Form FR Y-3F FR Y-3F Application for a Foreign Organization to Acquire a U.S.

FR Y-3F
OMB Number 7100-0119
Approval expires July 31, 2021
Page 1 of 2

Board of Governors of the Federal Reserve System

Application for a Foreign Organization to Acquire a
U.S. Bank or Bank Holding Company—FR Y-3F
An application is authorized by section 3(a) of the Act (12
U.S.C. § 1842 and 1844). The Federal Reserve may not
conduct or sponsor, and an organization (or a person) is not

hereby applies to the Board pursuant to section 3(a) of the Bank
Holding Company Act of 1956, as amended, ("Act"), for prior approval to acquire a U.S. Bank or a bank holding company through
the acquisition of direct or indirect ownership, control, or power to
vote at least
(
%) of the voting shares of:

Legal Name of Applicant

Street

City

required to respond to, a collection of information unless it
displays a currently valid OMB control number.

Number

Country

(Type of organization, such as corporation, limited partnership, general partnership,
limited liability company/corporation, business trust, association, or trust)

Percent

Corporate Title of Bank or Bank Holding Company

organized under the laws of
Country / Locality

Name, title, address, e-mail address, and telephone number of
person(s) to whom inquiries concerning this application may be
directed:
Name

Title

Name

Street

City

Title

Street
State

Zip Code

City

State

E-mail Address

E-mail Address

Area Code / Phone Number

Area Code / Phone Number

Zip Code

Does applicant or notificant request confidential treatment for any
portion of this submission?

Yes
As required by the instructions, a letter justifying the
request for confidential treatment is included.
The information for which confidential treatment is being
sought is separately bound and labeled "Confidential."

No

Public reporting burden for this information collection is estimated to range between 71–91 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 information collection, 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 (7100–0119), Washington, DC 20503.

07/2018

FR Y–3F
Page 2 of 2

Certification
I certify that the information contained in this application has
been examined carefully by me and is true, correct, and complete, and is current as of the date of this submission to the best
of my knowledge and belief. I acknowledge that any misrepresentation or omission of a material fact constitutes fraud in the
inducement and may subject me to legal sanctions provided by
18 U.S.C § 1001 and 1007.

Part 261, that the applicant and individual consent to public
release of all details in the application and in any related submissions containing information concerning that individual.

I also certify, with respect to information pertaining to an individual and submitted to the Board of Governors of the Federal
Reserve System (“Federal Reserve”) in (or in connection with)
this application, that the applicant has the authority, on behalf of
the individual, to provide such information to the Federal Reserve
and to consent or object to public release of such information.
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 §

I acknowledge that approval of this application is in the discretion
of the Federal Reserve. Actions or communications, whether
oral, written, or electronic, by the Federal Reserve or its employees in connection with this filing, including approval if granted,
do not constitute a contract, either express or implied, or any
other obligation binding upon the agency, the United States or
any other entity of the United States, or any officer or employee
of the United States. Such actions or communications will not
affect the ability of the Federal Reserve to exercise its supervisory, regulatory, or examination powers under applicable laws
and regulations. I further acknowledge that the foregoing may not
be waived or modified by any employee or agency of the Federal
Reserve or of the United States.

Corporate Title of Bank (or Bank Holding Company)

Date of Application

Street

Signature of Chief Executive Officer or Designee

City

State

Zip Code

03/2014