Form TD F 90-22.1

Draft

General Instructions

Who Must File this Report. Each United States person who

has a financial interest in or signature or other authority over

any foreign financial accounts, including bank, securities, or

other types of financial accounts, in a foreign country, if the

aggregate value of these financial accounts exceeds $10,000

at any time during the calendar year, must report that

relationship each calendar year by filing this report with the

Department of the Treasury on or before June 30, of the

succeeding year.

Exceptions

An officer or employee of a bank which is currently examined

by Federal bank supervisory agencies for soundness and

safety need not report that he has signature or other

authority over a foreign bank, securities or other financial

account maintained by the bank, if the officer or employee

has NO personal financial interest in the account.

An officer or employee of a domestic corporation whose

equity securities are listed upon any United States national

securities exchange or which has assets exceeding $10

million and 500 or more shareholders of record need not file

such a report concerning signature or other authority over a

foreign financial account of the corporation, if he has NO

personal financial interest in the account and he has been

advised in writing by the chief financial officer or similar

responsible officer of the corporation that the corporation has

filed a current report, which includes that account. An officer

or employee of a domestic subsidiary of such a domestic

corporation need not file this report concerning signature or

other authority over the foreign financial account if the

domestic parent meets the above requirements, he has no

personal financial interest in the account, and he has been

advised in writing by the responsible officer of the parent that

the subsidiary has filed a current report which includes that

account. If a United States subsidiary is named in a

consolidated FBAR of the parent, the subsidiary will be

deemed to have filed a report for purposes of this exception.

An officer or employee of a foreign subsidiary more than

50% owned by such a domestic corporation need not file

this report concerning signature or other authority over the

foreign financial account if the employee or officer has no

personal financial interest in the account, and he has been

advised in writing by the responsible officer of the parent that

the parent has filed a current report which includes that

account.

General Definitions

United States Person. The term “United States person”

means a citizen or resident of the United States, or a person

in and doing business in the United States. See 31 C.F.R.

103.11(z) for a complete definition of “person.” The United

States includes the states, territories and possessions of the

United States. See the definition of United States at 31

C.F.R. 103.11(nn) for a complete definition of United States.

A foreign subsidiary of a United States person is not required to file this report,

although its United States parent corporation may be

required to do so. A branch of a foreign entity that is doing business in the United States is required to file this report even if not separately incorporated under U.S. law.

Financial Account. This term includes any bank, securities,

securities derivatives or other financial instruments accounts.

Such accounts generally also encompass any accounts in

which the assets are held in a commingled fund, and the

account owner holds an equity interest in the fund (including mutual

funds). The term also means any savings, demand, checking, deposit, time

deposit, or any other account (including debit card and prepaid credit card

accounts ) maintained with a financial institution or other

person engaged in the business of a financial institution.

Individual bonds, notes, or stock certificates held by the filer

are not a financial account nor is an unsecured loan to a

foreign trade or business that is not a financial institution.

Account in a Foreign Country. A “foreign country” includes

all geographical areas located outside the United States. See

“United States Person” above for a definition of United

States. The geographical location of the account, not the

nationality of the financial entity in which the account is

found determines whether it is in a foreign country. Report

any financial account (except a military banking facility) that

is located in a foreign country, even if it is held at an affiliate

of a United States bank or other financial institution. Do not

report any account maintained with a branch, agency, or

other office of a foreign bank of other institution that is

located in the United States.

Military Banking Facility. Do not consider as an account in

a foreign country, an account in an institution known as a

“United States military banking facility” (or “United States

military finance facility”) operated by a United States financial

institution designated by the United States Government to

serve U.S. Government installations abroad, even if the

United States military banking facility is located in a foreign

country.

Financial Interest. A financial interest in a bank, securities,

or other financial account in a foreign country means an

interest described in one of the following three paragraphs:

1. A United States person has a financial interest in each

account for which such person is the owner of record or has

legal title, whether the account is maintained for his or her

own benefit or for the benefit of others including non-United

States persons.

2. A United States person has a financial interest in each

bank, securities, or other financial account in a foreign

country for which the owner of record or holder of legal title

is: (a) a person acting as an agent, nominee, attorney, or in

some other capacity on behalf of the U.S. person; (b) a

corporation in which the United States person owns directly

or indirectly more than 50 percent of the total value of shares

of stock or more than 50 percent of the voting power for all shares of stock; (c) a partnership in which the United States person

owns an interest in more than 50 percent of the profits(distributive share of income, taking into account any special allocation agreement) or more than 50 percent of the capital of the partnership; or (d) a trust in which the United States person either has a present beneficial interest, either directly or indirectly, in more than 50 percent of the assets or from which such person receives more than 50 percent of the current income.

3. A United States person has a financial interest in each bank, securities, or other financial account in a foreign country for which the owner of record or holder of legal title is a trust, or a person acting on behalf of a trust, that was established by such United States person and for which a trust protector has been appointed.  A “trust protector” is a person who is responsible for monitoring the activities of a trustee, with the authority to influence the decisions of the trustee or to replace, or recommend the replacement of, the trustee.

Correspondent or “nostro” accounts (international

interbank transfer accounts) that are

maintained by banks need not be reported on this form. but are

subject to other Bank Secrecy Act filing requirements. This

exception is intended to encompass those accounts utilized

for bank-to-bank settlement purposes only.

Signature or Other Authority Over an Account. A person

has signature authority over an account if such person can

control the disposition of money or other property in it by

delivery of a document containing his or her signature (or his

or her signature and that of one or more other persons) to

the bank or other person with whom the account is

maintained. Other authority exists in a person who can

exercise comparable power over an account by

communication with the bank or other person with whom the

account is maintained, either directly or through an agent,

nominee, attorney, or in some other capacity on behalf of the

U.S. person, either orally or by some other means.

Filing Information—Do NOT file with your

Federal Tax Return

When and where to file. This report must be filed on or

before June 30 of the year following the calendar year

reported. The report is required annually. File by mailing this report to the

Department of the Treasury, Post Office Box 32621, Detroit,

MI 48232-0621, or by hand-carrying it to any local office

of the Internal Revenue Service for forwarding to the

Department of the Treasury, Detroit, MI. Tax attaches are

located in the U.S. embassies in some countries.

A filer can receive instructions for verifying that a report

has been filed by calling the Detroit Computing Center

Hotline at 1-800-800-2877.

Extensions of time to file federal tax returns do not extend the

time for filing this report. There is no extension of time available

for filing this report. If a delinquent FBAR is filed, also

attach a statement explaining the reason for the late filing. See “When and where to file” (above) for filing instructions.

Amendment of a previously filed FBAR is accomplished by

checking the “Amended” box in the upper right hand corner of the first page of the form, making the needed additions or corrections,and then stapling it to a copy of the original form. Please also attach a statement

explaining the changes. See “When and where to file” (above) for filing instructions.

Record Keeping Requirements. If this Report is required,

certain records must be retained. Such records must contain the name in which

each such account is maintained, the number or other

designation of such account, the name and address of the

foreign bank or other person with whom such account is

maintained, the type of such account, and the maximum

value of each such account during the reporting period.

Retaining filed copies of this Report will help to meet these

requirements. The records must be retained for a period of

five years and must be kept at all times available for

inspection as provided by law.

Explanations for Specific Items

Part I

Item 1. The Report of Foreign Bank and Financial Accounts

(FBAR) is an annual report. Enter the calendar year being reported.

Amendment of a previously filed FBAR is accomplished by

checking the “Amended” box in the upper right hand corner of the first page of the form, making the needed additions and corrections, and then stapling it to a copy of the original report. See “When and where to file” (above) for filing instructions.

Item 2. Check the appropriate box describing the filer. A

corporation which owns directly or indirectly more than a 50

percent interest in one or more other entities required to file

this report will be permitted to file a consolidated report on

TD F 90-22.1, on behalf of itself and such other entities.

Check box “d” in Item 2 and complete Part V. Consolidated

reports should be signed by an authorized official of the

parent corporation. Trusts and other entities, including tax-exempt organizations, should check box “e” and describe the filer on the line following box “e.”

Item 3. A filer should provide the filer’s taxpayer identification

number. Generally this is the filer’s U.S. social security

number (SSN)or employer identification number (EIN). Numbers

should be entered with no spaces, dashes or other punctuation throughout this report. If the filer does not possess such U.S. identification, the filer should complete Item 4.

Item 4. Complete Item 4 only if the filer has no U.S. taxpayer

identification number. Item 4 requires the filer to provide the

information about an official foreign government document

evidencing the filer’s nationality or residence. The filer should

write in the document number followed by the country of

issuance. The filer may check off the type of document. If

“other” is checked, the filer should write in the type of

document. For example, an individual who is not a U.S. citizen would provide a

passport number, the name of the country of issuance, and

check off “passport”.

Item 5. Enter the date of birth of the filer using the month,

day, and year convention.

Items 6, 7 and 8. Enter the name of the filer. An

organization should enter its name

in the Last Name space.

Items 9, 10, 11, 12 and 13. Enter the address of the filer.

An individual filer residing in the United States should enter the

street address of filer’s United States residence, not a post

office box. An individual filer residing outside the United

States should enter the filer’s United States mailing address.

If the filer has no U.S. mailing address the filer may provide a

foreign address. An organization should enter its United

States mailing address.

Item 14. If the filer has a financial interest in 25 or more

foreign financial accounts, the filer should check the yes box,

sign and date the report (Items 44, 45 and 46) and leave

blank Part II (Continuation of Separate Accounts) or Part III

(Joint Accounts) of the report. If the group of

entities covered by a consolidated report has a financial

interest in 25 or more foreign financial accounts, the

reporting parent corporation need only complete Part V (for

consolidated reporting) Items 34 through 42, for the identity

information of the account owners, but need not complete

the account information. Detailed information about each

account, including all information called for on this report,

must be recorded and retained for five years from June 30 of

the year following the calendar year reported. Any person

who reports 25 or more foreign financial accounts must,

when requested by the Department of the Treasury, provide

all the information omitted from Part II, III or V as

appropriate.

Part II

Item 15. Provide the maximum value of the account during

the calendar year being reported. The maximum value of an

account is the largest amount of currency or non-monetary

assets that appear on any quarterly or more frequent account

statement issued for the applicable year. If periodic account

statements are not issued, the maximum account asset

value is the largest amount of currency and non-monetary

assets in the account at any time during the year.

Convert foreign currency by using the official exchange

rate at the end of the year. In valuing currency of a country

that uses multiple exchange rates, use the rate which would

apply if the currency in the account were converted into

United States dollars at the close of the calendar year.

The value of stock, other securities or other non-monetary

assets in an account reported on TD F 90-22.1 is the fair

market value at the end of the calendar year or, if withdrawn

from the account, at the time of the withdrawal. For purposes

of Item 15, if the filer had a financial interest in more than

one account, each account is to be valued separately

in accordance with the foregoing two paragraphs. If the filer

had a financial interest in one or more but fewer than 25

accounts, and is unable to determine whether the maximum

value of these accounts exceeded $10,000 at any time

during the year, complete Part II, III, or V for each of these

accounts and enter “value unknown” in Item 15 for these

accounts.

Item 16. Indicate the type of account. If “Other” is selected

describe the account.

Item 17. Provide the name of the financial institution with

which the account is held.

Item 18. Provide the account number which the financial

institution uses to designate the account.

Item 19–23. Provide the complete mailing address of the

financial institution where the account is located. If the

foreign state or postal code is not known leave them blank.

Part III

Item 24. Enter the number of joint owners for the account. If

the exact number is not known, provide an estimate. In determining the

number of joint owners, the filer is not counted.

Items 25–33. Enter this identity information about the joint

owner. If there is more than one joint owner, enter the

identity information about the principal joint owner. The filer may

leave blank items for which no information is available.

A spouse having a joint financial interest in an account

with the filing spouse should be included as a joint account

owner in Part III of this report. The filer should write (spouse) on

Line 26 after the last name of the joint spousal owner. If the

only reportable accounts of the filer’s spouse are those

reported as joint accounts, the filer’s spouse need not file a separate report. If the accounts are owned jointly by both spouses, the filer’s spouse

should also sign the report. See the instructions for Item 44.

If the filer’s spouse has a financial interest in other

accounts that are not jointly owned with the filer or

has signature or other authority over other accounts, the

filer’s spouse should file a separate report for all accounts

including those owned jointly with the other spouse.

Part IV—No Financial Interest in Account

Item 34. You must provide the name, address, and

identifying number of the owner of a foreign financial account

over which you had signature or other authority but no

financial interest in the account. If there is more than one owner of the account over which you have authority, provide the information in Items 34-43 for

the primary owner for which you have authority.

If you complete the account information for more than one

account of the same owner, you need identify the owner only

once. Write “Same Owner” in Item 34 for the succeeding

accounts of the same owner.

Item 35. Provide the taxpayer identification number of the

owner of the account.

Items 36–42. Provide the identity information of the owner of

the account.

Item 43. Enter filer’s title for the position which gives him

authority over the account.

Part V—Consolidated Report for Corporate

Parent & Subsidiary Corporations

A corporation which owns directly or indirectly more than a 50

percent interest in one or more other entities required to file

this report will be permitted to file a consolidated report on

TD F 90-22.1, on behalf of itself and such other entities.

Check box “d” in Item 2 in Part I and complete Part V.

Item 34. You must provide the corporate name, identifying

number and address of the owner of the foreign financial

account as shown on the books of the financial institution.

If you complete the account information for more than one

account of the same owner you need identify the owner only

once. Write “Same Owner” in Item 34 for the succeeding

accounts of the same owner.

Item 35. Provide the taxpayer identification number of the

owner of the account.

Items 36–42. Provide the address of the owner of the

account.

Signatures

This report must be signed by the person named in Part I. If

the report is being filed on behalf of a partnership,

corporation, fiduciary or other legal entity, it must be signed by an authorized

individual. A spouse included as a joint owner, who elects

not to file a separate report in accordance with the

instructions in Part III, must also sign this report. See the

instructions for Part III.

Enter the title of the individual signing for a legal entity,

such as a corporation, which is shown as the filer. Leave

“Filer’s Title” blank if the filer is only reporting as an individual.

An individual filing because of a financial interest in his

individual accounts is filing as an individual. An individual

filing because of signature or other authority over a foreign

financial account is filing as an individual. If the filer only has signature authority over the account, he should enter his title in Part IV Item 42,

Filer’s Title with this Owner, to show his relationship to the

account. Enter the actual date signed.