Form FR 2056 FR 2056 Application for Adjustment in the Holding of Federal Res

FOR USE BY MEMBER BANKS INCLUDING THE MEMBER BANK THAT SURVIVES THE
MERGER OR CONSOLIDATION OF MEMBER BANKS.

FR 2056
OMB No. 7100–0042
Approval expires September 30, 2011

Board of Governors of the Federal Reserve System

Application for Adjustment in the Holding of
Federal Reserve Bank Stock
Date of Application

Under the terms and provisions of the Federal Reserve Act, as amended, this stock/mutual savings bank hereby makes application for the
adjustment shown below in its holdings of the capital stock of the Federal Reserve Bank of
.
The total deposit liabilities of this mutual savings bank as shown on its most recent Report of Condition (or contemplates reporting after the
merger or consolidation on
) is $
; or
Date of Transaction

The capital and surplus of this stock bank as shown on its most recent Report of Condition (or contemplates reporting after the merger
) is as follows—

or consolidation on
Date of Transaction

Perpetual preferred stock and related surplus ................................................................................................. $

Common stock...................................................................................................................................................

Paid-in surplus ..................................................................................................................................................

Less: retained earnings and accumulated other comprehensive income, if such combined

amount is negative .........................................................................................................................................

TOTAL ...........................................................................................................................................................

Number of Shares

, or
Six-tenths of one percent of the above total deposit liabilities equal to $
(as relevant), and the
Six percent of the above capital and surplus equal to $
number of shares of Federal Reserve Bank stock at the par value of $100 each1 which this bank is required
to hold is2 .............................................................................................................................................................
Federal Reserve Bank stock now held .................................................................................................................
This bank, therefore, hereby makes application for: 3,4
1. Additional Federal Reserve Bank stock ....................................................................................................

or

2. Cancellation of Federal Reserve Bank stock:

Shares paid for on or after March 28, 1942 ..............................................................................................

Shares paid for before March 28, 1942 ...................................................................................................

(Over)
1. One-half of the amount of the bank's subscription shall be paid to the Federal
Reserve Bank and the remaining half will be subject to call when deemed necessary by the Board of Governors of the Federal Reserve System.
2. If six percent of the paid-up capital and surplus, including reserve for dividends payable in common stock amounts to a sum not divisible by
100, the bank is required to hold one additional share of stock for
any excess or fractional part of $100.
3. Member banks may carry over changes within a calendar year until the cumulative change exceeds the lesser of 15 percent or 100 shares of Reserve Bank

stock. However, any change required by a member bank’s capital and surplus,
as shown on its Report of Condition as of December 31 of each year, must
be applied for even if the change is less than 100 shares of Reserve Bank
stock and less than 15 percent of the Reserve Bank stock held by the member
bank.
4. Cross out item 2 if application is for an increase in holdings of Federal Reserve
Bank stock; cross out item 1 if the application is for a reduction in holdings of
Federal Reserve Bank stock.

Public reporting burden for this collection of information is estimated to average 0.5
hours per response, including the 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 collection of
information, including suggestions for reducing this burden, to Secretary, Board

of Governors of the Federal Reserve System, Washington, DC 20551; and to the
Office of Management and Budget, Paperwork Reduction Project (7100–0042),
Washington, DC 20503. 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.

This application should be sent to the FEDERAL RESERVE BANK of your district.

FR 2056
Page 2

Application for Adjustment in the Holding of
Federal Reserve Bank Stock—Continued
We have read this form and certify that to the best of our knowledge and belief the information given is true, accurate, and complete.

Legal Name of Bank

City or Town and State

ABA Number

By
Name of President or Vice President

Signature of President or Vice President

Attest:
Name of Treasurer, Cashier, or Secretary

Signature of Treasurer, Cashier, or Secretary