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
ICR 198208-7100-003
OMB: 7100-0033
Federal Form Document
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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
EACH STATE MEMBER BANK OF THE FEDERAL
RESERVE SYSTEM IS REQUIRED TO FILE ANNUALLY A FORM FFIEC 003 WHICH
DISCLOSES INFORMATION ON OWNERSHIP OF THE BANK AND LOAN INVOLVING
THE BANK'S EXECUTIVE OFFICER AND PRINCIPAL SHAREHOLDERS. STATE
MEMBER BANKS ARE REQUIRED TO MAKE COPIES OF THE REPORT AVAILABLE TO
THE PUBLIC UPON REQUEST.
On behalf of this Federal agency, I certify that
the collection of information encompassed by this request complies
with 5 CFR 1320.9 and the related provisions of 5 CFR
1320.8(b)(3).
The following is a summary of the topics, regarding
the proposed collection of information, that the certification
covers:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a
benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control
number;
If you are unable to certify compliance with any of
these provisions, identify the item by leaving the box unchecked
and explain the reason in the Supporting Statement.