FR Y-12 (Semiannual)

FR Y-12
OMB Number 7100-0300
Approval expires March 31, 2022
Page 1 of 4

DRAFT

Board of Governors of the Federal Reserve System

Consolidated Holding Company Report of
Equity Investments in Nonfinancial Companies—FR Y-12
Report at the close of business as of the last calendar day of the reporting period.
This report is required by law: Section 5(c) of the BHC Act
(12 U.S.C. § 1844(c)), section 10 of HOLA (12 U.S.C § 1467a(b)),
section 165 of the Dodd-Frank Act (12 U.S.C. § 5365), and
section 252.153(b)(2) of Regulation YY (12 CFR 252.153(b)(2)).

the instructions provided by the Federal Reserve System. The
Federal Reserve may not conduct or sponsor and an organization
(or a person) is not required to respond to, a collection of information unless it displays a currently valid OMB control number.

The Consolidated Holding Company Report of Equity Investments
in Nonfinancial Companies is to be prepared in accordance with
NOTE: The Consolidated Holding Company Report of Equity Investments in Nonfinancial Companies must be signed and attested by
an Executive Officer of the reporting holding company.

Date of Report:
Month / Day / Year (BHEI 9999)

I, the undersigned Executive Officer of the named holding company, attest that the Consolidated Holding Company Report of
Equity Investments in Nonfinancial Companies for this report
date has been prepared in conformance with the instructions
issued by the Federal Reserve System and is true and correct to
the best of my knowledge and belief.

Printed Name of Executive Officer at Holding Company (BHEI C490)

Legal Name of Holding Company (RSSD 9017)

Title of Executive Officer of Holding Company (BHEI C491)

(Mailing Address of Holding Company) Street / P.O. Box (RSSD 9110)

Signature of Executive Officer of Holding Company (BHEI H321)

City (RSSD 9130)

State (RSSD 9200) Zip Code (RSSD 9220)

Date of Signature (MM/DD/YYYY) (BHEI J196)

Person to whom questions about this report should be directed:

Name / Title (BHEI 8901)

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

Area Code / Phone Number (BHEI 8902)

S.F.
E-mail Address (BHEI 4086)

average 16.5

Public reporting burden for this information collection is estimated to average16.5 hours per response, including time to gather and maintain data in the required form and to review instructions and complete the information collection. Comments regarding this burden estimate or any other aspect of this information collection, including suggestions for reducing the burden,
may be sent 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 (7100-0300), Washington, DC 20503.
03/2019

Legal Name of Holding Company

As-of Date

Schedule A: Type of Investments

Insert
Column B titled

RSSD ID
C.I.

Change current column B to
column C and change title to All
Other unrealized holding gains
(losses) on equity securities.

Unrealized holding
gains (losses) on
equity securities not
held for trading1

(If no activity or if the following section does not apply, please enter zero "0".)

(Column A)
Acquisition Cost

1.
2.
3.
4.

Dollar Amounts in Thousands
Direct investments in public entities ......................
Direct investments in nonpublic entities .................
All indirect investments ......................................
Total portfolio (sum of items 1, 2, and 3) ................

BHEI

Amount

FR Y-12
Page 2 of 4

For Federal Reserve Bank Use Only

DRAFT
new

(Column B) C
Net Unrealized
Holding Gains
Not Recognized
as Income
BHEI

Amount

(Column C)
Carrying
Value

BHEI

C088

C089

C090

C093

C094

C095

C097
C101

C098
C102

C099
C103

Memoranda

D

Amount

(Column D) E
Publicly
Quoted Value

BHEI

Amount

C091

1.
2.
3.
4.

Number of Companies
BHEI 1-10 11-25 26-100 100+

1. Total portfolio............................................................................................................ C100
(Column A)
Acquisition
Cost

Dollar Amounts in Thousands BHEI
Financial holding companies only
2. Investments held under Merchant Banking (GLBA) authority .............. C104

Amount

(Column B) C
Net Unrealized
Holding Gains
Not Recognized
as Income
BHEI
C105

Amount

M.1.
(Column C)
Carrying
Value

BHEI

D

Amount

C106

M.2.

Income Amount

Dollar Amounts in Thousands BHEI

Amount

Only for holding companies filing FR Y-9C
3. Pre-tax impact on net income from items 1, 2, and 3 above ............................................................... B498

M.3.

Off-Balance-Sheet
Amount

Dollar Amounts in Thousands BHEI
For all holding companies
4. Investments managed for others ................................................................................................... C716

Amount

M.4.

Income Amount

Dollar Amounts in Thousands BHEI
Only for holding companies filing FR Y-9C
5. Pre-tax impact of management fee income (from item M4 above) ......................................................... J443

1. Column B is to be completed only by holding companies that have adopted ASU 2016-01, which includes provisions governing
the accounting for investments in equity securities. See the instructions for further detail on ASU 2016-01.

Amount

M.5.

03/2019

Legal Name of Holding Company

FR Y-12
Page 3 of 4

DRAFT

As-of Date

Schedule B: Type of Security
(Column A)
Acquisition
Cost

1.
2.
3.
4.

Dollar Amounts in Thousands
Common stock ..............................................................................................
Convertible debt and convertible preferred stock ..................................................
Other equity instruments..................................................................................
Total portfolio (sum of items 1, 2, and 3)..............................................................
Insert new

BHEI
C107

Amount

C109
C111
C113

(Column B)
Carrying
Value
BHEI
C108

Amount

1.
2.
3.
4.

C110
C112
C114

Column B titled
Unrealized Holding
Gains (Losses) on
Equity Securities not
Held for Trading1 1

Off-Balance-Sheet
Amount

Dollar Amounts in Thousands BHEI
Memoranda
1. Unused equity commitments .................................................................................................... C115

Amount

M.1.
Warrants

0=No BHEI
2. Does the holding company hold any warrants or similar instruments received in connection with
equity current
Change
Column B to
investment activity? (Enter "1" for yes; enter "0" for no.) .................................................................
M.2.
Column C1=Yes
and C717
change title
to

Schedule C: Type of Entity within the Banking Organization
(Column A)
Acquisition
Cost

Dollar Amounts in Thousands BHEI
1. Depository institutions:
a. SBICs ............................................................................. C117

Amount

All Other Unrealized Holding
Gains (losses) on Equity
Securities.
(Column B) C
Net Unrealized
Holding Gains Not
Recognized as
Income
BHEI

Amount

(Column C) D
Carrying
Value

BHEI

Amount

C718
C719
C720

C118
C122
C127

1.a.
1.b.
1.c.

C136
C722

C721
C723

C137
C724

C131
C726
C145

C725
C727
C729

C132
C728
C146

3. Total portfolio (sum of items 1.a through 2.e)................................ C150

C730

C151

2.a.
2.b.
2.c.
2.d.
2.e.
3.

Memoranda
1. Domestic investments ............................................................. C155
2. Foreign investments ............................................................... C157

C749
C750

C156
C158

b. Edge and agreement corporations......................................... C121
c. All other ........................................................................... C126
2. Parent holding and other nonbank subsidiaries:
a. SBICs .............................................................................
b. Edge and agreement corporations.........................................
c. Broker/Dealers ..................................................................
d. Private equity subsidiaries ...................................................
e. All other ...........................................................................

1. Column B is to be completed only by holding companies that have adopted ASU 2016-01, which includes provisions governing
the accounting for investments in equity securities. See the instructions for further detail on ASU 2016-01.

M.1.
M.2.

03/2019

FR Y-12
Page 4 of 4

Legal Name of Holding Company

As-of Date

Schedule D: Nonfinancial Investment Transactions During Reporting Period
Direct Public Investments
(Column A)
Acquisition
Cost

Dollar Amounts in Thousands
Type of Transaction
1. Purchases .....................................................................
2. Less: return of capital.......................................................
3. Net valuation changes......................................................
4. Other ............................................................................
5. Total transactions (sum of items 1 through 4) ........................

BHEI

Amount

(Column B)
Carrying
Value
BHEI

Amount

Direct Nonpublic Investments
(Column C)
Acquisition
Cost
BHEI

Amount

(Column D)
Carrying
Value
BHEI

Amount

Indirect (Fund) Investments
(Column E)
Acquisition
Cost
BHEI

Amount

(Column F)
Carrying
Value
BHEI

C731

C732

J434

J435

C733

C734

C735

J436
J439

J437
J438
J440

C737

C741

C736
C739
C742

C743

C738
C740
C744

C745

C746

J441

J442

C747

C748

Amount

1.
2.
3.
4.
5.

DRAFT
03/2019