Form 1562 Notice for Service Corporation Activity Securities Broke

OMB No. 1550-0013
Expiration Date: 6/30/2011

OFFICE OF THRIFT SUPERVISION
NOTICE FOR SERVICE CORPORATION ACTIVITY SECURITIES BROKERAGE
PAPERWORK REDUCTION ACT STATEMENT

The Office of Thrift Supervision (OTS) will use this Notice to acquire information concerning the
establishment of a service corporation which will engage in security brokerage activities, pursuant to
Sections 12 C.F.R. § 545.74(c) and 12 C.F.R. Part 559.
Public reporting burden for this collection of information is estimated to average 15 minutes per
response, including the time of reviewing instructions and completing a reviewing the collection of
information. Send comments regarding this burden estimate or any aspect of the collection of
information, including suggestions for reducing this burden, to Office of Thrift Supervision, Corporate &
International Activities, 1700 G Street N.W., Washington, D.C. 20552; and the Office of Management
and Budget, Paperwork Reduction Project (1550-0013), Washington, D.C. 20503.

OTS Form 1562
Revised June 2008

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OMB No. 1550-0013
Expiration Date: 6/30/2011

Docket Number: _________

OFFICE OF THRIFT SUPERVISION
NOTICE FOR SERVICE CORPORATION ACTIVITY SECURITIES BROKERAGE
TO: Office of Thrift Supervision

Date of Notice: _______________

We, the undersigned executive officer and secretary, pursuant to a resolution of a majority of the
board of directors of:
________________________________________________________________________________
Savings Institution Name
________________________________________________________________________________
Street Address of Savings Institution (include City, State, and Zip Code)
(hereinafter the Institution), hereby provide notice to the Office of Thrift Supervision (OTS) that the
Institution intends to acquire or establish a service corporation to engage in pre-approved securities
brokerage activities of _____, pursuant to 12 C.F.R. §§ 545.74(c) and 559.11 and do hereby certify:
1.

That the Institution shall comply with all requirements of 12 C.F.R. § 545.74(c);

2. That if applicable, the Institution has attached any additional information required
pursuant to 12 C.F.R. § 545.74;
3.

That the Institution has notified the FDIC, pursuant to 12 U.S.C. § 1828(m)(1), of the
establishment or acquisition of service corporation and has attached a copy of the FDIC
notification; and

4. That the OTS may request additional information or may impose conditions for the
acquisition or establishment of a service corporation to engage in pre-approved
securities brokerage services and may determine that the acquisition or establishment of
a service corporation to engage in preapproved securities brokerage services do not
comply with 12 C.F.R. § 545.74.

If this notice represents an acquisition of an existing company, please provide a copy of any
agreements.

_________________________________
Executive Officer

___________________________
Secretary
____________________________
Date of Receipt by OTS

OTS Form 1562
Revised June 2008

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