Information Collection

Comptroller's Licensing Manual

IC 19996 under ICR 201912-1557-005 · OMB 1557-0014.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1557-0014 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Comptroller's Licensing Manual	Form and Instruction
1 - General Policies & Procedures.pdf	Instruction
3 - Survey Letter.pdf	Other-Form Letter
4 - Significant Deviation Policy.pdf	Instruction
11 - Charters.pdf	Instruction
13 - Business Plan.pdf	Instruction
14 - Financial Projections.pdf	Instruction
15 - Application Ammendments.pdf	Other-Form Letter
16 - Public Notice Sample.pdf	Instruction
17 - Minority-Owned National Banks Policy Statement.pdf	Instruction
20 - Instructions - Articles of Association.pdf	Instruction
27 - Oaths of Bank Directors Instructions.pdf	Instruction
40 - Conversions.pdf	Instruction
45 - Instructions - Organization Certificate.pdf	Instruction
47 - Articles of Association 2.pdf	Instruction
49 - Branches & Relocations.pdf	Instruction
54 - Business Combinations.pdf	Instruction
69 - Public Notice and Instructions.pdf	Instruction
72 - Sample Agreements - Consolidation.pdf	Instruction
73 - Sample Agreements - Merger.pdf	Instruction
74 - Sample Agreements - Purchase & Assumption.pdf	Instruction
75 - Fiduciary Powers.pdf	Instruction
79 - Fiduciary Operating Plan-Instructions.pdf	Instruction
86 - OS Annual Report Instructions 5.2015 FINALOMB.docx	Instruction
92 - Branch Closings.pdf	Instruction
96 - Capital And Dividends.pdf	Instruction
114 - Change In Bank Control.pdf	Instruction
117 - Publication Notice.pdf	Instruction
118 - Changes In Directors & Senior Executive Officers.pdf	Instruction
119 - Notification Of Change Of Corporate Titile.pdf	Instruction
120 - Change Of Corporate Title & Address.pdf	Instruction
123 - Director Waivers.pdf	Instruction
129 - Management Interlocks.pdf	Instruction
133 - Issuance of Sub Debt Notice 5.2015 FINALOMB.docx	Instruction
137 - Termination Of National Bank Status.pdf	Instruction
150 - Federal Branches & Agencies.pdf	Instruction
152 - Initial and Additional Establishments - Sample Public Notice.pdf	Instruction
153 - Conditions for Initial and Additional Establishments.pdf	Instruction
159 - Acquisitions - Sample Public Notice.pdf	Instruction
161 - Notice of Contraction of Activities.pdf	Instruction
163 - Relocations - Sample Public Notice.pdf	Instruction
165 - Application Letter - Fiduciary Powers.pdf	Instruction
166 - Fiduciary Operating Plan - Instructions.pdf	Instruction
167 - Notice of Commencement of Fiduciary Activities.pdf	Instruction
1550.0005.Form138.Handbook[1].pdf	Instruction
1550.0032.Handbook[1].pdf	Instruction
Change in Assets Application 2 - Change In Assets Applications.pdf	Form and Instruction
Background Investigations 5 - Background Investigations.pdf	Form and Instruction
Consent Form for DEA Background Investigations form-consent-dea-background.pdf	Form
Interagency Biographical and Financial Report Interagency Biographical and Financial Report.docx	Form and Instruction
Corporate Background & Financial Report 8 - Corporate Background & Financial Report.pdf	Form and Instruction
Appointment of Agent 9 - Appointment Of Agent.pdf	Form
IRS Tax Check Waiver 10 - IRS Tax Check Waiver.pdf	Form
Charter Application 12 - Charter Application.pdf	Form and Instruction
First Meeting of Organizers 18 - First Meeting of Organizers.pdf	Form
Articles of Association 19 - Articles of Association.pdf	Form
Organization Certificate 21 - Organization Certificate.pdf	Form
Contact Person 22 - Contact Person.pdf	Form
Waiver of Notice of Organizing Board's First Meeting 23 - Waiver of Notice of Organizing Board's First Meeting.pdf	Form
Organizing Board's First Meeting 24 - Organizing Board's First Meeting.pdf	Form
Individual Oath of Bank Director Individual Oath of Bank Director.pdf	Form
Joint Oath of Bank Directors Joint Oath of Bank Directors.pdf	Form
Bylaws 28 - Bylaws.pdf	Form and Instruction
Subscription 29 - Subscription.pdf	Form
Capital Stock Payment Certificate 30 - Capital Stock Payment Certificate.pdf	Form
Corporate Resolution 31 - Corporate Resolution.pdf	Form
Proxy Card 32 - Proxy Card.pdf	Form
Notice of First Shareholder's Meeting 33 - Notice Of First Shareholder's Meeting.pdf	Form
Minutes of the First Shareholder's Meeting 34 - Minutes of the First Shareholder's Meeting.pdf	Form
Minutes of Subsequent Organizing Board Meetings 35 - Minutes of Subsequent Organizing Board Meetings.pdf	Form
Waiver of Notice of the First Board Meeting 36 - Waiver of Notice of the First Board Meeting.pdf	Form and Instruction
First Meeting of Directors 37 - First Meeting of Directors.pdf	Form
Organization Completed 38 - Organization Completed.pdf	Form
Preopening Checklist for Organizers 39 - Preopening Checklist for Organizers.pdf	Form
41 - Conversion Application Conversion Application.pdf	Form and Instruction
Authority for Conversion to National Bank Authority for Conversion to National Bank.pdf	Form
Letter Certifying Conversion Completion to National Bank Conversion Completion Certification by Applicant (Conversion to a NB).pdf	Form and Instruction
Letter Certifying Conversion Completion of Conversion to Conversion Completion Certification by Applicant (Conversion to FSA).pdf	Form
Oaths of Bank Directors 44 - Oaths of Bank Directors.pdf	Form and Instruction
Organization Certificate 46 - Organization Certificate 2.pdf	Form
Bylaws 48 - Bylaws 2.pdf	Form
Branch and Relocation Application Branch and Relocation Application.pdf	Form and Instruction
Main Office Relocation to Existing Branch Site within th 51 - Main Office Relocation to Existing Branch Site within the Same City, Town or Village.pdf	Form
Opening Date of Branch Office 52 - Opening Date of Branch Office.pdf	Form
Opening Date for Relocation of Main Office to Branch Sit 53 - Opening Date for Relocation of Main Office to Branch Site within the Same Town, City or Village.pdf	Form
Business Combination Application - Checklist and Communi 55 - Business Combination Application - Checklist and Community Reinvestment Commitments.pdf	Form
Business Combination Application - Streamlined 56 - Business Combination Application - Streamlined.pdf	Form and Instruction
Interagency Bank Merger Act Application Interagency Bank Merger Act Application.docx	Form and Instruction
Branches Requiring Authorization 58 - Branches Requiring Authorization.pdf	Form
Bank Merger Screen 59 - Bank Merger Screen.pdf	Form and Instruction
Merger with Nonbank Subsidiary or Affliliate 60 - Merger of NB with Nonbank affiliate - NB Results 5.2015 FINALOMB.docx	Form
Application - Interim National Bank Charter 61 - Interim Bank Charter App 5.2015 FINALOMB.docx	Form
Application - Reorganization - Subsidiary of a BHC 62 - NB Reorg to Sub of BHC 5.2015 FINALOMB.docx	Form
Stock Payment Certificate and Oaths of Directors and Off 63 - Stock Payment Certificate and Oaths of Directors and Officers.pdf	Form
Shareholders' Waiver of Notice of Shareholders' Meeting 64 - Shareholders' Waiver of Notice of Shareholders' Meeting and Written Consent of Business Combination.pdf	Form
Board of Directors' Waiver of Notice of Board Meeting an 65 - Board of Directors' Waiver of Noticve of Board Meeting and Written Consent of Business Combination.pdf	Form
Emergency Processing Request 66 - Emergency Processing Request.pdf	Form
Notice of Consummation 67 - Notice of Consummation.pdf	Form and Instruction
Notice of Shareholders' Meeting to Vote on Combination 68 - Notice of Shareholders' Meeting to Vote on Combination.pdf	Form and Instruction
Secretary's Certificate of Board of Directors' Approval 70 - Secretary's Certificate of Board of Directors' Approval of Combination.pdf	Form
Secretary's Certificate of Shareholders' Approval of Com 71 - Secretary's Certificate of Shareholders' Approval of Combination.pdf	Form
Application Fiduciary Powers Application.pdf	Form
After-the-Fact Notice Fiduciary Powers After the Fact Notice.pdf	Form
Surrender of Fiduciary Powers Notice of Surrender of Fiduciary Powers.pdf	Form
Commencement of Fiduciary Activities Notice Notice for Commencement of Fiduciary Activity.pdf	Form
Investments in Subsidiaries & Equities 81 - Investments in Subsidiaries & Equities.pdf	Form
After-the-Fact Notice-Subsidiary 82 - NB ATF Notice Op Sub 5.2015 FINALOMB.docx	Form
After-the-Fact Notice-Equity Investment 84 - ATF OE and Pass-Thru Notice 5.2015 FINALOMB.docx	Form
Annual Report on Operating Subsidiaries 85 OS Annual Report Form 5.2015 FINALOMB.docx	Form
Operating Subsidiary Application 87 - NB and FSA Op Sub App 5.2015 FINALOMB.docx	Form
Bank Service Company Application NB and FSA Bank SVC CO Notice 5.2015 FINALOMB.docx	Form
Financial Subsidiary Notice 89 - NB Fin Sub Notice 5.2015 FINALOMB.docx	Form
Financial Subsidiary Certification 90 - NB Fin Sub Cert 5.2015 FINALOMB.docx	Form
Financial Subsidiary Notice & Certification 91 - Financial Subsidiary Notice & Certification.pdf	Form
Advance Branch Closing & Downgrade Notice Advance Branch Closing Notice.pdf	Form and Instruction
Final Branch Closing Notice Final Branch Closing Notice.pdf	Form and Instruction
Sample Customer Notice of Branch Closing 95 - Sample Customer Notice of Branch CLosing.pdf	Form and Instruction
Application - Increase in Capital for Other than Cash 97 - Increase in Permanent Capital Application 5.2015 FINALOMB.docx	Form and Instruction
Application - Reduction of Permanent Capital Increase In Permanent Capital Notice.pdf	Form
Application - Quasi-Reorganization 100 - Quasi-reorganization Application 5.2015 FINALOMB.docx	Form
Application - Reverse Stock Split 103 - Reverse Stock Split Application 5.2015 FINALOMB.docx	Form
Notice - Increase in Stock for Cash 104 - Increase in Permanent Capital Notice 5.2015 FINALOMB.docx	Form and Instruction
Affidavit 115 - Affidavit.pdf	Form
Interagency Notice of Change in Control Interagency Change in Bank Control Notice.docx	Form and Instruction
Notification of Change of Corporate Title 121 - Change in Corporate Title 5.2015 FINALOMB.docx	Form and Instruction
Change of Address Change of Address.pdf	Form and Instruction
124 - Citizenship Waiver Request Citizenship Waiver Request.pdf	Form and Instruction
125 - Residency Waiver Request Residency Waiver Request.pdf	Form and Instruction
Investment in Bank Premises 126 - Investment In Bank Premises.pdf	Form
After the Fact Notice 127 - After The Fact Notice.pdf	Form and Instruction
Application for Increase 128 - Application For Increase.pdf	Form and Instruction
130-131-132 - Management Interlocks Application Management Interlock Application 4.2015 FINALOMB.docx	Form and Instruction
Application to Issue Subordinated Debt 134 - Issuance of Subordinated Debt Application 5.2015 FINALOMB.docx	Form
Application to Prepay Subordinated Debt 135 - Prepayment of Sub Debt Application 5.2015 FINALOMB.docx	Form
Notice of Debt Issuance 136 - Notice of Debt Issuance.pdf	Form and Instruction
138 - Voluntary Liquidation Final Report Vol Liq Final Report 4.2015 FINALOMB.docx	Form
139 - Notice of Intent of Conversion Out Conversions Out Prelim Notice 4.2015 FINALOMB.docx	Form and Instruction
Public Notice of Voluntary Liquidation 140 - Public Notice of Voluntary Liquidation.pdf	Form and Instruction
141 - Voluntary Liquidation - Board of Directors' and Sh Vol Liq BoardShareholder Resolution 4.2015 FINALOMB (2).docx	Form
142 - Voluntary Liquidation - Report of Condition at Com Vol Liq Report of Cond Commence 4.2015 FINALOMB.docx	Form
143 - Voluntary Liquidation - Annual Report Vol Liq Annual Report 4.2015 FINALOMB (2).docx	Form
144 - Final Notice - Expedited Liquidation Final Notice Exp Liq 4.2015 FINALOMB.docx	Form and Instruction
145 - Notice of Intent - Expedited Liquidation Notice of Intent of Exp Liq 4.2015 FINALOMB.docx	Form and Instruction
146 - Final Notice of Conversion Out Conversions Out Final Notice 4.2015 FINALOMB.docx	Form
147 - Final Notice of Merger or Consolidation Out and No Final Notice of Merger or Consolidation Out and Notice of Intent - Merger or Consolidation Out.docx	Form
148 - Notice upon Commencement of Voluntary Liquidation Vol Liq Final Notice 4.2015 FINALOMB.docx	Form
149 - Notice of Intent - Voluntary Liquidation Vol Liq Prelim Notice 4.2015 FINALOMB.docx	Form
Application to Establish an Initial-Additional Federal B 151 - Application to Establish an Initial-Additional Federal Branch or Agency W Instructions.pdf	Form
Financial Data 154 - Financial Data.pdf	Form
Request for After-the-Fact Approval 155 - Request for After-The-Fact Approval.pdf	Form
Request for After-the-Fact Notice Acquisitions 156 - Request for After-The-Fact Notice Acquisitions.pdf	Form
After-the-Fact Notice Acquisitions 157 - After-The-Fact Notice Acquisitions.pdf	Form and Instruction
Application to Acquire a Federal Branch or Agency 158 - Application to Acquire a Federal Branch or Agency.pdf	Form
Application for a Change of Status of an Office of a For 160 - Application for a Change of Status of an Office of a Foreign Bank.pdf	Form
Federal Branch & Agency Relocation Application 162 - Federal Branch & Agency Relocation Application.pdf	Form
Notice of Effective Date for Relocation 164 - Notice Of Effective Date for Relocation.pdf	Form and Instruction
Senior Management Resolution on Surrender of Fiduciary 168 - Senior Management Resolution on Surrender of Fiduciary.pdf	Form and Instruction
Notice Letter - Standard Voluntary Liquidation 169 - Notice Letter - Standard Voluntary Liquidation.pdf	Form and Instruction
Resolution to Voluntary Liquidate 170 - Resolution to Voluntary Liquidate.pdf	Form
Voluntary Liquidation - Sample Public Notice 171 - Voluntary Liquidation - Sample Public Notice.pdf	Form and Instruction
Liquidation - Interim Progress Report 172 - Liqudiation - Interim Progress Report.pdf	Form
Liquidation - Final Report 173 - Liqudiation - Final Report.pdf	Form
Capital Equivalency Deposit Agreement 174 - Capital Equivalency Deposit Agreement.pdf	Form
Notice of a Change in Activities or Operations 175 - Notice Of Change In Activities Or Operations.pdf	Form and Instruction
Notice for a Change in Control 176 - Notice For a Change In Control.pdf	Form and Instruction
Senior Management Resolution or Conversion of a Federal 177 - Senior Management Resolution or Conversion of a Federal Branch or Agency to a State-Licensed Operation of a Foreign Bank.p	Form and Instruction
Non-Controlling Equity Investment Application 178 - Non-Controlling Equity Investment Application.pdf	Form and Instruction
138 Interagency Charter and Federal Deposit Insurance Applic 1550-0005.Form138[1].pdf	Form
1623 Interagency Biographical and Financial Report 1550-0005.Form1623[1].pdf	Form
1680, 1681, 1682, Mutual to Stock Conversion Application Form 1680.2011[1].pdf	Form
1639 Interagency Bank Merger Act Application 1550.0016. Bank_MergerApplication.08.01.08[1].doc	Form and Instruction
1584 Notice of Filing Pursuant to 12 CFR Section 563.22(c) fo Form .1584.2010[1].pdf	Form
1561 Notice for Issuance of Subordinated Debt or Mandatorily 1550.0030.Form1561.2[1].pdf	Form
1622 Interagency Notice of Change in Control 1550.0032.form1622[1].pdf	Form
1623 Interagency Biographical and Financial Report 1550-0005.Form1623[1].pdf	Form
1582 Application for Conversion of a Depository Institution t 1550-0007 (Revised Form 1582)[1].pdf	Form
1583 Notice or Application for Capital Distribution 1550.0059.Form1583[1].pdf	Form
Charter - Federal Stock Association Model Federal Stock Association Charter.pdf	Form
Bylaws - Mutual Savings Associations Model Bylaws for Mutual Savings Association.pdf	Form
Charter - Federal Mutual Association Model Mutual Association Charter.pdf	Form
Bylaws - Federal Stock Association Model Bylaws for Stock Associations.pdf	Form
Charter and Bylaw Amendments Notice for Charter and Bylaw Amendment.pdf	Form and Instruction
Voluntary Liquidation - Liquidation Plan Vol Liq Liq Plan 4.2015 FINALOMB.docx	Form and Instruction
After-the-Fact Notice—Satisfaction of DPC Other Equity I Other Equity Investments or Pass Through Investments Application.pdf	Form
12 USC 1828(m) Investment Application Federal Savings As FSA Pass-Thru 1828m and 5.58f2 5.2015 FINALOMB.docx	Form and Instruction
Subsidiary Redesignation Notice Federal Savings Associat FSA Redesignation Notice 5.2015 FINALOMB.docx	Form and Instruction
Other Equity Investments—National Banks Pass-Through Inv NB and FSA OE and Pass-Thru App 5.2015 FINALOMB.docx	Form and Instruction
Equity Investment in Statutory Subsidiary—National Banks NB ATF Notice Stat Subs 5.2015 FINALOMB.docx	Form and Instruction
Merger of a National Bank With a Nonbank Affiliate Resul Merger of NB with Nonbank Affiliate - Nonbank Results 5.2015 FINALOMB.docx	Form and Instruction
Agency Office Additional Services Application Agency Office Additional Services 5.2015 FINALOMB.docx	Form and Instruction
After the Fact Notice: FSA Branch/Relocation After the Fact Notice FSA Branch or Relocation.pdf	Form and Instruction
Individual Oath of FSA Director Individual Oath of FSA Director.pdf	Form
Reduction of Permanent Capital and Capital Distribution Reduction of Permanent Capital and Capital Distribu Notice FSA.pdf	Form and Instruction
Reduction of Permanent Capital or Dividends Payable in P Reduction of Permanent Capital or Dividends Payable In Property Application.pdf	Form and Instruction
Interagency Change in Director and Senior Executive Offi Interagency Change in Director and SEO.docx	Form
Branch and Relocation Application branch-and-relocation-application.pdf	Form and Instruction
Federal Branch and Agency Relocation Application form-fed-branch-relo-app-v2.pdf	Form
Branch and Relocation Application - Redlined branch-and-relocation-application.redlined.pdf	Form
Federal Branch and Agency Relocation Application - Redli form-fed-branch-relo-app-v2.redlined.pdf	Form
Application to Establish and Initial or Additional Feder form-establish-fed-branch-app.pdf	Form
Application to Establish an Initial or Additional Federa form-establish-fed-branch-app.redlined.pdf	Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Comptroller's Licensing Manual

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 12 CFR 145 12 CFR 163 12 CFR 28 12 CFR 5 12 CFR 26 12 CFR 7

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	N/A	Branch and Relocation Application	branch-and-relocation-application.pdf	Yes	No	Fillable Printable
Form	N/A	Federal Branch and Agency Relocation Application	form-fed-branch-relo-app-v2.pdf	Yes	No	Fillable Printable
Form	N/A	Branch and Relocation Application - Redlined	branch-and-relocation-application.redlined.pdf	Yes	No	Fillable Printable
Form	N/A	Application to Establish an Initial or Additional Federal Branch or Agency - Redlined	form-establish-fed-branch-app.redlined.pdf	Yes	No	Fillable Printable
Form	N/A	Federal Branch and Agency Relocation Application - Redlined	form-fed-branch-relo-app-v2.redlined.pdf	Yes	No	Fillable Printable
Form	N/A	Application to Establish and Initial or Additional Federal Branch or Agency	form-establish-fed-branch-app.pdf	Yes	No	Fillable Printable
Instruction			1 - General Policies & Procedures.pdf	Yes	No	Printable Only
Form and Instruction	N/A	Change in Assets Application	2 - Change In Assets Applications.pdf	Yes	Yes	Fillable Fileable
Other-Form Letter			3 - Survey Letter.pdf	Yes	Yes	Fillable Fileable
Instruction			4 - Significant Deviation Policy.pdf	Yes	No	Printable Only
Form and Instruction	N/A	Background Investigations	5 - Background Investigations.pdf	Yes	Yes	Fillable Fileable
Form	N/A	Consent Form for DEA Background Investigations	form-consent-dea-background.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	N/A	Interagency Biographical and Financial Report	Interagency Biographical and Financial Report.docx	Yes	Yes	Fillable Fileable
Form and Instruction	N/A	Reduction of Permanent Capital or Dividends Payable in Property Application	Reduction of Permanent Capital or Dividends Payable In Property Application.pdf	Yes	No	Fillable Printable
Form	N/A	Interagency Change in Director and Senior Executive Officer	Interagency Change in Director and SEO.docx	Yes	No	Fillable Printable
Form and Instruction	N/A	Corporate Background & Financial Report	8 - Corporate Background & Financial Report.pdf	Yes	Yes	Fillable Fileable
Form	N/A	Appointment of Agent	9 - Appointment Of Agent.pdf	Yes	Yes	Fillable Fileable
Form	N/A	IRS Tax Check Waiver	10 - IRS Tax Check Waiver.pdf	Yes	Yes	Fillable Fileable
Instruction			11 - Charters.pdf	Yes	No	Printable Only
Form and Instruction	N/A	Charter Application	12 - Charter Application.pdf	Yes	Yes	Fillable Fileable
Instruction			13 - Business Plan.pdf	Yes	No	Printable Only
Instruction			14 - Financial Projections.pdf	Yes	No	Printable Only
Other-Form Letter			15 - Application Ammendments.pdf	Yes	Yes	Fillable Fileable
Instruction			16 - Public Notice Sample.pdf	Yes	No	Printable Only
Instruction			17 - Minority-Owned National Banks Policy Statement.pdf	Yes	No	Printable Only
Form	N/A	First Meeting of Organizers	18 - First Meeting of Organizers.pdf	Yes	No	Fillable Fileable
Instruction			129 - Management Interlocks.pdf	Yes	No	Printable Only
Form and Instruction	N/A	130-131-132 - Management Interlocks Application	Management Interlock Application 4.2015 FINALOMB.docx	Yes	Yes	Fillable Printable
Instruction			133 - Issuance of Sub Debt Notice 5.2015 FINALOMB.docx	Yes	No	Printable Only
Form	N/A	Application to Issue Subordinated Debt	134 - Issuance of Subordinated Debt Application 5.2015 FINALOMB.docx	Yes	Yes	Fillable Fileable
Form	N/A	Application to Prepay Subordinated Debt	135 - Prepayment of Sub Debt Application 5.2015 FINALOMB.docx	Yes	Yes	Fillable Fileable
Form and Instruction	N/A	Notice of Debt Issuance	136 - Notice of Debt Issuance.pdf	Yes	Yes	Fillable Fileable
Instruction			137 - Termination Of National Bank Status.pdf	Yes	No	Printable Only
Form	N/A	138 - Voluntary Liquidation Final Report	Vol Liq Final Report 4.2015 FINALOMB.docx	Yes	Yes	Fillable Fileable
Form and Instruction	N/A	139 - Notice of Intent of Conversion Out	Conversions Out Prelim Notice 4.2015 FINALOMB.docx	Yes	Yes	Fillable Fileable
Form and Instruction	N/A	Public Notice of Voluntary Liquidation	140 - Public Notice of Voluntary Liquidation.pdf	Yes	Yes	Fillable Fileable
Form	N/A	141 - Voluntary Liquidation - Board of Directors' and Shareholders' Resolution	Vol Liq BoardShareholder Resolution 4.2015 FINALOMB (2).docx	Yes	Yes	Fillable Fileable
Form	N/A	142 - Voluntary Liquidation - Report of Condition at Commencement of Liquidation	Vol Liq Report of Cond Commence 4.2015 FINALOMB.docx	Yes	Yes	Fillable Fileable
Form	N/A	143 - Voluntary Liquidation - Annual Report	Vol Liq Annual Report 4.2015 FINALOMB (2).docx	Yes	Yes	Fillable Fileable
Form	N/A	Articles of Association	19 - Articles of Association.pdf	Yes	Yes	Fillable Fileable
Instruction			20 - Instructions - Articles of Association.pdf	Yes	No	Printable Only
Form	N/A	Organization Certificate	21 - Organization Certificate.pdf	Yes	Yes	Fillable Fileable
Form	N/A	Contact Person	22 - Contact Person.pdf	Yes	Yes	Fillable Fileable
Form	N/A	Waiver of Notice of Organizing Board's First Meeting	23 - Waiver of Notice of Organizing Board's First Meeting.pdf	Yes	No	Fillable Fileable
Form	N/A	Organizing Board's First Meeting	24 - Organizing Board's First Meeting.pdf	Yes	No	Fillable Fileable
Form	N/A	Individual Oath of Bank Director	Individual Oath of Bank Director.pdf	Yes	No	Fillable Fileable
Form	N/A	Joint Oath of Bank Directors	Joint Oath of Bank Directors.pdf	Yes	Yes	Fillable Fileable
Instruction			27 - Oaths of Bank Directors Instructions.pdf	Yes	No	Printable Only
Form and Instruction	N/A	Bylaws	28 - Bylaws.pdf	Yes	Yes	Fillable Fileable
Form	N/A	Subscription	29 - Subscription.pdf	Yes	Yes	Fillable Fileable
Form	N/A	Capital Stock Payment Certificate	30 - Capital Stock Payment Certificate.pdf	Yes	Yes	Fillable Fileable
Form	N/A	Corporate Resolution	31 - Corporate Resolution.pdf	Yes	Yes	Fillable Fileable
Form	N/A	Proxy Card	32 - Proxy Card.pdf	Yes	Yes	Fillable Fileable
Form	N/A	Notice of First Shareholder's Meeting	33 - Notice Of First Shareholder's Meeting.pdf	Yes	Yes	Fillable Fileable
Form	N/A	Minutes of the First Shareholder's Meeting	34 - Minutes of the First Shareholder's Meeting.pdf	Yes	Yes	Fillable Fileable
Form	N/A	Minutes of Subsequent Organizing Board Meetings	35 - Minutes of Subsequent Organizing Board Meetings.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	N/A	Waiver of Notice of the First Board Meeting	36 - Waiver of Notice of the First Board Meeting.pdf	Yes	Yes	Fillable Fileable
Form	N/A	First Meeting of Directors	37 - First Meeting of Directors.pdf	Yes	Yes	Fillable Fileable
Form	N/A	Organization Completed	38 - Organization Completed.pdf	Yes	Yes	Fillable Fileable
Form	N/A	Preopening Checklist for Organizers	39 - Preopening Checklist for Organizers.pdf	Yes	Yes	Fillable Fileable
Instruction			40 - Conversions.pdf	Yes	No	Printable Only
Form and Instruction	N/A	41 - Conversion Application	Conversion Application.pdf	Yes	Yes	Fillable Fileable
Form	N/A	Authority for Conversion to National Bank	Authority for Conversion to National Bank.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	N/A	Letter Certifying Conversion Completion to National Bank	Conversion Completion Certification by Applicant (Conversion to a NB).pdf	Yes	Yes	Fillable Fileable
Form	N/A	Letter Certifying Conversion Completion of Conversion to FSA	Conversion Completion Certification by Applicant (Conversion to FSA).pdf	Yes	Yes	Fillable Fileable
Form and Instruction	N/A	Oaths of Bank Directors	44 - Oaths of Bank Directors.pdf	Yes	Yes	Fillable Fileable
Instruction			45 - Instructions - Organization Certificate.pdf	Yes	No	Printable Only
Form	N/A	Organization Certificate	46 - Organization Certificate 2.pdf	Yes	Yes	Fillable Fileable
Instruction			47 - Articles of Association 2.pdf	Yes	No	Printable Only
Form	N/A	Bylaws	48 - Bylaws 2.pdf	Yes	Yes	Fillable Fileable
Instruction			49 - Branches & Relocations.pdf	Yes	No	Printable Only
Form and Instruction	N/A	Branch and Relocation Application	Branch and Relocation Application.pdf	Yes	Yes	Fillable Fileable
Form	N/A	Main Office Relocation to Existing Branch Site within the Same City	51 - Main Office Relocation to Existing Branch Site within the Same City, Town or Village.pdf	Yes	Yes	Fillable Fileable
Form	N/A	Opening Date of Branch Office	52 - Opening Date of Branch Office.pdf	Yes	Yes	Fillable Fileable
Form	N/A	Opening Date for Relocation of Main Office to Branch Site within the Same Town, City or Village	53 - Opening Date for Relocation of Main Office to Branch Site within the Same Town, City or Village.pdf	Yes	Yes	Fillable Fileable
Instruction			54 - Business Combinations.pdf	Yes	No	Printable Only
Form	N/A	Business Combination Application - Checklist and Community Reinvestment Commitments	55 - Business Combination Application - Checklist and Community Reinvestment Commitments.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	N/A	Business Combination Application - Streamlined	56 - Business Combination Application - Streamlined.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	N/A	Interagency Bank Merger Act Application	Interagency Bank Merger Act Application.docx	Yes	Yes	Fillable Fileable
Form	N/A	Branches Requiring Authorization	58 - Branches Requiring Authorization.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	N/A	Bank Merger Screen	59 - Bank Merger Screen.pdf	Yes	Yes	Fillable Fileable
Form	N/A	Merger with Nonbank Subsidiary or Affliliate	60 - Merger of NB with Nonbank affiliate - NB Results 5.2015 FINALOMB.docx	Yes	Yes	Fillable Fileable
Form	N/A	Application - Interim National Bank Charter	61 - Interim Bank Charter App 5.2015 FINALOMB.docx	Yes	Yes	Fillable Fileable
Form	N/A	Application - Reorganization - Subsidiary of a BHC	62 - NB Reorg to Sub of BHC 5.2015 FINALOMB.docx	Yes	Yes	Fillable Fileable
Form	N/A	Stock Payment Certificate and Oaths of Directors and Officers	63 - Stock Payment Certificate and Oaths of Directors and Officers.pdf	Yes	Yes	Fillable Fileable
Form	N/A	Shareholders' Waiver of Notice of Shareholders' Meeting and Written Consent of Business Combination	64 - Shareholders' Waiver of Notice of Shareholders' Meeting and Written Consent of Business Combination.pdf	Yes	Yes	Fillable Fileable
Form	N/A	Board of Directors' Waiver of Notice of Board Meeting and Written Consent of Business Combination	65 - Board of Directors' Waiver of Noticve of Board Meeting and Written Consent of Business Combination.pdf	Yes	Yes	Fillable Fileable
Form	N/A	Emergency Processing Request	66 - Emergency Processing Request.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	N/A	Notice of Consummation	67 - Notice of Consummation.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	N/A	Notice of Shareholders' Meeting to Vote on Combination	68 - Notice of Shareholders' Meeting to Vote on Combination.pdf	Yes	Yes	Fillable Fileable
Instruction			69 - Public Notice and Instructions.pdf	Yes	No	Printable Only
Form	N/A	Secretary's Certificate of Board of Directors' Approval of Combination	70 - Secretary's Certificate of Board of Directors' Approval of Combination.pdf	Yes	Yes	Fillable Fileable
Form	N/A	Secretary's Certificate of Shareholders' Approval of Combination	71 - Secretary's Certificate of Shareholders' Approval of Combination.pdf	Yes	Yes	Fillable Fileable
Instruction			72 - Sample Agreements - Consolidation.pdf	Yes	No	Printable Only
Instruction			73 - Sample Agreements - Merger.pdf	Yes	No	Printable Only
Instruction			74 - Sample Agreements - Purchase & Assumption.pdf	Yes	No	Printable Only
Instruction			75 - Fiduciary Powers.pdf	Yes	No	Printable Only
Form and Instruction	N/A	After the Fact Notice	127 - After The Fact Notice.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	N/A	Application for Increase	128 - Application For Increase.pdf	Yes	Yes	Fillable Fileable
Form	N/A	Application	Fiduciary Powers Application.pdf	Yes	Yes	Fillable Fileable
Form	N/A	After-the-Fact Notice	Fiduciary Powers After the Fact Notice.pdf	Yes	Yes	Fillable Fileable
Form	N/A	Surrender of Fiduciary Powers	Notice of Surrender of Fiduciary Powers.pdf	Yes	Yes	Fillable Fileable
Instruction			79 - Fiduciary Operating Plan-Instructions.pdf	Yes	No	Printable Only
Form	N/A	Commencement of Fiduciary Activities Notice	Notice for Commencement of Fiduciary Activity.pdf	Yes	Yes	Fillable Fileable
Form	N/A	Investments in Subsidiaries & Equities	81 - Investments in Subsidiaries & Equities.pdf	Yes	Yes	Fillable Fileable
Form	N/A	After-the-Fact Notice-Subsidiary	82 - NB ATF Notice Op Sub 5.2015 FINALOMB.docx	Yes	Yes	Fillable Fileable
Form	N/A	After-the-Fact Notice-Equity Investment	84 - ATF OE and Pass-Thru Notice 5.2015 FINALOMB.docx	Yes	Yes	Fillable Fileable
Form	N/A	Annual Report on Operating Subsidiaries	85 OS Annual Report Form 5.2015 FINALOMB.docx	Yes	Yes	Fillable Fileable
Instruction			86 - OS Annual Report Instructions 5.2015 FINALOMB.docx	Yes	No	Printable Only
Form	N/A	Operating Subsidiary Application	87 - NB and FSA Op Sub App 5.2015 FINALOMB.docx	Yes	Yes	Fillable Fileable
Form	N/A	Bank Service Company Application	NB and FSA Bank SVC CO Notice 5.2015 FINALOMB.docx	Yes	Yes	Fillable Fileable
Form	N/A	Financial Subsidiary Notice	89 - NB Fin Sub Notice 5.2015 FINALOMB.docx	Yes	Yes	Fillable Fileable
Form	N/A	Financial Subsidiary Certification	90 - NB Fin Sub Cert 5.2015 FINALOMB.docx	Yes	Yes	Fillable Fileable
Form	N/A	Financial Subsidiary Notice & Certification	91 - Financial Subsidiary Notice & Certification.pdf	Yes	Yes	Fillable Fileable
Instruction			92 - Branch Closings.pdf	Yes	No	Printable Only
Form and Instruction	N/A	Advance Branch Closing & Downgrade Notice	Advance Branch Closing Notice.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	N/A	Final Branch Closing Notice	Final Branch Closing Notice.pdf	Yes	No	Fillable Printable
Form and Instruction	N/A	Sample Customer Notice of Branch Closing	95 - Sample Customer Notice of Branch CLosing.pdf	Yes	Yes	Fillable Fileable
Instruction			96 - Capital And Dividends.pdf	Yes	No	Printable Only
Form and Instruction	N/A	Application - Increase in Capital for Other than Cash	97 - Increase in Permanent Capital Application 5.2015 FINALOMB.docx	Yes	Yes	Fillable Fileable
Form	N/A	Application - Reduction of Permanent Capital	Increase In Permanent Capital Notice.pdf	Yes	Yes	Fillable Fileable
Form	N/A	Application - Quasi-Reorganization	100 - Quasi-reorganization Application 5.2015 FINALOMB.docx	Yes	Yes	Fillable Fileable
Form	N/A	Application - Reverse Stock Split	103 - Reverse Stock Split Application 5.2015 FINALOMB.docx	Yes	Yes	Fillable Fileable
Form and Instruction	N/A	Notice - Increase in Stock for Cash	104 - Increase in Permanent Capital Notice 5.2015 FINALOMB.docx	Yes	Yes	Fillable Fileable
Instruction			114 - Change In Bank Control.pdf	Yes	No	Printable Only
Form	N/A	Affidavit	115 - Affidavit.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	N/A	Interagency Notice of Change in Control	Interagency Change in Bank Control Notice.docx	Yes	Yes	Fillable Fileable
Instruction			117 - Publication Notice.pdf	Yes	No	Printable Only
Instruction			118 - Changes In Directors & Senior Executive Officers.pdf	Yes	No	Printable Only
Instruction			119 - Notification Of Change Of Corporate Titile.pdf	Yes	No	Printable Only
Instruction			120 - Change Of Corporate Title & Address.pdf	Yes	No	Printable Only
Form and Instruction	N/A	Notification of Change of Corporate Title	121 - Change in Corporate Title 5.2015 FINALOMB.docx	Yes	Yes	Fillable Fileable
Form and Instruction	N/A	Change of Address	Change of Address.pdf	Yes	No	Fillable Fileable
Instruction			123 - Director Waivers.pdf	Yes	No	Printable Only
Form and Instruction	N/A	124 - Citizenship Waiver Request	Citizenship Waiver Request.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	N/A	125 - Residency Waiver Request	Residency Waiver Request.pdf	Yes	Yes	Fillable Fileable
Form	N/A	Investment in Bank Premises	126 - Investment In Bank Premises.pdf	Yes	Yes	Fillable Fileable
Form	N/A	Application to Acquire a Federal Branch or Agency	158 - Application to Acquire a Federal Branch or Agency.pdf	Yes	Yes	Fillable Fileable
Instruction			159 - Acquisitions - Sample Public Notice.pdf	Yes	No	Printable Only
Form	N/A	Application for a Change of Status of an Office of a Foreign Bank	160 - Application for a Change of Status of an Office of a Foreign Bank.pdf	Yes	Yes	Fillable Fileable
Instruction			161 - Notice of Contraction of Activities.pdf	Yes	No	Printable Only
Form and Instruction	N/A	144 - Final Notice - Expedited Liquidation	Final Notice Exp Liq 4.2015 FINALOMB.docx	Yes	Yes	Fillable Printable
Form and Instruction	N/A	145 - Notice of Intent - Expedited Liquidation	Notice of Intent of Exp Liq 4.2015 FINALOMB.docx	Yes	Yes	Fillable Printable
Form	N/A	146 - Final Notice of Conversion Out	Conversions Out Final Notice 4.2015 FINALOMB.docx	Yes	Yes	Fillable Fileable
Form	N/A	147 - Final Notice of Merger or Consolidation Out and Notice of Intent - Merger or Consolidation	Final Notice of Merger or Consolidation Out and Notice of Intent - Merger or Consolidation Out.docx	Yes	Yes	Fillable Fileable
Form	N/A	148 - Notice upon Commencement of Voluntary Liquidation	Vol Liq Final Notice 4.2015 FINALOMB.docx	Yes	Yes	Fillable Fileable
Form	N/A	149 - Notice of Intent - Voluntary Liquidation	Vol Liq Prelim Notice 4.2015 FINALOMB.docx	Yes	Yes	Fillable Fileable
Instruction			150 - Federal Branches & Agencies.pdf	Yes	No	Printable Only
Form	N/A	Application to Establish an Initial-Additional Federal Branch or Agency	151 - Application to Establish an Initial-Additional Federal Branch or Agency W Instructions.pdf	Yes	Yes	Fillable Fileable
Instruction			152 - Initial and Additional Establishments - Sample Public Notice.pdf	Yes	No	Printable Only
Instruction			153 - Conditions for Initial and Additional Establishments.pdf	Yes	No	Printable Only
Form	N/A	Financial Data	154 - Financial Data.pdf	Yes	Yes	Fillable Fileable
Form	N/A	Request for After-the-Fact Approval	155 - Request for After-The-Fact Approval.pdf	Yes	Yes	Fillable Fileable
Form	N/A	Request for After-the-Fact Notice Acquisitions	156 - Request for After-The-Fact Notice Acquisitions.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	N/A	After-the-Fact Notice Acquisitions	157 - After-The-Fact Notice Acquisitions.pdf	Yes	Yes	Fillable Fileable
Form	N/A	Federal Branch & Agency Relocation Application	162 - Federal Branch & Agency Relocation Application.pdf	Yes	Yes	Fillable Fileable
Instruction			163 - Relocations - Sample Public Notice.pdf	Yes	No	Printable Only
Form and Instruction	N/A	Notice of Effective Date for Relocation	164 - Notice Of Effective Date for Relocation.pdf	Yes	Yes	Fillable Fileable
Instruction			165 - Application Letter - Fiduciary Powers.pdf	Yes	No	Printable Only
Instruction			166 - Fiduciary Operating Plan - Instructions.pdf	Yes	No	Printable Only
Instruction			167 - Notice of Commencement of Fiduciary Activities.pdf	Yes	No	Printable Only
Form and Instruction	N/A	Senior Management Resolution on Surrender of Fiduciary	168 - Senior Management Resolution on Surrender of Fiduciary.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	N/A	Notice Letter - Standard Voluntary Liquidation	169 - Notice Letter - Standard Voluntary Liquidation.pdf	Yes	Yes	Fillable Fileable
Form	N/A	Resolution to Voluntary Liquidate	170 - Resolution to Voluntary Liquidate.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	N/A	Voluntary Liquidation - Sample Public Notice	171 - Voluntary Liquidation - Sample Public Notice.pdf	Yes	Yes	Fillable Fileable
Form	N/A	Liquidation - Interim Progress Report	172 - Liqudiation - Interim Progress Report.pdf	Yes	No	Fillable Fileable
Form	N/A	Liquidation - Final Report	173 - Liqudiation - Final Report.pdf	Yes	Yes	Fillable Fileable
Form	N/A	Capital Equivalency Deposit Agreement	174 - Capital Equivalency Deposit Agreement.pdf	Yes	No	Fillable Fileable
Form and Instruction	N/A	Notice of a Change in Activities or Operations	175 - Notice Of Change In Activities Or Operations.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	N/A	Notice for a Change in Control	176 - Notice For a Change In Control.pdf	Yes	No	Fillable Fileable
Form and Instruction	N/A	Senior Management Resolution or Conversion of a Federal Branch or Agency to a State-Licensed Operation of a Foreign Bank	177 - Senior Management Resolution or Conversion of a Federal Branch or Agency to a State-Licensed Operation of a Foreign Bank.pdf	Yes	No	Fillable Fileable
Form and Instruction	N/A	Non-Controlling Equity Investment Application	178 - Non-Controlling Equity Investment Application.pdf	Yes	Yes	Fillable Fileable
Form	138	Interagency Charter and Federal Deposit Insurance Application	1550-0005.Form138[1].pdf	No		Printable Only
Form	1623	Interagency Biographical and Financial Report	1550-0005.Form1623[1].pdf	No		Printable Only
Instruction			1550.0005.Form138.Handbook[1].pdf	No		Printable Only
Form	1680, 1681, 1682, 1683	Mutual to Stock Conversion Application	Form 1680.2011[1].pdf	Yes	No	Fillable Printable
Form and Instruction	1639	Interagency Bank Merger Act Application	1550.0016. Bank_MergerApplication.08.01.08[1].doc	No		Printable Only
Form	1584	Notice of Filing Pursuant to 12 CFR Section 563.22(c) for Institutions that Qualify for Expedited Treatment	Form .1584.2010[1].pdf	No		Printable Only
Form	1561	Notice for Issuance of Subordinated Debt or Mandatorily Redeemable Preferred Stock	1550.0030.Form1561.2[1].pdf	No		Printable Only
Form	1622	Interagency Notice of Change in Control	1550.0032.form1622[1].pdf	No		Printable Only
Form	1623	Interagency Biographical and Financial Report	1550-0005.Form1623[1].pdf	No		Printable Only
Instruction			1550.0032.Handbook[1].pdf	No		Printable Only
Form	1582	Application for Conversion of a Depository Institution to a Federal Stock or Mutual Savings Association	1550-0007 (Revised Form 1582)[1].pdf	No		Printable Only
Form	1583	Notice or Application for Capital Distribution	1550.0059.Form1583[1].pdf	No		Printable Only
Form	N/A	Charter - Federal Stock Association	Model Federal Stock Association Charter.pdf	Yes	No	Fillable Printable
Form	N/A	Bylaws - Mutual Savings Associations	Model Bylaws for Mutual Savings Association.pdf	Yes	No	Fillable Printable
Form	N/A	Charter - Federal Mutual Association	Model Mutual Association Charter.pdf	Yes	No	Fillable Printable
Form	N/A	Bylaws - Federal Stock Association	Model Bylaws for Stock Associations.pdf	Yes	No	Fillable Printable
Form and Instruction	N/A	Charter and Bylaw Amendments	Notice for Charter and Bylaw Amendment.pdf	Yes	No	Fillable Printable
Form and Instruction	N/A	Voluntary Liquidation - Liquidation Plan	Vol Liq Liq Plan 4.2015 FINALOMB.docx	Yes	No	Fillable Printable
Form	N/A	After-the-Fact NoticeâSatisfaction of DPC Other Equity InvestmentsâNational Banks Pass-Through InvestmentsâFederal Savings Associations	Other Equity Investments or Pass Through Investments Application.pdf	Yes	No	Fillable Printable
Form and Instruction	N/A	12 USC 1828(m) Investment Application Federal Savings Associations	FSA Pass-Thru 1828m and 5.58f2 5.2015 FINALOMB.docx	Yes	No	Fillable Printable
Form and Instruction	N/A	Subsidiary Redesignation Notice Federal Savings Association	FSA Redesignation Notice 5.2015 FINALOMB.docx	Yes	No	Fillable Printable
Form and Instruction	N/A	Other Equity InvestmentsâNational Banks Pass-Through InvestmentsâFederal Savings Associations Application	NB and FSA OE and Pass-Thru App 5.2015 FINALOMB.docx	Yes	No	Fillable Printable
Form and Instruction	N/A	Equity Investment in Statutory SubsidiaryâNational Banks After-the-Fact Notice	NB ATF Notice Stat Subs 5.2015 FINALOMB.docx	Yes	No	Fillable Printable
Form and Instruction	N/A	Merger of a National Bank With a Nonbank Affiliate Resulting in a Nonbank Affiliate Application	Merger of NB with Nonbank Affiliate - Nonbank Results 5.2015 FINALOMB.docx	Yes	No	Fillable Printable
Form and Instruction	N/A	Agency Office Additional Services Application	Agency Office Additional Services 5.2015 FINALOMB.docx	Yes	No	Fillable Printable
Form and Instruction	N/A	After the Fact Notice: FSA Branch/Relocation	After the Fact Notice FSA Branch or Relocation.pdf	Yes	No	Fillable Printable
Form	N/A	Individual Oath of FSA Director	Individual Oath of FSA Director.pdf	Yes	No	Fillable Printable
Form and Instruction	N/A	Reduction of Permanent Capital and Capital Distribution Notice - FSA	Reduction of Permanent Capital and Capital Distribu Notice FSA.pdf	Yes	No	Fillable Printable

Federal Enterprise Architecture Business Reference Module

Line of Business: Economic Development

Subfunction: Financial Sector Oversight

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 3,713

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 36 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	3,713	0	3,713
Annual IC Time Burden (Hours)	12,533	-5	12,538
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.