th e b o r r o w e r , and
(v i) h e r e b y c e r tifie s a n d a ffir m s th a t t o th e b e st o f th e o f f ic e r ’s k n o w le d g e a n d b e lie f all th e in fo r m a tio n c o n
ta in e d h e r e in is tru e, a c c u r a te a n d c o m p le t e a n d th a t sa id s e c u r itie s are g e n u in e a n d a u th e n tic a n d n o t s to le n
fo r g e d o r c o u n t e r f e it a n d th a t th e fa c e o f th e se c u r ity h a s n o t b e e n a lte r e d .

D a te ...............................................................................................................

S I G N E D ....................................................................................................
(Bank officer's signature)

(Title)

(Print or type name)

*To accept this statement in good faith, the officer of the bank (1) must be alert to the circumstances surrounding the credit an
(2) if the officer has any information which would cause a prudent person not to accept the statement without inquiry, must hav
investigated and be satisfied that the statement is truthful. Among the facts which would require such investigation are receipt o
the statement through the mail or from a third party.
T H IS F O R M M U S T B E R E T A IN E D B Y T H E B A N K F O R A T L E A S T T H R E E Y E A R S
A F T E R T H E C R E D IT IS E X T IN G U IS H E D