OCC's BSA/AML Quantity of Risk Summary Form

Bank Secrecy Act/Anti-Money Laundering Risk Assessment

MLR_RSF_2019

Community Bank Population

OMB: 1557-0231

Document [pdf]
Download: pdf | pdf
MLR-RSF
Tracking Code:2NJCRFL

Identifying Information
C harter Number
999888

Bank Name
Test Bank 999888

Cash Intensive Businesses
Reported data should be rounded to the nearest whole number and reflect total number and dollar values as of September 30.
Do you have anything to report? *

Total Number *

Total Volume *

1. Convenience Stores

0

0

2. Liquor Stores

0

0

3. Domestic Charitable Organizations

0

0

4. Jewelry, Gem, and Precious Metal Dealers

0

0

5. Casinos

0

0

6. Car Dealers

0

0

7. Boat/Airplane

0

0

Domestic Accounts
Reported data should be rounded to the nearest whole number and reflect total number and dollar values as of September 30.
Do you have anything to report? *

Total Number *

Total Volume *

8. Domestic Private Banking

0

0

9. Domestic Commercial Letters of Credit

0

0

10. Stand-By Letters of Credit

0

0

Domestic Customers
Reported data should be rounded to the nearest whole number and reflect total number and dollar values as of September 30.
Do you have anything to report? *

Total Number *

Total Volume *

11. Customers/Accounts opened through the Internet,
Mail, Wire, or Phone (non-branch)

0

0

12. Domestic Deposit Brokers

0

0

13. Travel Agencies

0

0

14. Broker Dealers

0

0

15. Telemarketers

0

0

16. Remotely Created Check Customers

0

0

17. Domestic Remote Deposit Capture Customers

0

0

18. Third Party Senders

0

0

Domestic Transactions
Reported data should be rounded to the nearest whole number and reflect the total sum number and dollar volume from October
1 of the previous year to September 30 of the current year.
Do you have anything to report? *

Total Number *

Total Volume *

19. Issuance of Traveler's Checks, Official BankChecks
& Money Orders

0

0

20. Domestic Wire Transfers

0

0

21. Domestic PUPID Wire Transfers

0

0

22. ACH

0

0

23. Remotely Created Checks

0

0

24. Domestic Remote Deposit Capture

0

0

Foreign Customers
Reported data should be rounded to the nearest whole number and reflect total number and dollar values as of September 30.

Do you have anything to report? *

Total Number *

Total Volume *

25. Non-Resident Alien Accounts
Non-Resident Alien Accounts

0

0

0

0

0

0

0

0

Foreign Charitable Organizations

0

0

30. Import/Export

0

0

0

0

0

0

26. Politically Exposed Persons
Politically Exposed Persons
27. Foreign Off-Shore Corporations
Foreign Off-Shore Corporations
28. Foreign Deposit Brokers
Foreign Deposit Brokers
29. Foreign Charitable Organizations

31. Foreign Remote Deposit Capture Customers
Foreign Remote Deposit Capture Customers
32. Bulk Cash/Currency Repatriation Customers
Bulk Cash/Currency Repatriation Customers

International Accounts
Reported data should be rounded to the nearest whole number and reflect total number and dollar values as of September 30.
Do you have anything to report? *

Total Number *

Total Volume *

33. International Branches
International Branches

0

0

0

0

0

0

0

0

34. Foreign Correspondent Accounts
Foreign Correspondent Accounts
35. Payable Through Accounts
Payable Through Accounts
36. Pouch Services
Pouch Services
37. Foreign Bank Affiliate (e.g. Parallel Banks)

Foreign Bank Affiliate (e.g. Parallel Banks)

0

0

0

0

0

0

0

0

0

0

38. International Department
International Department
39. International Private Banking
International Private Banking
40. Embassy and Consulate Banking
Embassy and Consulate Banking
41. International Commercial Letters of Credit
International Commercial Letters of Credit

International Transactions
Reported data should be rounded to the nearest whole number and reflect the total sum number and dollar volume from October
1 of the previous year to September 30 of the current year.
Do you have anything to report? *

Total Number *

Total Volume *

42. International Bank Drafts
International Bank Drafts

0

0

0

0

0

0

0

0

0

0

0

0

0

0

43. International Wire Transfers
International Wire Transfers
44. International PUPID Wire Transfers
International PUPID Wire Transfers
45. Remittance Products
Remittance Products
46. Cross-Border ACH
Cross-Border ACH
47. International Remote Deposit Capture
International Remote Deposit Capture
48. Bulk Cash/Currency Repatriation
Bulk Cash/Currency Repatriation

Money Services Businesses
Reported data should be rounded to the nearest whole number and reflect total number and dollar values as of September 30.

Do you have anything to report? *

Total Number *
49. Domestic Casas de Cambio/Currency Exchange:

Total Volume *

0

0

Foreign Casas de Cambio/Currency Exchange

0

0

51. Money Transmitters

0

0

52. Check Cashers

0

0

53. Issuers or Sellers of Traveler's Checks or Money
Orders

0

0

54. Providers of Prepaid Access

0

0

55. Sellers of Prepaid Access

0

0

50. Foreign Casas de Cambio/Currency Exchange

Prepaid Cards
Reported data should be rounded to the nearest whole number and reflect total number and dollar values as of September 30.
For Prepaid C ards - Reloadable and Prepaid C ards - Non-Reloadable, please report the total sum number and dollar volume from
October 1 of the previous year to September 30 of the current year.
Do you have anything to report? *

Total Number *

Total Volume *

56. Prepaid Cards
Prepaid C ards - Reloadable

0

0

Prepaid C ards - Non-Reloadable

0

0

0

0

Prepaid C ard Programs - Third Party Sponsored Reloadable

0

0

Prepaid C ard Programs - Third Party Sponsored - NonReloadable

0

0

0

0

Prepaid C ard Programs - Bank Sponsored - Reloadable

0

0

Prepaid C ard Programs - Bank Sponsored - Non-Reloadable

0

0

0

0

Prepaid Cards
57. Prepaid Card Programs - Third Party Sponsored

Prepaid Card Programs - Third Party Sponsored
58. Prepaid Card Programs - Bank Sponsored

Prepaid Card Programs - Bank Sponsored

59. Prepaid Cardholders
Prepaid C ardholders - Reloadable

0

0

Prepaid C ardholders - Non-Reloadable

0

0

Prepaid Cardholders

0

0

60. Prepaid Card Program Managers

0

0

Trust Department / Investments / Brokered Accounts
Reported data should be rounded to the nearest whole number and reflect total number and dollar values as of September 30.
Do you have anything to report? *

Total Number *

Total Volume *

Charitable Trusts & Foundations
61. Domestic Charitable Trusts & Foundations

0

0

0

0

62. Foreign Charitable Trusts & Foundations
Foreign Charitable Trusts & Foundations

Customer Directed Trust Accounts (non-discretionary)
63. Custodial Accounts

0

0

64. Investment Advisory Accounts

0

0

65. Revocable Trusts

0

0

66. Foreign Grantor or Beneficiaries

0

0

67. Loans to Closely Held Corporations

0

0

Other

68. Brokerage Department/Operations

0

0

69. Investment Advisory/Management

0

0

Optional Feedback

Optional: Feedback/Suggestions on ways to improve the Risk Summary form and OC C ' Money Laundering Risk System data
collection process.
In addition,you may include pertinent information regarding your submitted data.

Paperwork Reduction Act Statement:
This collection of information has been approved by the Office of Management and Budget (OMB) under control number 15570231 (expires 10/31/2019). Under the Paperwork Reduction Act, an agency may not conduct or sponsor, and a person is not
required to respond to, a collection of information unless it displays a currently valid OMB control number. The OC C estimates
that it will take community bank, federal branches and agency respondents 6 hours, midsize bank respondents 25 hours, and
large bank respondents 80 hours, to complete this form.


File Typeapplication/pdf
File Modified2019-08-11
File Created2017-09-13

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