Form 5300 Call Report

NATIONAL CREDIT
UNION ADMINISTRATION
ALEXANDRIA, VA 22314-3428
OFFICIAL BUSINESS

TO THE BOARD OF DIRECTORS
OF THE CREDIT UNION
ADDRESSED:
This booklet contains the Call
Report, Form 5300. This form is
effective September 30, 2016 until
superseded. Please complete the
Call Report using accounting and
statistical information from your
credit union’s records as of reporting
cycle date. Instructions for
completing the form are available for
separate download on the NCUA
website, www.ncua.gov. The NCUA
website provides the quarterly filing
date. In addition, credit union
contacts of record receive quarterly
email notifications of the cycle
highlights.
If you have any non-technical
questions, please contact your
National Credit Union Administration
Regional Office or your state credit
union supervisor, as appropriate.
Please call NCUA Customer Service
at 1-800-827-3255 with any technical
questions.

NATIONAL
CREDIT UNION
ADMINISTRATION

CALL REPORT
Form 5300
Effective
September 30, 2016
Until Superseded

INSTRUCTIONS FOR REPORTING REQUIREMENTS
The Call Report contains three sections: a core section (pages 1 -10), PCA Net Worth Calculation
Worksheet (Page 11), and supplementary schedules.
All credit unions must complete the core section every reporting period. The PCA Net Worth
Calculation Worksheet requires no input unless you completed a merger or acquisition that qualifies
for Business Combination Accounting or intend to use an optional Total Assets Election and/or
Alternative Risk Based Net Worth calculation to compute your net worth ratio. In this case, you
must input your financial information into the system.
The supplementary schedules A - E, pages 13 - 25, requires your input only if applicable. The
table below reflects the supplementary schedules and applicable reporting requirements for each
schedule.
SCHEDULE

REPORTING REQUIREMENT

A - Specialized Lending

Complete this schedule if your credit union:
● has indirect loans outstanding,
● has real estate loans outstanding or real estate
lending activity year to date,
● has purchased loans from, or sold loans to, other
financial institutions year to date,
● has participation loans outstanding or participation
● has business loans outstanding or business lending
● has any Troubled Debt Restructured (TDR) loans
outstanding or has approved TDR loans year-to-date.
● has purchased or obtained credit impaired loans in a
merger.

B - Investments, Supplemental Information

Complete this schedule if your credit union:
● has investments classified as Trading, Available for
Sale, or Held to Maturity,
● has non-security investments that meet the
requirements of Section 703.10(a),
● has investments purchased under an investment pilot
● has investment repurchase agreements,
● has investments not authorized by the FCU Act or
● has investments in brokered certificates of deposit or
brokered share certificates.

C - Credit Union Service Organization
(CUSO) Information

Complete this schedule if your credit union has
investments, loans, or an aggregate cash outlay in
CUSOs.

D - Derivative Transactions Report

Complete this schedule if your credit union uses
derivative contracts.

E - Bank Secrecy Act/Anti-Money
Laundering Information

Complete this schedule if Money Services Businesses
hold accounts at your credit union.

INSTRUCTIONS FOR CORRECTING A SUBMITTED CALL REPORT
If a previously submitted Call Report contains errors, inaccurate information, or omissions, you must
correct and resubmit it.

Credit Union Name:_____________________________ Federal Charter/Certificate Number:________________

CERTIFICATION OF NCUA 5300 CALL REPORT AS OF: _______________________
By signing below, I hereby certify the information being submitted is complete and accurate to the best of
my knowledge and has been certified by the person below.  If submitted information is not accurate, I
understand I am required to submit a corrected Call Report upon notification or the discovery of a need for
correction. I understand false entries and reports or statements, including material omissions, with intent to
injure or defraud the credit union, the National Credit Union Administration, its examiners, or other
individuals or companies is punishable under 18 U.S.C. 1006.     

Certifying Official:
Last Name:
Please Print
First Name:
Please Print
Last Name:
(Signature )
First Name:
(Signature )
Date:_________________________

Validation Date:_____________________

The instructions to prepare this form meet the requirement to provide guidance to small credit unions under
Section 212 of the Small Business Regulatory Enforcement Fairness Act of 1996.
You are not required to provide the information requested on a form that is subject to the Paperwork
Reduction Act unless the form displays a valid OMB control number.
Public reporting burden of this collection of information is estimated to average 6 hours per response,
including the time for reviewing instructions, searching existing data needed, and completing and reviewing
the collection of information. Send comments regarding this burden estimate or any other aspects of this
collection of information, including suggestions for reducing this burden to:
National Credit Union Administration
Office of the Chief Information Officer
1775 Duke Street
Alexandria, VA 22314-3428

OMB No. 3133-0004
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NCUA 5300
Effective September 30, 2016
Previous Editions Are Obsolete

Credit Union Name:_________________________________________

Federal Charter/Certificate Number:________________

STATEMENT OF FINANCIAL CONDITION AS OF: _______________
(ROUND CENTS TO THE NEAREST WHOLE DOLLAR. DO NOT REPORT CENTS.)
This page must be completed by all credit unions.
ASSETS
CASH:
Acct
Code
1. Cash on Hand (Coin and Currency)………………………..…..…………………..……………………………..

Amount

730A

2. Cash on Deposit (Amounts Deposited in Financial Institutions)

Amount

a. Cash on Deposit in Corporate Credit Unions………......………………….……..……

730B1

b. Cash on Deposit in Other Financial Institutions…………....………..…………...……

730B2

c. Total Cash on Deposit (Amounts Deposited in Financial Institutions)…………………………………………..

730B

3. Cash Equivalents (Investments with Original Maturities of Three Months or Less)……….…………………..

730C

INVESTMENTS: If your credit union reports amounts for items 4, 5, or 6 below, complete Schedule B - Investments, Supplemental Information.
A
<= 1 Year

B
Acct
Code

> 1-3 Years

C1
Acct
Code

> 3-5 Years

C2
Acct
Code

> 5-10 Years

E

D
Acct
Code

> 10 Years

Acct
Code

TOTAL AMOUNT

Acct
Code

4. Trading Securities……………..

965A

965B

965C1

965C2

965D

965

5. Available for Sale Securities…

797A

797B

797C1

797C2

797D

797E

6. Held-to-Maturity Securities……

796A

796B

796C1

796C2

796D

796E

7. Deposits in commercial banks,
S&Ls, savings banks…..

744A

744B

744C1

744C2

744D

744C

8. Loans to and investments in
natural person credit unions …….

672A

672B

672C1

672C2

672D

672C

9. Membership capital at corp.
CUs/Nonperpetual Capital Account

769A1

769A

10. Paid-in capital at corp.
CUs/Perpetual Contributed Capital

769B1

769B

11. All other investments in corporate
credit unions…………..

652A

652B

652C1

652C2

652D

652C

12. All other investments…………

766A

766B

766C1

766C2

766D

766E

13. TOTAL INVESTMENTS
(Sum of Items 4-12)…….…………

799A1

799B

799C1

799C2

799D

799I

LOANS Held for Sale: See Instructions.

Amount

14. Loans Held for Sale………………………………………………………………………………………………………………………………………………………………………

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003

Page 1

Credit Union Name:________________________________________________
Federal Charter/Certificate Number:________________
STATEMENT OF FINANCIAL CONDITION AS OF: _______________
This page must be completed by all credit unions.
ASSETS -- CONTINUED
LOANS & LEASES: LOANS & LEASES: Report participation loans (loans purchased by the credit union) in the appropriate category within this section. Also, please
complete Schedule A - Specialized Lending, if your credit union has any real estate loans, member business loans outstanding, originated any real estate loans, or
member business loans during the reporting period.
Acct
Acct
Interest Rate
Number of Loans
Amount
Code
Code

Acct
Code

15. Unsecured Credit Card Loans………...……………….

521

993

396

16. All Other Unsecured Loans/Lines of Credit……...……

522

994

397

17. Payday Alternative Loans (PAL loans) (Federal CU Only)..

522A

994A

397A

18. Non-Federally Guaranteed Student Loans………………….

595A

963A

698A

19. New Vehicle Loans…………...………………………..

523

958

385

20. Used Vehicle Loans………..……...……………………

524

968

370

21. Total 1st Mortgage Real Estate Loans/Lines of Credit

563

959

703

22. Total Other Real Estate Loans/Lines of Credit ……….

562

960

386

23. Leases Receivable………….....……………………….

565

954

002

24. Total All Other Loans/Lines of Credit…………..………

595

963

698

025A

025B

25. TOTAL LOANS & LEASES (Sum of items 15-24)………………………...….………
26. Less: Allowance for Loan & Lease Losses…………..…..…………………………...………...……………………….

719

Other Assets:
27. Foreclosed and Repossessed Assets

Number of Loans

Acct
Code

Amount

Acct
Code

a. Real Estate…………………………….……

798B1

798A1

b. Automobiles………………………………...

798B2

798A2

c. Other…………….…………………………..

798B3

798A3

d. Total Foreclosed and Repossessed Assets………

798B

798A

Acct
Code

Amount

28. Land and Building………………………………….……………..……………………………...……....…………………..

007

29. Other Fixed Assets…………………………………………………………………………………………………...……..

008

30. NCUA Share Insurance Capitalization Deposit…………………………………………………………………………….
31. Intangible Assets

Amount

794
Acct
Code

a. Identifiable Intangible Assets…………………….…………………………..…….

009D1

b. Goodwill…….....…………………..…………………………………………………

009D2

c. Total Intangible Assets……………………………………………………………..

009D

32. Other Assets

Amount

Acct
Code

a. Accrued Interest on Loans……………………………….……...………………...

009A

b. Accrued Interest on Investments………………………….……………………….

009B

c. All Other Assets…………………….……………………………………………….

009C

d. Non-Trading Derivative Assets, net……………………………………………….

009E

e. Total Other Assets……….…......……………..…………………………………….

009
010

33. TOTAL ASSETS (Sum of items 1, 2c, 3, 13, 14, 25 less 26, 27d, 28, 29, 30, 31c, and 32e)………………………..…………
Number
34. Loans Granted Year-to-Date…………………………...…………………………….

Acct
Code

Acct
Code

Amount

031A

031B

031C

031D

35. Non-Federally Guaranteed Student Loans in Deferred Status……………………

963B

698B

36. Loans Outstanding to Credit Union Officials and Senior Executive Staff…………

995

956

a. Payday Alternative Loans (PAL loans) Granted Year-to-Date
(also include amount in Line 34) (Federal CU Only)

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Page 2

Credit Union Name:_________________________________________

Federal Charter/Certificate Number:________________

STATEMENT OF FINANCIAL CONDITION AS OF: _______________
This page must be completed by all credit unions.
A. < 1 Year

LIABILITIES:

Acct
Code

B1. 1 - 3 Years

Acct
Code

B2. > 3 Years

Acct
Code

C. Total Amount

Acct
Code

1. Draws Against Lines of Credit ……….......…..…….……………

883A

883B1

883B2

883C

2. Other Notes, Promissory Notes and Interest Payable……...…..

011A

011B1

011B2

011C

3. Borrowing Repurchase Transactions………………………..….

058A

058B1

058B2

058C

4. Subordinated Debt…………………...………………….…...….…

867A

867B1

867B2

867C

925A1

925A2

925A

860B1

860B2

860C

5. Subordinated Debt included in Net Worth……………...………
6. TOTALS (each column)……………….…...…………....…………

860A

7. Non-Trading Derivative Liabilities, net……..……….....……………………………….……………….……….………

825A

8. Accrued Dividends & Interest Payable on Shares & Deposits……..……….....………………….…………………

820A

9. Accounts Payable and Other Liabilities……………….…………………..……………….………...…...……………

825

SHARES/DEPOSITS:

Dividend Rate

Acct
Code

Number of Accounts

Acct
Code

A. < 1 Year

Acct
Code

B1. 1 - 3 Years

Acct
Code

B2. > 3 Years

Acct
Code

C. Total Amount

Acct
Code

10. Share Drafts……

553

452

902A

902

11. Regular Shares………

552

454

657A

657

12. Money Market Shares…

532

458

911A

13. Share Certificates…

547

451

908A

908B1

908B2

908C

14. IRA/KEOGH Accounts…

554

453

906A

906B1

906B2

906C

15. All Other Shares…

585

16. TOTAL SHARES…
17. Nonmember Deposits…
18. TOTAL SHARES and DEPOSITS…………

599

911

455

630A

630B1

630B2

630

966

013A

013B1

013B2

013

457

880A

880B1

880B2

880

460

018A

018B1

018B2

018

Additional Shares/ Deposits (Included in the Shares/Deposits Listed Above):

Amount

Acct

19. Accounts Held by Member Government Depositors…………………………………………………………

631

20. Accounts Held by Nonmember Government Depositors…………………………………………………

632

21. Employee Benefit Member Shares…………………………………………………………………………

633

22. Employee Benefit Nonmember Shares……………………………………………………………………

634

23. 529 Plan Member Deposits….………………………………………………………………………………

635

24. Non-dollar denominated deposits………………………………………………………………………

636

25. Health Savings Accounts…………………………………………………………………………………………

637

26. Dollar Amount of Share Certificates = or > $100,000 (Excluding brokered share certificates participated
out by the broker in shares of less than $100,000)…………………………………………………………………..….

638

27. Dollar Amount of IRA/Keogh Accounts = or > $100,000….………………………………………………………....

639

28. Dollar Amount of Share Drafts Swept to Regular Shares or Money Market Accts as part of Sweep Program

641

29. Dollar Amount of Business Share Accounts………………………………………………………………………

643

30. Negative Shares Included in All Other Unsecured Loans/Lines of Credit on Page 2…………………………

644

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Page 3

Credit Union Name:______________________________________________ Federal Charter/Certificate Number:________________

STATEMENT OF FINANCIAL CONDITION AS OF: _______________
This page must be completed by all credit unions.

EQUITY:

Amount

Acct code

31. Undivided Earnings………………………………………………….………………………………………..……..……..……..

940

32. Regular Reserves…………………………...…………………………...…………………………………..……..……..……..

931

33. Appropriation for Non-Conforming Investments (State Credit Unions ONLY)……..........………..……..…

668

34. Other Reserves.(Appropriations of Undivided Earnings)……………………………………………......……..……..……..

658

35. Equity Acquired in Merger…………………………………………………………………………………..……..……..……..

658A

36. Miscellaneous Equity ……….………....…………………….…………….………………………………..……..……..……..

996

37. Accumulated Unrealized Gains (Losses) on Available for Sale Securities…………………………………..……..……..

945

38. Accumulated Unrealized Losses for OTTI (Due to Other Factors) on HTM Debt Securities………………..……..……..

945C

39. Accumulated Unrealized Net Gains (Losses) on Cash Flow Hedges……....….……………………..……..……..……..

945A

40. Other Comprehensive Income (unless already included in item 36-38)…………………………………..……..……..……..

945B

41. Net Income (unless this amount is already included in Undivided Earnings)……..…………………..……..……..……..

602

42. TOTAL LIABILITIES, SHARES, AND EQUITY (Sum items 6-9, 18, and 31-41; must equal line 33, P.2.)……..………

014

If the credit union has any unfunded commitments or loans sold or swapped with recourse, complete Pg 10 - Liquidity, Commitments and Sources.

NCUA INSURED SAVINGS COMPUTATION
(ROUND CENTS TO THE NEAREST WHOLE DOLLAR. DO NOT REPORT CENTS.)
This section must be completed by all credit unions.
Insured shares and deposits, as described in Part 745 of the NCUA Rules and Regulations, are authorized by state law and issued to members
(or nonmembers in the case of low-income designated credit unions), other credit unions, or government depositors. Report uninsured shares in this section.
Do not include notes payable or other forms of borrowings. Eligible accounts are generally insured up to $250,000 each.
(See instructions for the following line items.)
A. Uninsured IRA and KEOGH Member Shares and Deposits

Uninsured Amount

Acct Code
065A1

A1. Uninsured KEOGH Member Shares and Deposits for Employee Benefit Plans

065A3
065B1

B. Uninsured Employee Benefit Member Shares and Deposits

065C1

C. Uninsured Member 529 Plan Deposits

065D1

D. Uninsured Member Accts Held by Government Depositors
E. Other Uninsured Member Shares and Deposits

065E1

F. TOTAL UNINSURED MEMBER SHARES AND DEPOSITS (A+A1+B+C+D+E)

065A4
067A1

G. Uninsured Nonmember Employee Benefit Shares and Deposits

067B1

H. Uninsured Nonmember Accts Held by Government Depositors
I. Other Uninsured Nonmember Shares and Deposits

067C1

J. TOTAL UNINSURED NONMEMBER SHARES AND DEPOSITS (G+H+I)

067A2

K. TOTAL UNINSURED SHARES AND DEPOSITS (F+J)

068A

L. TOTAL INSURED SHARES AND DEPOSITS (item 18 from page 3 less item K)

069A

OMB No. 3133-0004
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NCUA 5300
Effective September 30, 2016
Previous Editions Are Obsolete

Page 4

Credit Union Name:_____________________________________________________

Federal Charter/Certificate Number:________________

STATEMENT OF INCOME AND EXPENSE
This page must be completed by all credit unions.
REPORT YEAR-TO-DATE NUMBERS FOR THE CYCLE
INTEREST INCOME YEAR-TO-DATE: JANUARY 1, ______ to ____________________

Amount

Acct
Code

1.

Interest on Loans (Gross-before interest refunds)…..…..……………………….………………………

110

2.

(Less) Interest Refunded…………….…………...…………..……………………………………………

119

3.

Income from Investments (Including Interest and Dividends)…..………………...……………….………

120

4.

Trading Profits and Losses (Realized and Unrealized Gains/Losses)…………………………..……

124

5.

TOTAL INTEREST INCOME (Sum of items 1-4)………...………………...………………………………

115

INTEREST EXPENSE YEAR-TO-DATE: JANUARY 1, ______ to ____________________
380

6.

Dividends on Shares (Includes dividends earned during current period)……………………...………

7.

Interest on Deposits (Total interest expense for deposit accounts) (State Credit Union ONLY)…

381
340

8.

Interest on Borrowed Money……………………………………...……………………..…………………

9.

TOTAL INTEREST EXPENSE (Sum of items 6-8)………………………….………………………….........

350

10.

Provision for Loan & Lease Losses…………………….……...…………………………………………

300

11.

NET INTEREST INCOME AFTER PROVISION FOR LOAN AND LEASE LOSSES
116

(Item 5 less item 9 less item 10)……………………………..…………………………………......………
NON-INTEREST INCOME YEAR-TO-DATE: JANUARY 1, ______ to ____________________
12.
13.
14.

131

Fee Income…………………………………………………………………………..…………………………
Other Operating Income (Includes unconsolidated CUSO Income and Gain (Loss) associated with the Hedged
Item (Non-Investment Assets) in a Non-Trading, Fair Value (FV) Derivatives Hedge)….....

659
420

Gain (Loss) on Investments (DO NOT include Gain or Loss on Trading Securities)………………
a. Total Other-Than-Temporary Impairment (OTTI) Losses…

420A

b. Less: Portion OTTI Losses in Other Comprehensive Income..

420B

c. OTTI Losses Recognized in Earnings (Include in Item 14)…

420C

d. Gain (Loss) associated with the Hedged Item (Investments) in a NonTrading, FV Derivatives Hedge (Include in Item 14)

420D

15.

Gain (Loss) on Non-Trading Derivatives…………………………………………………………..…………

421

16.

Gain (Loss) on Disposition of Fixed Assets……………………………………….………………………

430

17.

Gain from Bargain Purchase (Merger)………………………………………………………………………

431

18.

Other Non-operating Income (Expense)……………………………………..………………………………

440

TOTAL NON-INTEREST INCOME (Sum of items 12-18)…………………………..…………………………

117

19.

NON-INTEREST EXPENSE YEAR-TO-DATE: JANUARY 1, ______ to ____________________
20.

210

Total Employee Compensation and Benefits……………………………….………………………………

21.

Travel and Conference Expense………………………………………….………………………………

230

22.

Office Occupancy Expense…………………………..……………………………………………………

250

23.

Office Operations Expense……………………………………..……………………………………………

260

24.

Educational and Promotional Expenses……………………………...…………………………………

270

25.

Loan Servicing Expense………………………………………..…………………………………………

280

26.

Professional and Outside Services……………………………...…………………………………………

290

27.

Member Insurance

Amount

a. NCUSIF Premium Expense……………………………………

Acct
Code
311A

b. Temporary Corporate CU Stabilization Fund Assessment…

311

c. Other Member Insurance Expense…………………………..

310A

d. Total Member Insurance…………..…………………………………...……………………………

310

28.

Operating Fees (Examination and/or supervision fees)………………………..…………………………

320

29.

Miscellaneous Operating Expenses………………………………….………………………………………

360

30.

TOTAL NON-INTEREST EXPENSE (Sum of items 20-29)………………………….……………………

671

31.

NET INCOME (LOSS) (line 11 plus line 19 less line 30)…………………………...…………………

661A

RESERVE TRANSFERS YEAR-TO-DATE: JANUARY 1, ______ to ____________________
32.

Transfer to Regular Reserves……………………………….………………………………………………….

393

OTHER CALCULATIONS
33.

NET INCOME (LOSS) EXCLUDING NCUSIF PREMIUMS AND TEMPORARY CORPORATE CU STABILIZATION
FUND ASSESSMENT REPORTED ON LINES 27a & 27b (Item 31 + Item 27a+ Item 27b)…………………………

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Previous Editions Are Obsolete

660A

Page 5

Federal Charter/Certificate Number:________________

Credit Union Name:______________________________________________

MISCELLANEOUS INFORMATION AS OF: _______________
This page must be completed by all credit unions.
Acct
Code
1.

875

Does your credit union maintain share/deposit insurance coverage in addition to the NCUSIF?
(Do not include Life Savings and Borrowers' Protection Insurance or Surety Bond Coverage.)

Yes/No

a. If so, indicate the name of the insurance company……………………….

876

b. Dollar amount of shares and/or deposits insured by the company named above…………………

877

2.

Number of current members (not number of accounts)…………………………………………………….

083

3.
4.

Number of potential members……………………………………………………………………………...….
Number of credit union employees who are:

084

5.

a. Full-Time (26 hours or more per week)…………………………………………………………………..

564A

b. Part-Time (25 hours or less per week)……………………………………………………………….….

564B

Provide the aggregate of all capital and operating lease payments on fixed assets, without
discounting commitments for future payments to present value……..……..……..……..……..………

980

1003

6. Has the credit union completed a merger or acquisition that qualifies for Business Combination Accounting
on or after January 1, 2009? If this answer is "Yes" please complete line 7 on Page 11.

7.

If you have a transactional world wide website, how many members use it………………..……..……..……..

8.

Does the credit union plan to add any new branches or expand existing facilities in the next 12 months?.....

Yes/No
892B

566B
Yes/No

1 - 3 Years
9.

Uninsured Secondary Capital (Low-Income Designated CUs Only)…….

Acct
Code
925B1

> 3 Years

Acct
Code
925B2

Total Amount

Acct
Code
925

Acct
Code
10. Amount of Grants Awarded to Your Credit Union Year-to-Date…………………………………………………………………

926

11. Amount of Grants Received by Your Credit Union Year-to-Date…………………………………………………………………

927

12. Number of International Remittances Originated Year-to-Date……………………………………………………………………

928

OMB No. 3133-0004
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NCUA 5300
Effective September 30, 2016
Previous Editions Are Obsolete

Page 6

Federal Charter/Certificate Number:________________

Credit Union Name:_________________________________________
DELINQUENT LOANS BY COLLATERAL TYPE AS OF: _______________
This page must be completed by all credit unions.

Report Number Only
TOTAL NUMBER OF DELINQUENT LOANS BY
COLLATERAL TYPE

Reportable Delinquency
30- 59 days

60-179 days

180-359 days

Total Number of Reportable Delinquent
Loans

>=360 days

1a.

Unsecured Credit Card Loans…………………………

024A

026A

027A

028A

045A

2a.

Payday Alternative Loans (PAL loans) (Federal CU Only)..

089A

127A

128A

129A

130A

3a.

Non-Federally Guaranteed Student Loans……………

053A

053B

053C

053D

053E

4a.

New Vehicle Loans…………...………………………..

035A1

035B1

035C1

035D1

035E1

5a.

Used Vehicle Loans…………...………………………..

035A2

035B2

035C2

035D2

035E2

6a.

1st Mortgage Real Estate Loans/Lines of Credit
1. Fixed Rate (incl. Hybrid/Balloon > 5 yrs)……………

029A

029B

029C

029D

029E

2. Adjustable Rate (incl. Hybrid/Balloon 5 yrs or less)

030A

030B

030C

030D

030E

1. Fixed Rate/Hybrid/Balloon……………………………

032A

032B

032C

032D

032E

2. Adjustable Rate……………………………………

033A

033B

033C

033D

033E

7a.

Other Real Estate Loans/Lines of Credit

8a.

Leases Receivable……………………………………

034A

034B

034C

034D

034E

9a.

All Other Loans (See Instructions)……………………

035A

035B

035C

035D

035E

020A

021A

022A

023A

041A

10a. TOTAL NUMBER OF DELINQUENT LOANS

Report Amount Only
TOTAL AMOUNT OF DELINQUENT LOANS BY
COLLATERAL TYPE

Reportable Delinquency
30- 59 days

60-179 days

180-359 days

Total Amount of Reportable Delinquent
Loans

>=360 days

1b.

Unsecured Credit Card Loans……………………………

024B

026B

027B

028B

045B

2b.

Payday Alternative Loans (PAL loans) (Federal CU Only)

089B

127B

128B

129B

130B

3b.

Non-Federally Guaranteed Student Loans………………

020T

021T

022T

023T

041T

4b.

New Vehicle Loans…………...………………………..

020C1

021C1

022C1

023C1

041C1

5b.

Used Vehicle Loans…………...………………………..

020C2

021C2

022C2

023C2

041C2

6b.

1st Mortgage Real Estate Loans/Lines of Credit
1. Fixed Rate (incl. Hybrid/Balloon > 5yrs)………………

751

752

753

754

713A

2. Adjustable Rate (incl. Hybrid/Balloon 5 yrs or less)

771

772

773

774

714A

1. Fixed Rate/Hybrid/Balloon………………………………

755

756

757

758

715A

2. Adjustable Rate………………………………………

775

776

777

778

716A
041D

7b.

Other Real Estate Loans/Lines of Credit

8b.

Leases Receivable…………………………………………

020D

021D

022D

023D

9b.

All Other Loans (See Instructions)………………………

020C

021C

022C

023C

041C

020B

021B

022B

023B

041B

10b. TOTAL AMOUNT OF DELINQUENT LOANS

OMB No. 3133-0004
Expires 06/30/2017

NCUA 5300
Effective September 30, 2016
Previous Editions Are Obsolete

Page 7

Federal Charter/Certificate Number:________________

Credit Union Name:_________________________________________
ADDITIONAL DELINQUENCY INFORMATION AS OF: _______________
(Included in the delinquent loan information reported on Page 7)
This page must be completed by all credit unions.

Report Number Only
Reportable Delinquency

30-59 days

60-179 days

180-359 days

Total Number of Reportable Delinquent
Loans

>=360 days

11a. Indirect Loans…….………...……………………………

036A

036B

036C

036D

036E

12a. Participation Loans………...………………………….

037A

037B

037C

037D

037E

13a. Interest Only & Payment Option 1st Mortgage Loans

038A

038B

038C

038D

038E

14a. Interest Only & Payment Option Other RE/LOC Loans

039A

039B

039C

039D

039E

15a. Residential Construction excluding Business Purpose

040A

040B

040C

040D

040E

16a. Member Business Loans Secured by Real Estate

043A1

043B1

043C1

043D1

043E1

17a. Member Business Loans NOT Secured by Real Estate

043A2

043B2

043C2

043D2

043E2

18a. Nonmember Business Secured by Real Estate

046A1

046B1

046C1

046D1

046E1

19a. Nonmember Business Loans NOT Secured By Real Estate

046A2

046B2

046C2

046D2

046E2

20a. Agricultural Loans………...…………………………..

044A

044B

044C

044D

044E

21a. Business Construction & Development Loans…….

047A

047B

047C

047D

047E

22a. TDR Loans Secured by First Mortgages

054A

054B

054C

054D

054E

23a. TDR Loans Secured by Other RE/LOCs

055A

055B

055C

055D

055E

24a. TDR RE Loans Also Reported as Business Loans

056A

056B

056C

056D

056E

25a. TDR Consumer Loans NOT Secured by Real Estate

057A

057B

057C

057D

057E

26a. TDR Business Loans NOT Secured by Real Estate

059A

059B

059C

059D

059E

27a. Loans Held for Sale…………………………………

060A

060B

060C

060D

060E

Report Amount Only
Reportable Delinquency

30- 59 days

60-179 days

180-359 days

Total Amount of Reportable Delinquent
Loans

>=360 days

11b. Indirect Loans…….………...……………………………

020E

021E

022E

023E

041E

12b. Participation Loans………...………………………….

020F

021F

022F

023F

041F

13b. Interest Only & Payment Option 1st Mortgage Loans

020I

021I

022I

023I

041I

14b. Interest Only & Payment Option Other RE/LOC Loans

020M

021M

022M

023M

041M

15b. Residential Construction excluding Business Purpose

020N

021N

022N

023N

041N

16b. Member Business Loans Secured by Real Estate

020G1

021G1

022G1

023G1

041G1

17b. Member Business Loans NOT Secured by Real Estate

020G2

021G2

022G2

023G2

041G2

18b. Nonmember Business Secured by Real Estate

020P1

021P1

022P1

023P1

041P1

19b. Nonmember Business Loans NOT Secured By Real Estate

020P2

021P2

022P2

023P2

041P2

20b. Agricultural Loans………...…………………………..

020H

021H

022H

023H

041H

21b. Business Construction & Development Loans…….

020Q

021Q

022Q

023Q

041Q

22b. TDR Loans Secured by First Mortgages

020U

021U

022U

023U

041U

23b. TDR Loans Secured by Other RE/LOCs

020V

021V

022V

023V

041V

24b. TDR RE Loans Also Reported as Business Loans

020W

021W

022W

023W

041W

25b. TDR Consumer Loans NOT Secured by Real Estate

020X

021X

022X

023X

041X

26b. TDR Business Loans NOT Secured by Real Estate

020Y

021Y

022Y

023Y

041Y

27b. Loans Held for Sale…………………………………

071F

071G

071H

071I

071J

OMB No. 3133-0004
Expires 06/30/2017

NCUA 5300
Effective September 30, 2016
Previous Editions Are Obsolete

Page 8

Credit Union Name:______________________________________________

Federal Charter/Certificate Number:________________

LOAN CHARGE OFFS AND RECOVERIES AS OF: _______________
This page must be completed by all credit unions.
LOAN LOSS INFORMATION

YTD
Charge Offs

Acct
Code

YTD
Recoveries

Acct Code

1. Unsecured Credit Card Loans………………………..

680

681

2. Payday Alternative Loans (PAL loans) (Federal CU Only)…

136

137

3. Non-Federally Guaranteed Student Loans………………….

550T

551T

4. New Vehicle Loans…………...………………………..

550C1

551C1

5. Used Vehicle Loans…………...………………………..

550C2

551C2

6. Total 1st Mortgage Real Estate Loans/Lines of Credit

548

607

7. Total Other Real Estate Loans/Lines of Credit………

549

608

8. Leases Receivable….………………………………..

550D

551D

9. All Other Loans (See Instructions)…………………..

550C

551C

550

551

10. Total Charge Offs and Recoveries………..…..
ADDITIONAL LOAN LOSS INFORMATION
(Included in the loan losses reported above.)

YTD
Charge Offs

Acct
Code

YTD
Recoveries

Acct Code

11. Indirect Loans………………………………………

550E

551E

12. Participation Loans…………………………………..

550F

551F

13. Interest Only & Payment Option 1st Mortgage Loans

550I

551I

14. Interest Only & Payment Option Other RE/LOC Loans

550M

551M

15. Residential Construction excluding Business Purpose

550N

551N

16. Member Business Loans Secured by Real Estate

550G1

551G1

17. Member Business Loans NOT Secured by Real Estate

550G2

551G2

18. Nonmember Business Secured By Real Estate

550P1

551P1

19. Nonmember Business Loans NOT Secured By Real Estate

550P2

551P2

20. Agricultural Loans……...……………………………..

550H

551H

21. Business Construction & Development Loans

550Q

551Q

22. TDR Loans Secured by First Mortgages

550U

551U

23. TDR Loans Secured by Other RE/LOCs

550V

551V

24. TDR RE Loans Also Reported as Business Loans

550W

551W

25. TDR Consumer Loans NOT Secured by Real Estate

550X

551X

26. TDR Business Loans NOT Secured by Real Estate

550Y

551Y

27. All loans charged off due to Bankruptcy YTD………

682

28. Number of members with loans (outstanding) who have filed for:

No. of Members

Acct Code

a. Chapter 7 Bankruptcy YTD……………………..

081

b. Chapter 13 Bankruptcy YTD……………………

082

c. Chapter 11 or 12 Bankruptcy YTD……………………

088
Amount

29. Total outstanding loan balances subject to bankruptcies identified in items 28a - 28c.

Acct Code
971

No. of Loans
30. Real Estate Loans Foreclosed Year-to-Date (Report Balance at time of Foreclosure)

Acct
Code
1005A

Amount

Acct Code
1005

31. Congressional Reporting Requirement
a. Dollar amount of loans with interest rates that exceed 15% (Federal Credit Unions Only)........................
b. Aggregate weighted average interest rate for the loans
with interest rates that exceed 15% (Federal Credit Unions Only).............................................................

OMB No. 3133-0004
Expires 06/30/2017

NCUA 5300
Effective September 30, 2016
Previous Editions Are Obsolete

567
568

Page 9

Federal Charter/Certificate Number:________________

Credit Union Name:______________________________________________
LIQUIDITY, COMMITMENTS AND SOURCES AS OF: _______________
All credit unions must complete lines 1 through 10, if applicable.

OFF-BALANCE SHEET COMMITMENTS AND OTHER ITEMS
1.
A.
B.
C.
D.
E.

Amount Committed Directly by
Credit Union

Unfunded Commitments for Business Loans
Member Business Loans Secured by Real Estate
Member Business Loans NOT Secured by Real Estate
Nonmember Business Loans Secured By Real Estate
Nonmember Business Loans NOT Secured By Real Estate
Total Unfunded Commitments for Business Loans

Acct
Code

Amount Committed through
Third Party / Indirect

Acct
Code

Total Amount

Acct
Code

814D1

814D2

814F1

814F2

814F

814G1

814G2

814G

814H1

814H2

814H

814E1

814E2

814E

Miscellaneous Business Loan Unfunded Commitments (Include in the appropriate security category of item 1 above.)
814J1
A. Agricultural Related Business Loans………………………..
814A2
B. Construction & Land Development…………………..
813A
C. Outstanding Letters of Credit……........……………………………

814D

2.

3.
A.
B.
C.
D.
E.
F.
G.
H.
I.

Unfunded Commitments for All Remaining Loans (Non-Business Loans)
Revolving Open-End lines secured by 1-4 Family Residential Properties……….
Credit Card Lines…………........…..………………….…………………..
Unsecured Share Draft Lines of Credit………………..………
Overdraft Protection Program Commitments…………
Residential Construction Loans excluding Business Purpose…………………
Federally Insured Home Equity Conversion Mortgages (HECM)(Reverse Mortgages)
Proprietary Reverse Mortgage Products…………..
Other Unfunded Commitments…………….……………….………
Total Unfunded Commitments for Non-Business Loans
Total Unfunded Commitments for all
loan types (Sum items 1E and 3I)……

4.

814J2

814J

814A3

814A1

813B

813

811A3

811A4

811

812A

812B

812

815A

815B

815

822A

822B

822

811A1

811A2

811A

811B1

811B2

811B

811C1

811C2

811C

816B1

816B2

816

816E1

816E2

816E

816A1

816A2

816A
818

Dollar Amount of Pending Bond Claims……………………...…….……………………………………………………

CONTINGENT LIABILITIES
5.
6.

819

Loans Transferred with Limited Recourse Qualifying for Sales Accounting………………………………………..
Other Contingent Liabilities…………………………………..…..…………………………………………………………

818A

CREDIT AND BORROWING ARRANGEMENTS
7.
8.

Amount of Borrowings Subject to Early Repayment at Lender’s Option……………………………………………..
Assets Pledged to Secure Borrowings…………………………………………………………………………………..

9.

Lines of Credit

Uncommitted LOC

A. Corporate Credit Unions
B. Natural Person Credit Unions
C. Other Credit Lines
D. TOTAL
10. Borrowings
A. Corporate Credit Unions
B. Natural Person Credit Unions
C. Other Sources
D. FHLB
E. CLF
F. FRB
G. TOTAL

OMB No. 3133-0004
Expires 06/30/2017

Draws Against LOC

865A
878

884A1

Acct
Code
884A2

884C1

884C2

884C

884D1

884D2

884D

884E

882

881

Acct Code

Committed LOC

Acct
Code

Total Amount

Acct
Code
884

Acct
Code

885A

885B

885C

Acct
Code
885D

885A1

885B1

885C1

885D1

885A2

885B2

885C2

885D2

885A3

885B3

885C3

885D3

885B4

885C4

885D4

885C5

885D5

885C6

885D6

Acct Code

Term Borrowings

885A4

NCUA 5300
Effective September 30, 2016
Previous Editions Are Obsolete

885B5

Other Borrowings

Total Borrowings

Page 10

Federal Charter/Certificate Number:________________
Credit Union Name:______________________________________________
PCA NET WORTH CALCULATION WORKSHEET AS OF: _______________
A credit union is not required to provide input on this page unless it has chosen an alternative total assets option offered on lines
10 through 12 to calculate Net Worth, elected to calculate an alternative Risk Based Net Worth ratio, or completed a merger/
acquisition after 12/31/2008.
o Online Filers : Information entered on preceding schedules will populate line items below in the online 5300 System,
excluding items 7a - 7d and optional items 10, 11 and 12.

NET WORTH TO TOTAL ASSETS RATIO
Acct
Code

Amount

NUMERATOR: NET WORTH
1. Undivided Earnings………………………………………………….………………………….……………………………..

940

2. Regular Reserves………………………………...………...………………..……………………………………………….

931

3. Appropriation for Non-Conforming Investments (State Credit Union ONLY)……………………………………………

668

4. Other Reserves (Appropriations of Undivided Earnings)………………………………………..………………………..

658

5. Subordinated Debt included in Net Worth………………..………………………………………………………………….

925A

6. Net Income (unless this amount is already included in Undivided Earnings)…………………………………………….
7. Adjusted Retained Earnings acquired through Business Combinations

Amount

a. Prior Quarter-End Adjusted Retained Earnings acquired through Business

602
Acct
Code
1004A

Combinations……………………………………………………………………..
b. Adjustments made to Retained Earnings acquired through Business
Combinations during current quarter (See Instructions)……………………..
c. Adjusted Gain from Bargain Purchase due to Business Combinations
completed during current quarter (See Instructions)………………………….

1004B
1004C

d. Current Quarter's Total Adjusted Retained Earnings acquired through

1004

Business Combinations (7a + 7b - 7c)………………………………………………………………………………
8. TOTAL NET WORTH (Sum of items 1-6 and 7d)………………...…...………………….………………………………

997

DENOMINATOR: TOTAL ASSETS
9. Total Assets (quarter-end)……………………………………...……………………………………………………………

010

Total Assets Elections (Optional)
Retain line 9 quarter-end total assets above as net worth ratio denominator, or select one of the total assets computation options below by inputting
the result in the appropriate line item. Line 13 below will compute your net worth ratio using line 9 quarter-end total assets as your denominator
unless you enter an amount in line 10, 11 or 12.
10. Average of Daily Assets over the calendar quarter…………………………………………...………………………….

010A

11. Average of the three month-end balances over the calendar quarter………………………………………………….

010B

12. The average of the current and three preceding calendar quarter-end balances………………………………………

010C

13. Net Worth Ratio (Line 8 divided by line 9, 10, 11, or 12)

998

14a. Risk Based Net Worth (RBNW) Requirement (Standard Calculation)…………………………………………………..

999

b. Risk Based Net Worth (RBNW) Alternative Method under Section 702.107…………………………………………..

999A

15. Net Worth Classification if credit union is not new (Based upon Call Report
data only--See instructions.)…………………………………….

700

16. Net Worth Classification if credit union is new………………………….…

701

A "New" credit union has less than $10 million in assets and was chartered
in the last 10 years. (Based upon Call Report data only--See instructions.)

OMB No. 3133-0004
Expires 06/30/2017

NCUA 5300
Effective September 30, 2016
Previous Editions Are Obsolete

Page 11

Credit Union Name:______________________________________________ Federal Charter/Certificate Number:________________
STANDARD COMPONENTS OF
RISK BASED NET WORTH REQUIREMENT (RBNW) AS OF: _______________
(AUTOMATED -- NO INPUT NECESSARY)
This information below is provided only for your information. No credit union is required to provide input on this page.
Information entered on preceding schedules will populate the line items below in the online 5300 System.
Manual Call Report filers will also leave these items blank.
A RBNW Requirement is only applicable for those credit unions with assets greater than $50,000,000 and a RBNW requirement greater
than six percent.
A
Risk portfolio

B
Dollar balance

C
D
Amount as percent of Risk weighting
quarter-end total
assets

E
Amount times risk
weighting

F
Standard component

Quarter-end total assets
Assets, line 33 (Acct 010)
(a) Long-term real estate loans
Sched A Sect 2 Line 10 (Acct. Code 710) less:
Sched A Sect 4 Line 12 (Acct. Code 718)
Sched A Sect 2 Line 17 (Acct. Code 712)
Threshold amount: 0 to 25%
Excess amount: over 25%
(b) MBLs outstanding
Sched A Sect 4 line 10 (Acct. Code 400)
Threshold amount: 0 to 15%
Threshold amount: >15 to 25%
Excess amount: over 25%
(c) Investments
Weighted-average life:
Page 1 Lines 2c, 3 and 13:
0 to 1 year (Acct. Code 799A1 + 730B + 730C-738A-739A)
> 1 year to 3 years (Acct. Code 799B-738B-739B)
> 3 years to 5 years (Acct. Code 799C1-738C-739C)
> 5 years to 10 years (Acct. Code 799C2-738D-739D)
> 10 years (Acct. Code 799D-738E-739E)
(d) Low-risk assets
Assets Line 1 (Acct. Code 730A)
Assets Line 30 (Acct. Code 794)
Schedule B Line 1b (Acct. Code 740)
Sum of risk portfolios (a) through (d) above
(e) Average-risk assets
Assets, line 33 (Acct. Code 010) less: Risk portfolio items (a)
through (d) above
(f) Loans sold with recourse
Page 10, line 5 (Acct. Code 819)
(g) Unused MBL commitments
Sched A Sect 4 line 11 (Acct. Code 814B)
(h) Allowance (Credit limited to 1.5% of loans)
Assets, line 26 (Acct. Code 719)
Sum of standard components:
RBNW requirement (Acct. Code 999B)

OMB No. 3133-0004
Expires 06/30/2017

NCUA 5300
Effective September 30, 2016
Previous Editions Are Obsolete

Page 12

Federal Charter/Certificate Number:________________

Credit Union Name:_________________________________________
SCHEDULE A
SPECIALIZED LENDING AS OF: _______________
Section 1:
Section 2:
Section 3:
Section 4:
also.
Section 5:
Section 6:

If your credit union has indirect loans, complete this section.
If your credit union has any real estate loans outstanding or has originated any real estate loans year-to-date, complete this section.
If your credit union has any participation loans outstanding or purchased or sold loans or participations year-to-date, complete this section.
If your credit union has any business loans outstanding or has originated/purchased any business loans year-to-date, complete this section. If these loans are secured by real estate, complete section 2
If your credit union has any Troubled Debt Restructured loans outstanding or has modified any loans year-to-date, complete this section.
If your credit union has purchased or obtained credit impaired loans in a merger, complete this section.

SECTION 1 - INDIRECT LOANS
1. INDIRECT LOANS

Number

Acct
Code

Acct
Code

Amount

617B

a. Indirect Loans - Point of Sale Arrangement……………………………………

618B

b. Indirect Loans - Outsourced Lending Relationship……………………………

617C

618C

c. TOTAL OUTSTANDING INDIRECT LOANS……………...……………………..

617A

618A

You may stop here if your credit union has no real estate loans or member business loans outstanding and has not originated any real estate loans or member business loans
year-to-date or if your credit union has not purchased or sold any loans or does not have any participation loans outstanding.

SECTION 2 - REAL ESTATE LOANS AND LINES OF CREDIT - INCLUDING BUS. LOANS SECURED BY REAL ESTATE
REAL ESTATE LOANS
FIRST MORTGAGE
1.

Fixed Rate

No. of Loans Outstanding

Acct
Code

Amt of Loans Outstanding

Acct
Code

No. of Loans Granted
Year- to-Date

Acct
Code

Amount Granted Year-To-Date

Acct
Code

a. > 15 Years…………….

972A

704A

982A

720A

b. 15 Years or less……...

972B

704B

982B

720B

a. > 5 Years………………

972C

704C

982C

720C

b. 5 Years or less……….

972D

704D

982D

720D

3.

Other Fixed Rate…………

972E

704E

982E

720E

4.

Adjustable Rate 1 yr or less

973A

705A

983A

721A

5.

Adjustable Rate > 1 yr……

973B

705B

983B

721B

2.

Balloon/Hybrid

OTHER REAL ESTATE
6.

Closed-End Fixed Rate……

974

706

984

722

7.

Closed-End Adjustable Rate

975

707

985

723

8.

Open-End Adjustable Rate

976

708

986

724

9.

Open-End Fixed Rate…….

976B

708B

986B

724B

978

710

988

726

10. TOTALS (each column)….
MISCELLANEOUS REAL ESTATE LOANS/
LINES OF CREDIT INFORMATION

No. of Loans Outstanding
11. Interest Only & Payment Option 1st Mortgage Loans

b. Proprietary Reverse Mortgage Products

OMB No. 3133-0004
Expires 06/30/2017

Amount Outstanding

704C2

12. Interest Only & Payment Option Other RE/LOC Loans
13. REVERSE MORTGAGES
a. Federally Insured Home Equity Conversion Mortgage (HECM)

Acct Code

704D1
Acct
No. of Loans Outstanding
Code

Amt of Loans Outstanding

Acct
Code

No. of Loans Granted
YTD

Acct
Code

Amount Granted YTD

Acct
Code

704C1

704C3

704D2

704D3

Acct
Code

Amount Granted YTD

Acct
Code

704F1

704F2

704F3

704F4

704G1

704G2

704G3

704G4

NCUA 5300
Effective September 30, 2016
Previous Editions Are Obsolete

Page 13

Federal Charter/Certificate Number:________________

Credit Union Name:_________________________________________
SCHEDULE A
SPECIALIZED LENDING (Continued) AS OF: _______________
SECTION 2 CONTINUED - REAL ESTATE LOANS AND LINES OF CREDIT

Amount

MISCELLANEOUS REAL ESTATE LOANS/LINES OF CREDIT INFORMATION (continued)

Acct
Code
704A1

14.

Balance Outstanding of 1st Mtg Residential Construction Loans - Excluding Business Purpose…

15.

Allowance for Losses on all Real Estate Loans………………………………………………

731

16.
17.

Total Amount of All 1st Mortgage Loans which have been sold in the secondary market year-to-date
Amount of Real Estate Loans Outstanding that will contractually refinance, reprice or

736

mature within the next 5 years and that are not reported in Sect 4, line 9………………..

712

18.

Amount of real estate loans sold but serviced by the credit union…………………………

779A

19.

Mortgaging Servicing Rights………..………...…………………………………………………

779

SECTION 3 - LOANS PURCHASED AND SOLD IN FULL & PARTICIPATION LOANS PURCHASED AND SOLD
LOANS PURCHASED AND SOLD YEAR-TO-DATE

1.

Number

Acct
Code
614

Amount

Acct
Code
615

a.

Loans Purchased In Full from Other Financial Institutions……………...………………….

b.

Loans Purchased In Full from Other Sources………….………...…...…………………….

612

613

c.

Loans, Excluding Real Estate Loans, Sold in Full……………………………………………

616

616A

2.

PARTICIPATION LOANS PURCHASED
Number

ALL OUTSTANDING
Acct
Code
Amount Outstanding

Acct
Code

Number

PURCHASED YTD
Acct
Code
Amount Purchased YTD

Acct
Code

a.

Purchased With Recourse ………..………….

619A1

619B1

690A1

690B1

b.

Purchased Without Recourse ………………..

619A2

619B2

690A2

690B2

TOTAL PURCHASED (each column)………..

619A3

619B

690A

3.

OUTSTANDING PARTICIPATION LOANS SOLD
Number

Participation Interest Retained
Acct
Amount of Participation Interest
Code
Retained

Acct
Code

Participation Interest Sold AND/OR Serviced
Acct
Amount of Participation Interest
Number
Code
Sold AND/OR Serviced

690
Acct
Code

a.

Sold With Recourse ………………………………….

691D1

691E1

691F1

691G1

b.

Sold Without Recourse …………………………

691D2

691E2

691F2

691G2

TOTAL OUTSTANDING SOLD (each column)…

691D

691E

691F

691G

4.

PARTICIPATION LOANS SOLD YEAR-TO-DATE
Number

Participation Interest Retained
Acct
Amount of Participation Interest
Code
Retained

Acct
Code

Participation Interest Sold AND/OR Serviced
Acct
Amount of Participation Interest
Number
Code
Sold AND/OR Serviced

Acct
Code

a.

Sold With Recourse YTD……………………………

691H1

691I1

691A1

691J1

b.

Sold Without Recourse YTD………....…..…..…

691H2

691I2

691A2

691J2

TOTAL SOLD YTD (each column)……………

691H

691I

691A

691

5.

PARTICIPATION LOANS OUTSTANDING BY TYPE

Purchased Participations, Outstanding on Financial Statements
Acct
Acct
Number
Amount
Code
Code

Portion of Participations Sold, Outstanding on Financial Statements
Acct
Acct
Number
Amount Sold Outstanding
Code
Code

a.

Consumer……………………………………………

691K1

691L1

691M1

691N1

b.

Non-Federally Guaranteed Student Loans……

691K7

691L7

691M7

691N7

c.

Real Estate…………………………………………

691K2

691L2

691M2

691N2

d.

Member Business Loans excluding C&D…………

691K3

691L3

691M3

691N3

e.

Non-Member Business Loans excluding C&D……

691K4

691L4

691M4

691N4

f.

Commercial Construction & Development…………

691K5

691L5

691M5

691N5

Loan Pools……………………………………………

691K6

691L6

691M6

691N6

TOTAL OUTSTANDING (each column)………

691K

691L

691M

691N

g.

OMB No. 3133-0004
Expires 06/30/2017

NCUA 5300
Effective September 30, 2016
Previous Editions Are Obsolete

Page 14

Federal Charter/Certificate Number:________________

Credit Union Name:________________________________________________________________

SCHEDULE A
REPORT YEAR-TO-DATE NUMBERS FOR THE PERIOD: JANUARY 1, ______ to ____________________
SECTION 4 - BUSINESS LENDING - Complete this section if the credit union has any business loans.

1.

Member Business Loans

No. of Loans

Acct
Code

Net Member Business Loan
Balance (NMBLB)

Acct
Code

No. of Loans Granted or
Purchased Year-to-Date

Acct
Code

NMBLB Granted or Purchased
Year-to-Date

Acct
Code

a.

Construction and Development Loans

143A1

143B1

143C1

143D1

b.

Secured by Farmland

961A1

042A1

099A1

463A1

c.

Secured by Non-Farm Residential Property

900G

400G

090G

475G

d.

Secured by Owner Occupied, Non-Farm, Non-Residential Property

900H

400H

090H

475H

e.

Secured by Non-Owner Occupied, Non-Farm, Non-Residential Property

900J

400J

090J

475J

f.

TOTAL REAL ESTATE SECURED

900K

718A1

090K

475K

g.

Loans to finance agricultural production and other loans to farmers

961A2

042A2

099A2

463A2

h.

Commercial and Industrial Loans

900L

400L

090L

475L

i.

Unsecured Business Loans

900C1

400C1

090C1

475C1

j.

Unsecured Revolving Lines of Credit for Business Purposes

900C2

400C2

090C2

475C2

k.

TOTAL MEMBER BUSINESS LOANS

900A

400A

090A

475A

143D2

2.

Purchased business loans or participation interests to nonmembers
a.

Construction and Development Loans

143A2

143B2

143C2

b.

Secured by Farmland

961A3

042A3

099A3

463A3

c.

Secured by Non-Farm Residential Property

900G1

400G1

090G1

475G1

d.

Secured by Owner Occupied, Non-Farm, Non-Residential Property

900H1

400H1

090H1

475H1

e.

Secured by Non-Owner Occupied, Non-Farm, Non-Residential Property

900J1

400J1

090J1

475J1

f.

TOTAL REAL ESTATE SECURED

900K1

718A2

090K1

475K1

g.

Loans to finance agricultural production and other loans to farmers

961A4

042A4

099A4

463A4

h.

Commercial and Industrial Loans

900L1

400L1

090L1

475L1

i.

Unsecured Business Loans

900C3

400C3

090C3

475C3

j.

Unsecured Revolving Lines of Credit for Business Purposes

900C4

400C4

090C4

475C4

k.

TOTAL NONMEMBER BUSINESS LOANS

900B

400B

090B

475B

TOTAL BUSINESS LOANS (1k+2k)

900T

400T

3.

Construction and Development Loans meeting the requirements of 723.3(a)

Acct
Code
143A

4.

Unsecured Business Loans outstanding meeting the requirement of 723.7(c) - (d)

900C

400C

5.

Purchased business loans or participation interests to members

900D

400D

6.

Agricultural Related Loans (1b+1g+2b+2g)

961A

042A

7.

Business Loans and Participations sold Year-to-Date

691B

691C

8.

Small Business Administration Loans

900F

MISCELLANEOUS BUSINESS LOAN INFORMATION

9.

Number

Amount

Acct
Code
143B

400F

Portion of Real Estate Loans included in line 10 of page 13 which are also
reported as business loans on lines 1f and 2f above

718A

RISK BASED NET WORTH (RBNW)
For credit unions with assets greater than $50,000,000

10. Loans and participation interests qualifying for RBNW

Acct
Code
400

11. Unfunded commitments for business loans and participation interests qualifying for RBNW

814B

Amount

12. Amount of Real Estate Loans included in line 10 of page 13 also reported as business loans
and participation interests qualifying for RBNW on line 10 directly above

OMB No. 3133-0004
Expires 06/30/2017

718

NCUA 5300
Effective September 30, 2016
Previous Editions Are Obsolete

Page 15

Federal Charter/Certificate Number:________________

Credit Union Name:________________________________________________________________

SCHEDULE A
SPECIALIZED LENDING (Continued) AS OF: _______________
This page must be completed by all credit unions

SECTION 5 - TROUBLED DEBT RESTRUCTURED LOANS - Complete this section if the credit union has any TDR loans outstanding.
Report loans that qualify under generally accepted accounting principles as troubled debt restructurings (TDRs). TDRs are loans for which the credit union, for economic or legal reasons related to a borrower's financial difficulties, grants a concession to the borrower
that it would not otherwise consider. Refer to FASB Accounting Standards Codification 310-40. These loans should also be reported as part of the overall balances in the appropriate category on the Statement of Financial Condition (page 2); in Schedule A, Section 2
for real estate loans; in Schedule A, Section 4 for business loans; and on pages 7 and 8, if delinquent. See Delinquent Loan instructions for information regarding TDR delinquency reporting.

TDR Loans in Accrual Status
No. of Loans
Outstanding

Acct
Code

Amount in Accrual
Status

TDR Loans in Nonaccrual Status
Acct
Code

No. of Loans
Outstanding

Acct
Code

Amount in Nonaccrual
Status

Total TDR Loans Outstanding by Category
Acct
Code

Total No. of Loans

Acct
Code

Total Amount

Acct
Code

1. a. TDR Loans Secured by First Mortgages

1006A

1007A

1008A

1009A

1010A

1011A

b. TDR Loans Secured by Other RE/LOCs

1006B

1007B

1008B

1009B

1010B

1011B

c. TDR RE Loans Also Reported as Business Loans

1006C

1007C

1008C

1009C

1010C

1011C

d. TDR Consumer Loans NOT Secured by Real Estate

1006D

1007D

1008D

1009D

1010D

1011D

e. TDR Business Loans NOT Secured by Real Estate

1006E

1007E

1008E

1009E

1010E

1011E

1006

1007

1008

1009

1000F

1001F

f.

Total TDR Loans Outstanding (a+b+d+e)

REPORT YEAR-TO-DATE NUMBERS FOR THE PERIOD: JANUARY 1, ______ to ____________________
Acct
Acct
Number of Loans
Amount YTD
Code
Code
2.

TDR Loans Approved Year-to-Date

1012A
Amount

3.

TDR portion of Allowance for Loan and Lease Losses

1002F
Acct
Code
1013

Section 6- PURCHASED CREDIT IMPAIRED LOANS (PCILs) - Complete this section if the credit union has any PCILs.
Report purchased impaired loans, whether obtained through merger or other purchase. The outstanding balances of these loans should also be reported on the correct lines of the Statement of Financial Condition (page 2); in Schedule A, Section 2 for real estate loans; in
Schedule A, Section 4 for business loans; and on pages 7 and 8, if delinquent.

Report all Balances as of Call Report Date
A

No. of Loans
Outstanding

1. a. PCILs Secured by First Mortgages
b. PCILs Secured by Other RE/LOCs
c. PCILs (RE Loans) Also Reported as Business Loans
d. PCILs (Consumer Loans) NOT Secured by Real Estate
e. PCILs (Business Loans) NOT Secured by Real Estate
f. Total PCILs Outstanding (a+b+d+e)

OMB No. 3133-0004
Expires 06/30/2017

B

Acct
Code
1014

Contractually Required
Payments Receivable of
PCILs

C

Calculated
(E=B-C-D)

D

Acct Nonaccretable Balance
Code
Outstanding
1014A

Acct
Code
1014B

1015

1015A

1015B

1015C

1015D

1015E

1016

1016A

1016B

1016C

1016D

1016E

1017
1018

1017A
1018A

1017B
1018B

1017C
1018C

1017D
1018D

1017E
1018E

1019

1019A

1019B

1019C

1019D

1019E

NCUA 5300
Effective September 30, 2016
Previous Editions Are Obsolete

Accretable Yield
Outstanding

F

Uncollectible amounts of
Recorded Investment in
PCILs charged off to the
Loan Receivable
Allowance for Loan and
Acct
Acct Lease Losses Account, Acct
(Amount included in
Code
Loans on Page 2)
Code
YTD
Code
1014C
1014D
1014E

Page 16

Federal Charter/Certificate Number:________________

Credit Union Name:_____________________________________________

SCHEDULE B
INVESTMENTS, SUPPLEMENTAL INFORMATION AS OF: _______________
Complete this schedule if amounts are reported on page 1, lines 4, 5, or 6; or if items below are applicable.
TYPES OF INVESTMENTS
1. U.S. Government Obligations
a. NCUA Guaranteed Notes
< = 1 Year
738A

> 1- 3 Years
738B

> 3 - 5 Years
738C

> 5 - 10 Years
738D

> 10 Years
738E

739A

739B

739C

739D

739E

Total Amount

Amt of Variable Rate

738

Amt of Fixed Rate

739
740

b. TOTAL NCUA GUARANTEED NOTES …………………………………………………………………………..
c. Total FDIC-Issued Guaranteed Notes……………………………………………………………………………

740A

d.

741C3

All Other U.S. Government Obligations…………………………………………………………………………

e. TOTAL U.S. GOVERNMENT OBLIGATIONS……………………………………………………………………
2. Federal Agency Securities
a. Agency/GSE Debt Instruments (not backed by mortgages)…………………………………..

741C
742C1

b. Agency/GSE Mortgage-Backed Securities……………………………………………………..

742C2

c. TOTAL FEDERAL AGENCY SECURITIES………………………………………………………..

742C

3. Securities Issued by States and Political Subdivisions in the U.S. ………………………………….
4. Other Mortgage-Backed Securities
a. Privately Issued Mortgage-Related Securities
i. Privately Issued Mortgage-Related Securities …...…………………………
ii. Privately Issued Securities (exclude from 4.a.i.) that fail to meet the definition of a
mortgage-related security (i.e., downgraded below the two highest rating categories)
after purchase (FCU Only) ….………………………..…………………………………
b. Privately Issued Mortgage-Backed Securities (SCU Only)…........……..….....……………….

745

981A
981C
981B
981

c. TOTAL OTHER MORTGAGE-BACKED SECURITIES…………………………………………….
5. Mutual Funds ……………………..………………..…………………………………...………….

743D

6. Common Trusts……………………………………………………………………………………….

743E
746

7. Bank Issued FDIC-Guaranteed Bonds………………………………………………………………………

Acct
Code
786A

Amount

INVESTMENTS MEETING SPECIFIC CRITERIA OF PART 703 (FCU ONLY)
8. Non-Mortgage Related Securities with Embedded Options or Complex Coupon Formulas……..
Non-Mortgage Related Securities with Maturities Greater than Three Years that Do Not Have Embedded Options or
9.
Complex Coupon Formulas……………………………

786B
786

10. Total of Securities Meeting the Requirements of Section 703.12(b) (Sum of items 2b+4c+8+9) ....
MORTGAGE-BACKED SECURITIES
11. Collateralized Mortg. Obligations/Real Estate Mortgage Investment Conduits (CMOs/REMICs)….

733
733A

12. Commercial Mortgage Backed Securities………………………………………………...…………...

OMB No. 3133-0004
Expires 06/30/2017

NCUA 5300
Effective September 30, 2016
Previous Editions Are Obsolete

Page 17

Federal Charter/Certificate Number:________________
Credit Union Name:_____________________________________________
SCHEDULE B
INVESTMENTS, SUPPLEMENTAL INFORMATION AS OF: _______________
Complete this schedule if amounts are reported on page 1, lines 4, 5, or 6; or if items below are applicable.
MISCELLANEOUS INVESTMENT INFORMATION
13. Total of Deposits and Shares Meeting the Requirements of Section 703.10(a) (FCU Only)……………………………………………………………….

785

14. Market Value of Investments Purchased Under an Investment Pilot Program - 703.19 (FCU Only)…………………..……………………………..……

785A

15. Fair Value of Held to Maturity Investments (reported on line 6 of page 1)…………………………………………….…………………………….…………

801

16. Investment Repurchase Agreements…………………………………………………………………...………………………………………………………….

780

17. Borrowing Repurchase Transactions Placed in Investments for Purposes of Positive Arbitrage………………......….……………………………………

781

18. Investments Not Authorized by the FCU Act or NCUA Rules and Regulations (SCU ONLY). Exclude investments listed in Line 20 a. or b. (below).

784A

19. Outstanding balance of brokered certificates of deposit and share certificates ………………………………..………………………………………….....

788

20. Amounts reported in the Asset section of the Statement of Financial Condition to fund employee benefit plans or deferred compensation plans under
Section 701.19(c) of NCUA Rules and Regulations (if FCU), or similar state provisions (if SCU), that are not authorized under Part 703 of NCUA Rules
and Regulations.

Recorded Value

Acct
Code

a. Securities………………………………………………………………………………………………………….………………….……………………………

789C

b. Other Investments……………………….…………………………………...………………………….……..………………………………………………..

789D

c. Other Assets:………………………………..…….……………………………………………………………………………………………………………..
i.

Split Dollar Life Insurance Arrangements
a)

Collateral Assignment……………………………….…………………………………………….………………………………………………….

789E

b)

Endorsement……………………………………….………………………………….……………………………………………………………….

789E1

ii. Other Insurance…………………..……………….………………………………………………………………………………………………………….

789E2

iii. Other Non-insurance……………….…….……………………………....………………………………………………………………………………….

789F

d. Total (sum items a. - c.)…………………….…………..…………………………………………………………………………………………………..

789G

Recorded Value
21. Amounts reported in Asset section of the Statement of Financial Condition to fund Charitable Donation Accounts………….…………………..……....
FCU= Federal Credit Union

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SCU= State Credit Union

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Previous Editions Are Obsolete

Page 18

Acct
Code
789H

Credit Union Name:_________________________________________

Federal Charter/Certificate Number:________________

SCHEDULE C
CREDIT UNION SERVICE ORGANIZATION (CUSO) INFORMATION AS OF: _______________

Report the following aggregate totals the credit union has in all CUSOs, regardless of whether your credit union owns the CUSO, has a "controlling financial interest,"
has the "ability to exert significant influence" or owns only a smaller portion of the CUSO.

Amount

ACCT CODE

Total Value of Investments in CUSOs

851

Total Amount loaned to CUSOs

852

Total Aggregate Cash Outlay in CUSOs

853

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NCUA 5300
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Page 19

Credit Union Name:_____________________________________________

Federal Charter/Certificate Number:________________

SCHEDULE D
DERIVATIVE TRANSACTIONS REPORT AS OF: _______________
SECTION 1 - Outstanding

1. Total Derivative Transactions Outstanding:
Total Notional Amount

Acct
Code

Fair Value of
Derivatives in a Gain
Position

Acct
Code

Fair Value of
Derivatives in a Loss
Position

Acct
Code

Net Fair Value Gain
(Loss)

Acct
Code

a. Interest Rate Swaps:
i. Pay-fixed………….……

1020

1020A

1020B

1020C

ii. Receive-fixed………….

1021

1021A

1021B

1021C

iii. Basis……..……………

1022

1022A

1022B

1022C

i. Caps Purchased……….

1023

1023A

1023B

1023C

ii. Floors Purchased………

1024

1024A

1024B

1024C

i. 2 & 3 Year Notes…………

1025

1025A

1025B

1025C

ii. 5 & 10 Year Notes………

1026

1026A

1026B

1026C

b. Interest Rate Options:

c. Treasury Futures:

d. Other Derivatives (List):

Acct #

i. _______________________

1027Z

1027

1027A

1027B

1027C

ii. _______________________
iii. _______________________

1028Z
1029Z

1028
1029

1028A
1029A

1028B
1029B

1028C
1029C

1030

1030A

1030B

1030C

Total Derivatives……………….

OMB No. 3133-0004
Expires 06/30/2017

NCUA 5300
Effective September 30, 2016
Previous Editions Are Obsolete

Page 20

Credit Union Name:________________________________________
Federal Charter/Certificate Number:________________
SCHEDULE D
DERIVATIVE TRANSACTIONS REPORT AS OF: _______________
SECTION 2 - Outstanding with Accounting Designation
Acct
Code

No Hedge Accounting Designation
Acct
Net Fair Value Gain
Notional Amount
Code
(Loss)

Acct
Code

i. Pay-fixed………….……

1020D

1020E

1020F

ii. Receive-fixed………….

1021D

1021E

1021F

iii. Basis……..……………
b. Interest Rate Options:

1022D

1022E

1022F

i. Caps Purchased……….

1023D

1023E

1023F

1024D

1024E

1024F

i. 2 & 3 Year Notes…………

1025D

1025E

1025F

ii. 5 & 10 Year Notes………
d. Other Derivatives (List): Acct Code

1026D

1026E

1026F

1. Derivative Transactions Outstanding with
No Hedge Accounting Designation:

Number of
Trades

a. Interest Rate Swaps:

ii. Floors Purchased………
c. Treasury Futures:

i. _________________

1027Z

1027D

1027E

1027F

ii. _________________
iii. ________________

1028Z
1029Z

1028D
1029D

1028E
1029E

1028F
1029F

1030D

1030E

1030F

Total Derivatives…………..
2. Derivative Transactions Outstanding with
Fair Value Hedge Accounting Designation:

# of Trades

Acct
Code

Fair Value Hedge Designation
Acct
Net Fair Value Gain
Notional Amount
Code
(Loss)

Acct
Code

a. Interest Rate Swaps:
i. Pay-fixed………….……

1020G

1020H

1020J

ii. Receive-fixed……...….

1021G

1021H

1021J

iii. Basis……..……………
b. Interest Rate Options:

1022G

1022H

1022J

i. Caps Purchased……….

1023G

1023H

1023J

ii. Floors Purchased………

1024G

1024H

1024J

i. 2 & 3 Year Notes…………

1025G

1025H

1025J

ii. 5 & 10 Year Notes………
d. Other Derivatives (List): Acct Code

1026G

1026H

1026J

c. Treasury Futures:

i. _________________

1027Z

1027G

1027H

1027J

ii. _________________
iii. ________________

1028Z
1029Z

1028G
1029G

1028H
1029H

1028J
1029J

1030G

1030H

1030J

Total Derivatives……………….
3. Derivative Transactions Outstanding with
Cash Flow Hedge Accounting Designation:

# of Trades

Acct
Code

Cash Flow Hedge Designation
Acct
Net Fair Value Gain
(Loss)
Notional Amount
Code

Acct
Code

a. Interest Rate Swaps:
i. Pay-fixed………….……

1020K

1020L

1020M

ii. Receive-fixed………….

1021K

1021L

1021M

iii. Basis……..……………
b. Interest Rate Options:

1022K

1022L

1022M

i. Caps Purchased……….

1023K

1023L

1023M

1024K

1024L

1024M

i. 2 & 3 Year Notes…………

1025K

1025L

1025M

ii. 5 & 10 Year Notes………
d. Other Derivatives (List): Acct Code

1026K

1026L

1026M

ii. Floors Purchased………
c. Treasury Futures:

i. _________________

1027Z

1027K

1027L

1027M

ii. _________________
iii. ________________

1028Z
1029Z

1028K
1029K

1028L
1029L

1028M
1029M

1030K

1030L

1030M

Total Derivatives……………….

OMB No. 3133-0004
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NCUA 5300
Effective September 30, 2016
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Page 21

Credit Union Name:_____________________________________________

Federal Charter/Certificate Number:________________

SCHEDULE D
DERIVATIVE TRANSACTIONS REPORT AS OF: _______________
SECTION 3 - Activity

1. Derivative Transactions activity:

Total Notional Amount
from Previous Quarter
(A)

Acct
Code

Notional Amount of
Derivative
Transactions Made in
Current Quarter
(B)

Acct
Code

Notional Amount
Amortized, Matured, or
Terminated in Current
Quarter
(C)

Acct
Code

Outstanding Total
Notional Amounts
(A) + (B) + (C)

Acct
Code

a. Interest Rate Swaps:
i. Pay-fixed………….

1020N

1020P

1020Q

1020R

ii. Receive-fixed…….

1021N

1021P

1021Q

1021R

iii. Basis………………

1022N

1022P

1022Q

1022R

i. Caps Purchased….

1023N

1023P

1023Q

1023R

ii. Floors Purchased…

1024N

1024P

1024Q

1024R

i. 2 & 3 Year Notes….

1025N

1025P

1025Q

1025R

ii. 5 & 10 Year Notes..

1026N

1026P

1026Q

1026R

b. Interest Rate Options:

c. Treasury Futures:

d. Other Derivatives (List):

Acct
Code

i. _________________

1027Z

1027N

1027P

1027Q

1027R

ii. _________________
iii. ________________

1028Z
1029Z

1028N
1029N

1028P
1029P

1028Q
1029Q

1028R
1029R

1030N

1030P

1030Q

1030R

Total Derivatives………………

OMB No. 3133-0004
Expires 06/30/2017

NCUA 5300
Effective September 30, 2016
Previous Editions Are Obsolete

Page 22

Credit Union Name:_____________________________________________

Federal Charter/Certificate Number:________________

SCHEDULE D
DERIVATIVE TRANSACTIONS REPORT AS OF: _______________
SECTION 4 - Maturity Horizon
Notional Amount
1. Current Notional Amount of
Derivatives based on Maturity (years
remaining in contract):

≤1 yr

Acct
Code

>1 to ≤3 yrs

Acct
Code

>3 to ≤5 yrs

Acct
Code

Acct
Code

>5 to ≤10 yrs

>10 yrs

Acct
Code

Total

Acct
Code

Weighted
Average yrs
to Maturity

Acct
Code

a. Interest Rate Swaps:
i. Pay-fixed………….

1020S

1020T

1020U

1020V

1020W

1020X

1020Y

ii. Receive-fixed…….

1021S

1021T

1021U

1021V

1021W

1021X

1021Y

iii. Basis………………

1022S

1022T

1022U

1022V

1022W

1022X

1022Y

b. Interest Rate Options:
i. Caps Purchased….

1023S

1023T

1023U

1023V

1023W

1023X

1023Y

ii. Floors Purchased…

1024S

1024T

1024U

1024V

1024W

1024X

1024Y

i. 2 & 3 Year Notes….

1025S

1025T

1025X

1025Y

ii. 5 & 10 Year Notes..

1026S

1026T

1026U

1026V

1026W

1026X

1026Y

c. Treasury Futures:

d. Other Derivatives (List):

Acct
Code

i. _________________

1027Z

1027S

1027T

1027U

1027V

1027W

1027X

1027Y

ii. _________________
iii. ________________

1028Z
1029Z

1028S
1029S

1028T
1029T

1028U
1029U

1028V
1029V

1028W
1029W

1028X
1029X

1028Y
1029Y

1030S

1030T

1030U

1030V

1030W

1030X

1030Y

Total Derivatives………………

Net Fair Value Gains (Losses)
2. Current Net Fair Value Gains (Losses)
of Derivatives based on Maturity (years
remaining in contract)

≤1 yr

Acct
Code

>1 to ≤3 yrs

Acct
Code

>3 to ≤5 yrs

Acct
Code

>5 to ≤10 yrs

Acct
Code

>10 yrs

Acct
Code

Total

Acct
Code

a. Interest Rate Swaps:
i. Pay-fixed………….

1020S1

1020T1

1020U1

1020V1

1020W1

1020X1

ii. Receive-fixed…….

1021S1

1021T1

1021U1

1021V1

1021W1

1021X1

iii. Basis………………

1022S1

1022T1

1022U1

1022V1

1022W1

1022X1

i. Caps Purchased….

1023S1

1023T1

1023U1

1023V1

1023W1

1023X1

ii. Floors Purchased…

1024S1

1024T1

1024U1

1024V1

1024W1

1024X1

i. 2 & 3 Year Notes….

1025S1

1025T1

ii. 5 & 10 Year Notes..

1026S1

1026T1

1026U1

1026V1

1026W1

b. Interest Rate Options:

c. Treasury Futures:

d. Other Derivatives (List):

1025X1
1026X1

Acct
Code

i. _________________

1027Z

1027S1

1027T1

1027U1

1027V1

1027W1

1027X1

ii. _________________
iii. ________________

1028Z
1029Z

1028S1
1029S1

1028T1
1029T1

1028U1
1029U1

1028V1
1029V1

1028W1
1029W1

1028X1
1029X1

1030S1

1030T1

1030U1

1030V1

1030W1

1030X1

Total Derivatives………………

OMB No. 3133-0004
Expires 06/30/2017

NCUA 5300
Effective September 30, 2016
Previous Editions Are Obsolete

Page 23

Credit Union Name:_____________________________________________

Federal Charter/Certificate Number:________________

SCHEDULE D
DERIVATIVE TRANSACTIONS REPORT AS OF: _______________
SECTION 5 - Counterparty Exposure for Derivative Transactions

Clearing or Bilateral Agreement :

1

Acct
Code

2

Acct
Code

3

Acct
Code

4

Acct
Code

Total

Acct
Code

1. Derivative Net Fair Value Gain (Loss) as of the end of
the current quarter:
a. Interest Rate Swaps

1031A

1031B

1031C

1031D

1031

b. Interest Rate Options

1032A

1032B

1032C

1032D

1032

c. Treasury Futures
d. Other
e. Total Net Fair Value as of the end of the
current quarter

1033A
1034A

1033B
1034B

1033C
1034C

1033D
1034D

1033
1034

1035A

1035B

1035C

1035D

1035

2. Fair Value of Collateral Pledged to (+) or Received from
(-) Counterparty (Variation Margin only):
a. Cash

1036A

1036B

1036C

1036D

1036

b. U.S. Treasury Securities

1037A

1037B

1037C

1037D

1037

c. U.S. Gov't Agency Debt
d. U.S. Gov't Agency Securities (MBS)

1038A
1039A

1038B
1039B

1038C
1039C

1038D
1039D

1038
1039

e. Total

1040A

1040B

1040C

1040D

1040

3. Net Credit Exposure from Derivatives

1041A

1041B

1041C

1041D

1041

4. Fair Value of Collateral posted as Initial Margin

1042A

1042B

1042C

1042D

1042

OMB No. 3133-0004
Expires 06/30/2017

NCUA 5300
Effective September 30, 2016
Previous Editions Are Obsolete

Page 24

Federal Charter/Certificate Number:________________

Credit Union Name:______________________________________________
SCHEDULE E

BANK SECRECY ACT/ANTI-MONEY LAUNDERING INFORMATION AS OF: _______________
Complete this schedule if the items below are applicable. This information will not be released to the public.
MONEY SERVICES BUSINESSES
Number of Accounts

Acct
Code

1. Total Money Services Businesses………………………………………

1050

2. Dealers in Foreign Exchange…………………………………………………

1051

3. Check Cashers…………………………………………………………………

1052

4. Monetary Instruments…………………………………………………………

1053

5. Money Transmitters……………………………………………………………

1054

6. Provider of Prepaid Access……………………………………………………

1055

7. Seller of Prepaid Access………………………………………………………

1056

OMB No. 3133-0004
Expires 06/30/2017

NCUA 5300
Effective September 30, 2016
Previous Editions Are Obsolete

Amount

Acct
Code
1050A

Page 25