Proposed Changes to Pages 16 and 18, December 2011

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Overview

Reg-16
Program_Svs-18

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Sheet 1: Reg-16

REGULATORY INFORMATION
Credit Union Name: _____________________________________								Charter Number: _________
1. Please provide the date of the most recent annual meeting held by the credit union.
2. Please provide the date of the most recent financial statement audit.
3. Indicate in the box the number of the description below that best characterizes the
	last audit performed of the credit union's records.
	1 = Financial statement audit performed by state licensed persons
	2 = Balance sheet audit performed by state licensed persons
	3 = Examinations of internal controls over call reporting performed by state licensed persons
	4 = Supervisory Committee audit performed by state licensed persons
	5 = Supervisory Committee audit performed by other external auditors
	6 = Supervisory Committee audit performed by the supervisory committee or designated staff
4. Please provide the effective date of the most recent Supervisory Committee verification
	of members' accounts
5. Indicate in the box the number of the description below that best characterizes who
	completed the verification of member's accounts
	1 = Supervisory Committee 2= Third Party
6. Indicate the Fidelity Bond Provider
7. Indicate the amount of Fidelity Coverage for any Single Loss (RR 713.5)
8. If you have 100 employees or 50 or more employees with a Federal contract of at least $50,000, what is the last date you filed
an EEO-1 Survey Report with the Equal Employment Opportunity Commission? (MM/DD/YYYY)
9. Do you have a diversity policy or program in your credit union? (Yes/No)
DISASTER RECOVERY INFORMATION
There have been no changes to my Disaster Recovery information since the last time I completed this form
1. In the event of a disaster, will the credit union communicate									Yes	No
	with members through a website?
2. Please check the resources or services you have available and would be willing to share with other credit unions
	during the time of an emergency if you did not need them. (Check all that apply)
	a. Cash Non-Member Share Drafts				d. Mobile Branch
	b. Generator				e. Office Space
	c. IT Support				f. Staff/Management Services
3. Please provide the date of the last disaster recovery test completed by the credit union.

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Sheet 2: Program_Svs-18

CREDIT UNION PROGRAMS AND MEMBER SERVICES
Credit Union Name: _____________________________________								Charter Number: _________
Credit Union Programs - Place an "x" in the box next to all the programs the credit union offers (Check all that apply)
	a. Mortgage Processing					f. Investments not authorized by the FCU
	b. Approved Mortgage Seller					Act (State Credit Union Only)
	c. Borrowing Repurchase Agreements					g. Deposits and Shares Meeting 703.10(a)
	d. Brokered Deposits (all deposits					h. Brokered Certificates of Deposit
	acquired through a third party)					i. Short-Term, Small Amount Loans (FCU Only)
	e. Investment Pilot Program
Member Service and Product Offerings - Place an "x" in the box next to all the products offered (Check all that apply)
	Transactional					Financial Education
	a. ATM/Debit Card Program					a. Financial Counseling
	b. Check Cashing					b. Financial Education
	c. International Remittances					c. Financial Literacy Workshops
	d. Low-cost wire transfers					d. First Time Homebuyer Program
	e. Money orders					e. In-School Branches
	f. No surcharge ATMs
						Credit
	Depository					a. Business Loans
	a. Business Share Accounts					b. Credit Builder
	b. Health Savings Accounts					c. Debt Cancellation/Suspension
	c. Individual Development Accounts					d. Direct Financing Leases
	d. No Cost Share Drafts					e. Indirect Business Loans
	e. Share Certificates with low minimum					f. Indirect Consumer Loans
	balance requirements					g. Indirect Mortgage Loans
						h. Interest Only or Pymt Option 1st
	Other Member Services					Mortgage Loans
	a. Bilingual Services					i. Micro Business Loans
	b. Insurance/Investment Sales					j. Micro Consumer Loans
	c. No Cost Bill Payer					k. Overdraft Lines of Credit
	d. No Cost Tax Preparation Services					l. Overdraft Protection/ Courtesy Pay
	e. Student Scholarship					m. Participation Loans
						n. Pay Day Loans
						o. Real Estate Loans
						p. Refund Anticipation Loans
						q. Risk Based Loans
						r. Share Secured Credit Cards
Short Term, Small Amount Loan Program (Federal Credit Unions Only):
If the credit union offers Short-Term Small Amount Loans, does your program include any of the following: (check all that apply)
	a. Credit Bureau Reporting
	b. Financial Education
	c. Forced Savings Component
	d. Payroll Deduction
Minority Credit Union Questions
1. Does your credit union have more than 50% of its current members and management officials who are African American, American
Indian, hispanic American, or Asian American? If yes, please identify the minority group(s) that apply below:
		African American			Hispanic American
		American Indian			Asian American
2. Does your credit union have more than 50% of its eligible potential members and management officials who are Afrian American,
American Indian, Hispanic American, or Asian American? If yes, please identify the minority group(s) that apply below:
		African American			Hispanic American
		American Indian			Asian American