Form FR Y-6 FR Y-6 Annual Report of Holding Companies

FR Y-6
OMB Number 7100-0297
Approval expires September 30, 2018
Page 1 of 2

Board of Governors of the Federal Reserve System

Annual Report of Holding Companies—FR Y-6
Report at the close of business as of the end of fiscal year
This Report is required by law: Section 5(c)(1)(A) of the Bank
Holding Company Act (12 U.S.C. § 1844(c)(1)(A)); sections 8(a)
and 13(a) of the International Banking Act (12 U.S.C. §§ 3106(a)
and 3108(a)); sections 11(a)(1), 25, and 25A of the Federal
Reserve Act (12 U.S.C. §§ 248(a)(1), 602, and 611a); and sections 113, 165, 312, 618, and 809 of the Dodd-Frank Act (12 U.S.C.
§§ 5361, 5365, 5412, 1850a(c)(1), and 5468(b)(1)). Return to the
appropriate Federal Reserve Bank the original and the number of
copies specified.

This report form is to be filed by all top-tier bank holding companies, top-tier savings and loan holding companies, and U.S. intermediate holding companies organized under U.S. law, and by
any foreign banking organization that does not meet the requirements of and is not treated as a qualifying foreign banking organization under Section 211.23 of Regulation K (12 C.F.R. §
211.23). (See page one of the general instructions for more detail
of who must file.) The Federal Reserve may not conduct or sponsor, and an organization (or a person) is not required to respond
to, an information collection unless it displays a currently valid
OMB control number.

NOTE: The Annual Report of Holding Companies must be signed by
one director of the top-tier holding company. This individual should
also be a senior official of the top-tier holding company. In the event
that the top-tier holding company does not have an individual who is
a senior official and is also a director, the chairman of the board must
sign the report. If the holding company is an ESOP/ESOT formed as
a corporation or is an LLC, see the General Instructions for the
authorized individual who must sign the report.

Date of Report (top-tier holding company's fiscal year-end):
Month / Day / Year

Reporter's Legal Entity Identifier (LEI) (20-Character LEI Code)

Reporter's Name, Street, and Mailing Address

I,
Name of the Holding Company Director and Official
Legal Title of Holding Company
Title of the Holding Company Director and Official

attest that the Annual Report of Holding Companies (including
the supporting attachments) for this report date has been prepared in conformance with the instructions issued by the Federal
Reserve System and are true and correct to the best of my
knowledge and belief.
With respect to information regarding individuals contained in this
report, the Reporter certifies that it has the authority to provide this
information to the Federal Reserve. The Reporter also certifies
that it has the authority, on behalf of each individual, to consent or
object to public release of information regarding that individual.
The Federal Reserve may assume, in the absence of a request for
confidential treatment submitted in accordance with the Board's
"Rules Regarding Availability of Information," 12 C.F.R. Part 261,
that the Reporter and individual consent to public release of all
details in the report concerning that individual.

(Mailing Address of the Holding Company) Street / P.O. Box

City

State

Zip Code

Physical Location (if different from mailing address)

Person to whom questions about this report should be directed:
Name

Title

Area Code / Phone Number / Extension

Area Code / FAX Number

E-mail Address
Signature of Holding Company Director and Official
Address (URL) for the Holding Company's web page
Date of Signature

For holding companies not registered with the SEC–
Indicate status of Annual Report to Shareholders:
is included with the FR Y-6 report
will be sent under separate cover
is not prepared

For Federal Reserve Bank Use Only
RSSD ID
C.I.

Is confidential treatment requested for any portion 0=No
of this report submission? .............................. 1=Yes
In accordance with the General Instructions for this report
(check only one),
1. a letter justifying this request is being provided along
with the report ......................................................
2. a letter justifying this request has been provided
separately............................................................
NOTE: Information for which confidential treatment is being
requested must be provided separately and labeled
as "confidential."

Public reporting burden for this information collection is estimated to vary from 1.3 to 101 hours per response, with an average of 5.50 hours per response, including 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, 20th and C Streets, NW, Washington, DC 20551, and to the
Office of Management and Budget, Paperwork Reduction Project (7100-0297), Washington, DC 20503.

12/2016

FR Y-6
Page 2 of 2

For Use By Tiered Holding Companies
Top-tiered holding companies must list the names, mailing address, and physical locations of each of their subsidiary holding companies
below.

Legal Title of Subsidiary Holding Company

Legal Title of Subsidiary Holding Company

(Mailing Address of the Subsidiary Holding Company) Street / P.O. Box

(Mailing Address of the Subsidiary Holding Company) Street / P.O. Box

City

City

State

Zip Code

State

Zip Code

Physical Location (if different from mailing address)

Physical Location (if different from mailing address)

Legal Title of Subsidiary Holding Company

Legal Title of Subsidiary Holding Company

(Mailing Address of the Subsidiary Holding Company) Street / P.O. Box

(Mailing Address of the Subsidiary Holding Company) Street / P.O. Box

City

State

Zip Code

City

State

Zip Code

Physical Location (if different from mailing address)

Physical Location (if different from mailing address)

Legal Title of Subsidiary Holding Company

Legal Title of Subsidiary Holding Company

(Mailing Address of the Subsidiary Holding Company) Street / P.O. Box

(Mailing Address of the Subsidiary Holding Company) Street / P.O. Box

City

State

Zip Code

City

State

Zip Code

Physical Location (if different from mailing address)

Physical Location (if different from mailing address)

Legal Title of Subsidiary Holding Company

Legal Title of Subsidiary Holding Company

(Mailing Address of the Subsidiary Holding Company) Street / P.O. Box

(Mailing Address of the Subsidiary Holding Company) Street / P.O. Box

City

State

Physical Location (if different from mailing address)

Zip Code

City

State

Zip Code

Physical Location (if different from mailing address)

12/2012