Form FR Y-3F FR Y-3F Application for a Foreign Organization to Acquire a U.S.

FR Y– 3F
OMB Number 7100–0119
Aproval expires September, 2011

Board of Governors of the Federal Reserve System

Application for a Foreign Organization
to Acquire a U.S. Bank or Bank Holding Company—FR Y-3F
Name, title, address, e-mail address, and telephone number of
persons(s) to whom inquiries concerning this application may be
directed:

Legal Name of Applicant

Street

City

Country

(Type of organization, such as corporation, limited partnership, general partnership,
limited liability company/corporation, business trust, association, or trust)

organized under the laws of
hereby applies to the Board pursuant to section 3(a) of the Bank
Holding Company Act of 1956, as amended, ("Act"), for prior approval to acquire a U.S. Bank or a bank holding company through
the acquisition of direct or indirect ownership, control, or power to
vote at least

(

%) of the voting shares of:

Number

Does Applicant or Notificant request confidential treatment for any portion of this submission?

Yes

No
As required by the the instructions, a letter justifiying the
request for confidential treatment is included.
The information for which confidential treatment is being
sought is separately bound and labeled "CONFIDENTIAL."

Public reporting burden for this information collection is estimated to range between
70–90 hours per response, including time to gather and maintain data in the required
form and to review instructions and complete the information collection. Send comments regarding this burden estimate or any other aspect of this information collection, including suggestions for reducing this burden to: Secretary, Board of Governors of the Federal Reserve System, 20th and C Streets, N.W., Washington, DC
20551, and to the Office of Management and Budget, Paperwork Reduction Project
(7100–0119), Washington, DC 20503.

An application is authorized by section 3(a) of the Act (12 U.S.C. 1842 and 1844).
The Federal Reserve may not conduct or sponsor, and an organization (or a person)
is not required to respond to, a collection of information unless it displays a currently
valid OMB control number.

FR Y– 3F
Page 2

Application for a Foreign Organization
to Acquire a U.S. Bank or Bank Holding Company—FR Y-3F
Certification
I certify that the information contained in this application has been
examined carefully by me and is true, correct, and complete, and is
current as of the date of this submission to the best of my knowledge
and belief. I acknowledge that any misrepresentation or omission of
a material fact constitutes fraud in the inducement and may subject
me to legal sanctions provided by 18 USC 1001 and 1007.

ability of Information,” 12 CFR Part 261, that the applicant and individual consent to public release of all details in the application and
in any related submissions containing information concerning that
individual.

I also certify, with respect to information pertaining to an individual
and submitted to the Board of Governors of the Federal Reserve
System (“Federal Reserve”) in (or in connection with) this application, that the applicant has the authority, on behalf of the individual,
to provide such information to the Federal Reserve and to consent
or object to public release of such information. The Federal Reserve
may assume, in the absence of a request for confidential treatment
submitted in accordance with the Board’s “Rules Regarding Avail-

I acknowledge that approval of this application is in the discretion
of the Federal Reserve. Actions or communications, whether oral,
written, or electronic, by the Federal Reserve or its employees in
connection with this filing, including approval if granted, do not constitute a contract, either express or implied, or any other obligation
binding upon the agency, the United States or any other entity of the
United States, or any officer or employee of the United States. Such
actions or communications will not affect the ability of the Federal
Reserve to exercise its supervisory, regulatory, or examination powers under applicable laws and regulations. I further acknowledge
that the foregoing may not be waived or modified by any employee
or agency of the Federal Reserve or of the United States.

Corporate Title of Bank (or Bank Holding Company)

Date of Application

Street

Signature of Chief Executive Officer or Designee

City

State

Zip Code