Branch Establishment

Branch and Relocation Application
Application No.:
For your convenience, the application that you are reviewing includes all questions
contained on the type of branch/relocation application that you completed. We have
provided all questions for your review to ensure that you have an opportunity to see those
questions that you answered and the questions that you did not previously see or answer.
Your attention should be focused on those questions with answers, with the other
questions provided for your information.

National Bank Identifying Information
Charter No.:
Name of Bank:
Street address:
City:
County:
State:
Zip:
Supervisory
District:
TYPE OF APPLICATION(Check appropriate boxes)
BRANCH ESTABLISHMENT
(Including expansion of mobile branch service area)
Staffed Branch
Drop Box/Night Depository
Seasonal Agency
Drive-in Facility
Temporary Facility
College/University
Major Disaster or Other Emergency
Other:
Mobile Facility
Mobile Van
Messenger Service
Other:
Other(for example, part-time, limited service):
Note: Establishment of a temporary alternate site meeting certain requirements is a notice
process, not a branch or branch relocation application process. (See the alternate site
discussion in the "Branches and Relocations" booklet.)
Filing Fee: $0.00
Application Identifying Information
Application is made for permission to:
_ Establish the type of branch previously indicated at the following address.

Branch Name:
* Street Address:
* City:
* County:
* State:
* Zip:
Note: Items preceded by an asterisk (*) are not applicable for mobile facilities. See the
"Mobile Facilities" section under Other Information.
Other Information (Check the following as applicable.)
Seasonal Agency
If this is a request to establish a seasonal agency, explain how this
request meets the requirements in 12 USC 36(c) with respect to
seasonal agencies. (See the definition of "seasonal agency" in the
glossary section of the "Branch and Relocation" booklet.)

Do you represent that upon the opening of a state or national bank
in the community where the seasonal agency will be established,
the bank will close this seasonal agency?
Temporary Facility - College/University
If this is a request to establish a college or university branch, is this
a request for approval under simplified branching procedures?
(See the discussion on college or university branch in the "Branch
and Relocation" booklet.)
If yes, provide the required information.
Include a representation that the facility will be open only during
registration periods and an additional period no greater than seven
days per year (not in contravention of state law limitations
applicable to state banks).

Temporary Facility - Major Disaster or Other Emergency
If this is a request to establish a temporary facility following a major
disaster, is the proposed facility in an area that the President of the
United States has declared a "major disaster area"?
A. If yes, will the proposed facility temporarily replace a branch
rendered inaccessible or inoperable due to the emergency?
1. If yes, is establishment of the temporary branch within the
geographic area in which the bank may establish a branch?
If yes, submission of a branch application to the OCC is not
required. However, after establishing the branch, notify the OCC in
writing with the branch name and its temporary location.
If no, contact the appropriate Licensing Manager to discuss
possible alternatives.
2. If no, is this a request to establish a temporary branch at anew

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

location in the major disaster area within the geographic area in
which the bank may establish a branch? [Note: A "new location" is
a facility that does not replace an existing branch that has been
rendered unusable as a result of the major disaster declared by the
President.]
If yes, submission of a written branch application to the OCC
might not be required. Contact the appropriate Licensing Manager
If no, follow normal branch application procedures.
B. If no, is this a request to establish a branch where banking services
are interrupted due to a local disaster, such as a fire?
1. If yes, do you seek a waiver of normal filing requirements?
If yes, contact the appropriate Licensing Manager to discuss the
waiver request.
2. If no, follow normal branch application procedures.
Temporary Facility - Other
If this is a request for another type of temporary facility, is this a
request for waiver or reduction of the publication period? (See the
"Branch and Relocation" booklet.)
If yes, provide the required information

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

If no, follow normal branch application procedures.
Mobile Facility
A. Is this a request to expand the mobile facility outside the
geographic area that it is currently authorized to serve?
B. Is this a request to utilize more than one messenger
simultaneously?
If yes, please indicate the number of messenger services:
C. Will more than one State be served?
If yes, enter the States in the textbox below:

D. (For mobile facilities, including mobile branches and messenger
services, or if an expansion of a previously approved mobile
facility.)
Delineate the boundaries of the geographic area that the facility will
serve.

Note: Alternatives include identifying the boundaries as (1)those of
an incorporated municipality, a county or other political
subdivision that has specific boundaries or (2)those within which
the mobile facility would operate (for example, in City X, County Y,
State Z between River A to the west, River B to the east, Street C to
the south, and Avenue D to the north).
Interstate Determination
Will the proposed new or relocated branch be located in a state that
is either the bank's main office state or a state in which the bank
will operate at least one other authorized branch at the time the
proposed branch will open?

Legal Notice
Legal notice of this application is being published on: in:
Publication
Name:
Street Address:
City:
State:
Zip:
Legal notice of this application is being published on: in:
Publication
Name:
Street Address:
City:
State:
Zip:
Contact Person
Requests for additional information or other communications about this proposal
should be directed to:
Name:
Title:
Street Address:
City:
State:
Zip:
Phone:
Fax:
Email:
Statutory and Regulatory Factors
1. Legality - (Complete Section A or B, as applicable.)
A. Intrastate Branch Establishment and Branch Relocation
1. Does state law impose geographic, numerical, proximity, CRA or
other limitations and/or requirements on the
establishment/relocation of branches?
Note: The laws of several states including CT, NY, SD, IL and NE, to
name a few, retain one or more of these types of restrictions.
Examples include: prohibitions on the establishment of branches
in towns of a certain size where another financial institution is
located; restrictions on branching by banks that control more than
a stated percentage of deposits in the state; restrictions that limit
branching to municipalities or towns; restrictions on branching
within a certain distance from an office of another financial
institution.
If yes, does this filing comply with those limitations?

Yes

No

Yes

No

Yes

No

Yes

No

Please provide a legal analysis to support the approval.

2. Does state law require that qualitative considerations be taken into
account by the regulator in determining whether to approve the
branch?
Note: The laws of several states retain these considerations.
Examples include: public interest; the convenience and needs of
the community in which the branch is proposed; the impact on
competition among banking institutions in the community; the
prospects for success of the branch; the impact of the branch on
the solvency of existing financial institutions in the community to
be served.
If yes, does this filing comply with those qualitative
considerations?
Please provide a legal analysis that includes all material facts to
support the approval.

If no, please provide a legal analysis to support approval of the
branch.

3. Is the relocation/establishment of the branch in compliance with
the capital requirements of 12 USC 36(c)? Note: If this application
is for a Seasonal Branch this question does not apply.
Yes
No
Not Applicable
If no, please explain why not:

4. If this application is to establish/relocate a nontraditional branch
(for example, mobile, messenger service, temporary, drop box,
drive-in, part-time, or limited service branch) does the state in
which the branch is proposed permit state banks to operate this
type of branch at the location proposed?
Yes
No
We have found no publicly available
state law authority addressing
this type of branch.
Not Applicable
Please provide a legal analysis to support the approval.

5. Is the applicant bank controlled by a bank holding company the
home state of which is different than the home state of the
applicant bank as "home state" is defined in 12 C.F.R. 25.62(d)(2)
and (3)?
Note: If yes, go to question 5-2. If no, go to question 5-1.
5-1. Is the proposed branch in a state other than the state where the
applicant bank's main office is located?
Note: If yes, go to question 5-2. If no, go to question 6.
5-2. In the applicant bank's most recent Community Reinvestment
Act Examination, did the OCC determine that the bank was not in
conformity with 12 C.F.R. Part 25, Subpart E ("Prohibition Against
Use of Interstate Branches Primarily for Deposit Production") in the
state where the branch is proposed? (If the bank was not a national
bank at the time of its last CRA examination, did its federal banking
regulator at that time determine that the institution was not in
conformity with that regulator's equivalent regulations?)
If yes, explain how the bank will meet the credit needs of the
community to be served by the proposed branch.

6. Are there any other legal issues involved in this proposal?
If yes, please provide a legal analysis and discuss the issues fully.

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Interstate Branch Establishment and Branch Relocation
1. Please set forth and analyze the authority to establish the branch
in, or relocate it to, another state focusing on the following with
respect to the state where the branch would be located:
Whether the state has in effect a law that applies equally to all
banks and which expressly permits all out of state banks to
establish de novo branches in the state;
Any conditions imposed on the establishment by out-of-state
banks of a branch in the state;
Compliance with applicable state filing requirements and
whether the applicant has provided a copy of the application
to the appropriate state banking regulator in the state;
Applicability of state antitrust laws; and
Adequacy of capital and management of the bank.

2. If the applicant bank has no bank affiliate in the state where the
branch is proposed:
(Note: This question does not apply if the applicant bank has a
bank affiliate in the state where the branch is proposed.)
Are the CRA ratings for all the bank affiliates of the applicant at
least "satisfactory"?
If no, please provide detail on CRA ratings and action plan.

Has the OCC determined that the applicant bank is not in
compliance with applicable state Community Reinvestment laws?
If yes, please provide detail on CRA ratings and action plan.

Yes

No

3. Are there any other legal issues involved in this proposal? For
instance, if the proposed branch will be a nontraditional branch
(such as a mobile branch, part-time branch, limited service or
temporary branch), check "yes" and explain in the textbox below.
If yes, please provide a legal analysis.

Yes

No

Yes

No

Yes
Yes

No
No

Yes

No

Yes

No

Yes

No

2. Bank Premises
A. Will the proposed action result in an investment in bank premises
that requires an application or notice under 12 USC 371d (see the
"Investment in Bank Premises" booklet)?
B. If prior approval is required, has it been granted?
C. If no, is an investment request included?
D. If yes, type your investment request in the textbox below.

If no, do you wish to proceed with the application?
3. Management Interlocks/Insider Conflicts
Will the proposed action result in or raise an issue that could
create a prohibited
interlock(12 USC 3201-3208 and 12 CFR 26) or a conflict of
interest?
If yes, explain the circumstances that result in any potential
conflict of interest or management
interlock and specify what action will be taken to prevent a
violation of the law.

4. Jointly Owned
Is this a jointly owned branch?
If yes, list the other institutions that will have an ownership
interest:

5. Environment
Will the proposed action have any significant effect on the quality
of the human environment, (for example, air and/or water quality,
noise levels, energy consumption, congestion of population, solid
waste disposal, or environmental integrity of private land) within
the meaning of the National Environmental Policy Act (NEPA), 42
USC 4321-4347, et seq? (See the Council on Environmental
Quality at www.whitehouse.gov/CEQ).
If yes, discuss the effect(s) and explain how the proposal causes
the effects.

Yes

No

Yes

No

Yes

No

6. Historic Properties
Will the proposed action affect any district, site, building, structure
or object listed in, or eligible for listing in, the National Register of
Historic Places pursuant to the National Historic Preservation Act
(NHPA), 16 USC 470f? (See the Advisory Council on Historic
Preservation at www.achp.gov for the Act and implementing
regulations). You are reminded that if a historic property may be
affected, no site preparation, demolition, alterations, construction
or renovation may occur without OCC's authorization.
Specify how such determination was made:
Consultation with the State Historic Preservation
Officer (SHPO) and/or Tribal Historic Preservation
Officer (THPO) (when tribal lands or historic properties
of significance to a tribe are involved).
Reviewed National Register of Historic Places (See
www.cr.nps.gov/nr).
Applied National Register criteria to unlisted
properties (See 36 CFR 60.4).
Reviewed historical records.
Contact with preservation organizations.
Other (Describe):
As appropriate, provide a copy of any documentation of
consultation with the SHPO and/or THPO. Are you providing
documentation?
If yes, provide a copy.

7. Community Reinvestment Act (CRA) Considerations
A. At its most recent examination, did the bank or any affiliated
institution receive a CRA rating of
"needs to improve" or "substantial noncompliance"?
If yes, describe what actions, if any, have been taken to redress
deficiencies in the institution's CRA
record of performance since the examination.

Yes

No

B. Will the proposed transaction affect the CRA assessment area
served
by the applicant?
If yes, discuss the effect.

Yes

No

8. Additional Attachments

Desired Action Date
I/We desire OCC action on this application no later than .
Certification
I hereby certify that the bank's board of directors has authorized the filing of this
application, and that to the best of my knowledge, it contains no
misrepresentations or omissions of material facts. In addition, I agree to notify the
OCC if the facts described in the filing materially change prior to receiving a
decision.
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.
I acknowledge that approval of this application is in the discretion of the
Comptroller of the Currency. Actions or communications, whether oral, written, or
electronic, by an agency or its employees in connection with this filing, including
approval of the application if granted, do not constitute a contract, either express or
implied, or any other obligation binding upon the agency, other federal banking
agencies, the United States, any other agency or 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 agency to exercise its supervisory, regulatory, or
examination powers under applicable law and regulations. I further acknowledge
that the foregoing may not be waived or modified by any employee or agent of a
federal banking agency or of the United States.

I agree I do not agree
(If you do not indicate that you agree with the terms of the certification you cannot certify.)

Signature
Signature of Authorized Officer:
Typed Name:
Title:
Date:
Name of Bank:
BankNet Security verified that was a valid signer for as of .