Instructions_for_QSR_holding_companies_v6

U.S. Department of the Treasury

INSTRUCTIONS for the Quarterly Supplemental Report for Bank Holding
Companies and Savings and Loan Holding Companies Participating in the
Small Business Lending Fund
GENERAL INSTRUCTIONS
The sections below constitute the Quarterly Supplemental Report.
Quarter-End Adjusted Baseline Calculation
Quarter-End Qualified Small Business Lending
Change in Qualified Small Business Lending Calculation
WHO MUST REPORT ON WHICH FORMS
Every bank holding company and savings and loan holding company participating in the Small Business Lending Fund (SBLF) is
required to submit a Quarterly Supplemental Report no more than 30 calendar days after the quarter in which SBLF funding is received
and in each of the following quarters until all SBLF securities have been redeemed.
DEFINITIONS AND RULES OF PRACTICE
Unless otherwise stated, the Quarterly Supplemental Report and the Instructions for the Quarterly Supplemental Report incorporate
the definitions and general rules of practice embodied in the Consolidated Reports of Condition and Income (Call Reports), as well as
the instructions pertaining thereto, of the Bank Holding Company’s or Savings and Loan Holding Company’s insured depository
institution subsidiaries.
ORGANIZATION OF THE INSTRUCTION BOOK
This instruction book is divided into two sections:
(1) The General Instructions describing overall reporting requirements.
(2) The Line Item Instructions for each section of the Quarterly Supplemental Report.
PREPARATION OF THE REPORT
Bank holding companies and savings and loan holding companies are required to prepare and file the Quarterly Supplemental
Report in accordance with these instructions. All reports shall be prepared in a consistent manner, aggregating data from all of the
Call Reports filed by the holding company’s insured depository institution subsidiaries, regardless of which ones received
downstreamed funding.
The financial records of the bank holding company or savings and loan holding company shall be maintained in such a manner and
scope so as to ensure that the Quarterly Supplemental Report can be prepared and filed in accordance with these instructions and will
reflect a fair presentation of the institution’s small business lending.
If you have general questions regarding this form, please contact the information line for the Small Business Lending Fund at
888-832-1147 (Monday-Friday, 9:00 AM-5:00 PM ET).
SIGNATURES
The cover (signature) page of the Quarterly Supplemental Report shall be used to complete the signature and attestation
requirement. The bank holding company or savings and loan holding company may use digital or handwritten signatures; however,
the choice will impact how the form is submitted. For details, see SUBMISSION OF THE REPORT instructions below.

Quarterly Supplemental Report for Bank Holding Companies
and Savings and Loan Holding Companies
Treasury Department Form: TD F 102.4A (05/03/2013) v6

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OMB Number: 1505-0228

Chief Executive Officer and Chief Financial Officer Declarations
Both the Chief Executive Officer (CEO) and the Chief Financial Officer (CFO) of the holding company (or the individuals performing
equivalent functions) shall sign the respective declarations on the cover (signature) page attesting to the correctness of the Quarterly
Supplemental Report that the holding company has filed with the Treasury and the appropriate supervisory agency.
SUBMISSION OF THE REPORT
Each bank holding company and savings and loan holding company must file its Quarterly Supplemental Report no more than 30
calendar days after the quarter by electronically entering the report data directly into the Report and emailing the completed copy,
along with the cover (signature) page, to Treasury at [email protected].
For bank holding companies and savings and loan holding companies using digital signatures, the completed electronic report is
submitted as a single document. For holding companies using handwritten signatures, both the completed electronic report and a
scanned copy of the entire report, including signature page, must be submitted.
One additional copy should be sent to the appropriate regional Federal Reserve Bank using existing procedures for filing reportrelated documentation.
Submission Date
Completed Quarterly Supplemental Report must be filed with the Federal Reserve and Treasury no later than 30 calendar days after
the end of the quarter, which is the same date the Call Report(s) used to pull the data are due. For example, the report pertaining to
the quarter ending March 31, 2012, must be filed by the following April 30, 2012.
RETENTION OF REPORTS
In general, a bank holding company or savings and loan holding company should maintain in its files a signed and attested record of
its completed Quarterly Supplemental Report, including any amended reports, for five (5) years after the report date.
MISCELLANEOUS GENERAL INSTRUCTIONS
Rounding
Dollar amounts must be reported in thousands with the figures rounded to the nearest thousand. Items less than $500 must be
reported as zero.
Verification
All fields must be completed. All addition and subtraction should be double-checked before reports are submitted. Totals and
subtotals in supporting materials should be cross-checked to corresponding items elsewhere in the reports. Before a report is
submitted, all amounts should be compared with the corresponding amounts in the previous report. If there are any unusual
changes from the previous report, a brief explanation of the changes should be attached to the submitted report.
RELEASE OF INDIVIDUAL BANK HOLDING COMPANY AND SAVINGS AND LOAN HOLDING COMPANY REPORTS
All sections of the Quarterly Supplemental Report submitted by each reporting bank holding company or savings and loan holding
company may be made available to the public by the Federal Reserve or Treasury.

Quarterly Supplemental Report for Bank Holding Companies
and Savings and Loan Holding Companies
Treasury Department Form: TD F 102.4A (05/03/2013) v6

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OMB Number: 1505-0228

LINE ITEM INSTRUCTIONS
Please note that some lines on the Supplemental Report are automatically calculated for ease of use. These lines are pre-populated with
zeros and will not accept manual entry.

Quarter-End Adjusted Baseline Calculation
This section is used to adjust an institution’s Small Business Lending Baseline for increases in qualified loan balances resulting from
mergers, acquisitions, and/or purchases of such loans. If the bank holding company or savings and loan holding company has gained
qualifying loans by merger, acquisition, and/or purchase since 7/1/2010 through the report date, the amount must be added to the
baseline.
Item No. Caption and Instructions
1

Initial Small Business Lending Baseline (line 12 of the Initial Supplemental Report)

2

Prior quarter cumulative reported qualified small business lending increases resulting from an acquisition of, or merger
with, another institution, and/or purchases of such loans as were reported on line 12 of the prior quarter’s submitted
Quarterly Supplemental Report

3

Balance increases in commercial and industrial loans resulting from an acquisition of, or merger with, another institution,
and/or purchases of such loans in the quarter being reported

4

Balance increases in loans secured by owner-occupied nonfarm, nonresidential properties resulting from an acquisition
of, or merger with, another institution, and/or purchases of such loans in the quarter being reported

5

Balance increases in loans to finance agricultural production and other loans to farmers resulting from an acquisition of,
or merger with, another institution, and/or purchases of such loans in the quarter being reported

6

Balance increases in loans secured by farmland resulting from an acquisition of, or merger with, another institution,
and/or purchases of such loans in the quarter being reported

7

Subtotal (sum lines 3, 4, 5, and 6)

8

Dollar portion of any such loan or group of such loans to the same borrower and its affiliates with an original principal or
commitment amount greater than $10 million

9

Dollar portion of such loans to businesses with more than $50 million in revenues, unless included in line 8
Include loans made to a business with more than $50 million in revenues during the most recent fiscal year ended as
of the date of the loan origination. If the recipient’s revenues for that fiscal year are unknown, use available annual
revenue information reasonably proximate to that fiscal year.

10

Dollar portion of line 7 guaranteed by the U.S. government, unless included in lines 8 or 9
Include only the portion of the loan which is guaranteed by the U.S. government.

11

Dollar portion of line 7 where a third party has assumed an interest, unless included in lines 8, 9, or 10
Include only the portion where a third party has assumed an interest.

12

Total cumulative reported qualified business lending increases resulting from an acquisition of, or merger with, another
institution, and/or purchases of such loans (line 12 equals line 2 plus line 7 minus lines 8, 9, 10, and 11)

13

Quarter-End Adjusted Small Business Lending Baseline (line 13 equals line 1 plus line 12)

Quarter-End Qualified Small Business Lending
Item No. Caption and Instructions
14

Balances of commercial and industrial loans (as reflected on the totals of Call Report Schedule RC-C, Part I, item 4)

15

Balances of loans secured by owner-occupied nonfarm, nonresidential properties (as reflected on the totals of Call Report
Schedule RC-C, Part I, item 1.e.(1))

16

Balances of loans to finance agricultural production and other loans to farmers (as reflected on the totals of Call Report
Schedule RC-C, Part I, item 3)

17

Balances of loans secured by farmland (as reflected on the totals of Call Report Schedule RC-C, Part I, item 1.b)

Quarterly Supplemental Report for Bank Holding Companies
and Savings and Loan Holding Companies
Treasury Department Form: TD F 102.4A (05/03/2013) v6

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OMB Number: 1505-0228

Item No. Caption and Instructions
18

Subtotal (sum lines 14, 15, 16, and 17)

19

Dollar portion of any such loan or group of such loans to the same borrower and its affiliates with an original principal or
commitment amount greater than $10 million

20

Dollar portion of such loans to businesses with more than $50 million in revenues, unless included in line 19
Include loans made to a business with more than $50 million in revenues during the most recent fiscal year ended as
of the date of the loan origination. If the recipient’s revenues for that fiscal year are unknown, use available annual
revenue information reasonably proximate to that fiscal year.

21

Dollar portion of line 18 guaranteed by the U.S. government, unless included in lines 19 or 20
Include only the portion of the loan which is guaranteed by the U.S. government.

22

Dollar portion of line 18 where a third party has assumed an interest, unless included in lines 19, 20, or 21

23

Total quarter-end qualified small business loans (line 23 equals line 18 minus lines 19, 20, 21, and 22)

Include only the portion where a third party has assumed an interest.

Net Charge-Off Adjustments
For lines 24 – 34: if net charge-offs are negative (i.e., recoveries exceed charge-offs), type a minus symbol (-) in the “Neg (-)” column
that corresponds with that line.
24

Cumulative net charge-offs before this quarter (line 34 from prior quarter’s report)

25

Net charge-offs on commercial and industrial

26

Net charge-offs on loans secured by owner-occupied nonfarm, nonresidential properties

27

Net charge-offs on loans to finance agricultural production and other loans to farmers

28

Net charge-offs on loans secured by farmland

29

Subtotal (sum lines 24, 25, 26, 27, and 28)

30

Dollar portion of net charge-offs on any such loans or group of loans (from lines 25, 26, 27, and 28) to the same borrower
and its affiliates with an original principal or commitment amount greater than $10 million

31

Dollar portion of net charge-offs on such loans (from lines 25, 26, 27, and 28) to businesses with more than $50 million in
revenues, unless included in line 30

32

Dollar portion of net charge-offs on loans (from lines 25, 26, 27, and 28) guaranteed by the U.S. government, unless
included in lines 30 and 31

33

Dollar portion of net charge-offs on loans (from lines 25, 26, 27, and 28) where a third party has assumed an interest, unless
included in lines 30, 31, and 32

34

Total cumulative net charge-offs (line 34 equals line 29 minus lines 30, 31, 32, and 33)

35

Quarter-End Adjusted Qualified Small Business Lending (line 35 equals line 23 plus line 34

Change in Qualified Small Business Lending Calculation
Item No. Caption and Instructions
36

Dollar value of current balances with the Small Business Lending Fund

37

Dollar value of Quarter-End Adjusted Small Business Lending Baseline (line 13)

38

Dollar value of Quarter-End Adjusted Qualified Small Business Lending (line 35)

39

Dollar value of increase in Qualified Small Business Lending from baseline (line 39 equals line 38 minus line 37)

40

Percent increase in Qualified Small Business Lending (line 40 equals line 39 divided by line 37; must be calculated to two
decimal points; if line 39 is 0, enter 0 on line 40)

Quarterly Supplemental Report for Bank Holding Companies
and Savings and Loan Holding Companies
Treasury Department Form: TD F 102.4A (05/03/2013) v6

4

OMB Number: 1505-0228