Form FR Y-9ES FR Y-9ES Financial Statements for Employee Stock Ownership Plan H

FR Y-9ES
OMB Number 7100-0128
Approval expires December 31, 2024
Page 1 of 4

Board of Governors of the Federal Reserve System

Financial Statements for Employee Stock Ownership Plan
Holding Companies—FR Y-9ES
Report at the close of business as of the last calendar day in December
This report is required by law: Section 5(c) of the Bank Holding
Company Act of 1956 (12 U.S.C. § 1844c) and Section 225.5(b) of
Regulation Y (12 C.F.R. § 225.5(b)); and Section 10(b)(2) of the
Home Owners' Loan Act (12 U.S.C. § 1467a(b)(2)) and Section
238.4(b) of Regulation LL (12 C.F.R. § 238.4(b)).

This report is to be filed by Employee Stock Ownership Plans that
also are holding companies. When such holding companies are
tiered holding companies, separate reports are also to be filed by
each of the subsidiary holding companies as discussed in the
instructions. 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.

NOTE: The Financial Statements for Employee Stock Ownership
Plan Holding Companies must be signed by an authorized officer
of the Employee Stock Ownership Plan.

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

The Financial Statements for Employee Stock Ownership Plan
Holding Companies is to be prepared in accordance with the instructions provided by the Federal Reserve System.
I, the undersigned Trustee or other authorized representative of the
named Employee Stock Ownership Plan Holding Company, have
reviewed the Financial Statements for Employee Stock Ownership
Plan Holding Companies filed by the named ESOP holding company and believe that the report has been prepared in accordance
with instructions issued by the Federal Reserve.
Printed Name of Trustee or Other Authorized Representative of the ESOP (ESOP C490)

Legal Title of ESOP HC (TEXT 9010)

Signature of Trustee or Other Authorized Representative of the ESOP (ESOP H321)

(Mailing Address of the ESOP HC) Street / P.O. Box (TEXT 9110)

Date of Signature (ESOP J196)

City (TEXT 9130)

State (TEXT 9200)

Zip Code (TEXT 9220)

ESOP holding companies must maintain in their files a manually signed and attested printout of the data submitted.
Person to whom questions about this report should be directed:
Name / Title (ESOP 8901)

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

Area Code / Phone Number (ESOP 8902)

FAX Number (ESOP 9116)

E-mail Address of Contact (ESOP 4086)
0=No ESOP
Is confidential treatment requested for any
portion of this report submission? ................. 1=Yes C447
In accordance with the General Instructions for this report
(check only one),
1. a letter justifying this request is being provided along
with the report (ESOP KY38) .........................................

2. a letter justifying this request has been provided
separately (ESOP KY38) .............................................
Public reporting burden for this information collection is estimated to average 0.5 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 (7100-0128), Washington, DC 20503.
12/2021

For Federal Reserve Bank Use Only

Name of ESOP Holding Company

FR Y-9ES
Page 2 of 4

RSSD ID
C.I.

Financial Statements for
Employee Stock Ownership Plan Holding Companies
The Statement of Changes in Net Assets is to be reported on a calendar year basis in thousands of dollars.

Schedule SC—Statement of Changes in Net Assets Available for Benefits
(for the Calendar Year)
Dollar Amounts in Thousands
1. Net appreciation (depreciation) in fair value of investments:
a. Employer securities ....................................................................................................
b. Other securities .........................................................................................................
2. Interest income .............................................................................................................
3. Dividend income ...........................................................................................................
4. Employer contributions ...................................................................................................
5. Participant contributions..................................................................................................
6. Other additions .............................................................................................................
7. Total additions (sum of items 1.a through 6) ........................................................................
8.
9.
10.
11.
12.

Interest expense ...........................................................................................................
Insurance expense ........................................................................................................
Distributions paid to participants .......................................................................................
Other deductions ...........................................................................................................
Total deductions (sum of items 8 through 11).......................................................................

ESOP

Amount

C316
C317
C318

1.a.
1.b.
2.
3.
4.
5.
6.
7.

C319
C320
C321
3328
C323
C324
C330

8.
9.
10.
11.
12.

C325
C326
C327

13. Net increase (decrease) (item 7 minus item 12) ................................................................... C328
14. Beginning of year: net assets available for benefits............................................................... C329
ESPT
15. End of year: net assets available for benefits (sum of item 13 and item 14) (must equal
C342
Schedule SB, item 15) ....................................................................................................

13.
14.
15.

Schedule SB—Statement of Net Assets Available for Benefits
Dollar Amounts in Thousands
Assets
1. Cash and cash equivalents (including money market instruments)...........................................
2. Holding company securities:
a. Equity securities ........................................................................................................
b. Debt securities ..........................................................................................................
3. Bank securities:
a. Equity securities ........................................................................................................
b. Debt securities ..........................................................................................................
4. Securities (other than securities reported in items 1, 2, 3, and 9) .............................................
5. Employer's contribution receivable ....................................................................................
6. Participants' contribution receivable...................................................................................
7. Dividends and interest receivable .....................................................................................
8. Cash surrender value of life insurance ...............................................................................
9. Other assets.................................................................................................................
10. Total assets (sum of items 1 through 9) ..............................................................................
Liabilities
11. Loans payable ..............................................................................................................
12. Interest payable ............................................................................................................
13. Other liabilities ..............................................................................................................
14. Total liabilities (sum of items 11 through 13) ........................................................................

ESOP

Amount

C322

1.

C331

2.a.
2.b.

C332
C333
C334
C335
C336
C337
C363
C009
C338
2170

C339
C340

3.a.
3.b.
4.
5.
6.
7.
8.
9.
10.

C341
2948

11.
12.
13.
14.

Net Assets Available For Benefits
15. Net assets available for benefits (item 10 minus item 14) ....................................................... C342

15.
12/2013

FR Y-9ES
Page 3 of 4

Schedule SB-M—Memoranda

1. Sponsoring employer

M.1.
(TEXT 9152)

Number

ESOP
2. Shares held by ESOP:
a. Total number of bank shares held by ESOP ..................................................................... C343

M.2.a.
Percentage

b. Percentage of bank shares held by ESOP included in 2.a................................................... 7285

M.2.b.
Number

c. Number of bank shares allocated to ESOP participants ..................................................... C344
d. Total number of holding company shares held by ESOP .................................................... C345

M.2.c.
M.2.d.
Percentage

e. Percentage of holding company shares held by ESOP included in 2.d................................... 7286

M.2.e.
Number

f. Number of holding company shares allocated to ESOP participants...................................... C346
3. Amount of ESOP debt reported as contra-equity by the sponsoring employer or unearned
ESOP shares on:
a. Bank Report of Condition ............................................................................................. C347
b. Holding company balance sheet.................................................................................... C348

M.2.f.
Amount

M.3.a.
M.3.b.
Date

4. Year ESOP was initially adopted .......................................................................................
a. Accounted for under AICPA Statement of Position 76-3 or Statement of Position 93-6
(Enter "1" for SOP 76-3; enter "2" for SOP 93-6)1..............................................................
b. Total number of plan participants as of December 31 of the report year .................................
5. Estimated employer liability for payment of plan benefits/distributions within two (2) years
after December 31 of the report year .................................................................................
6. The net amount of plan participant balances eligible for diversification under the
diversification requirement ..............................................................................................

C349

M.4.
Number

C350

M.4.a.
M.4.b.

C351
Amount
C352

M.5.

C353

M.6.

7. Did the plan engage in any transaction with parties-in-interest during the current report year?
(Enter "1" for yes; enter "0" for no) ...........................................................................................

0=No

8. Has there been a change in plan trustees or the plan administrative committee during the current
report year? (Enter "1" for yes; enter "0" for no) ..........................................................................

0=No

ESOP

1=Yes C354

M.7.

ESOP

1=Yes C355

M.8.

1. See FASB ASC Subtopic 718-40, Compensation-Stock Compensation—Employee Stock Ownership Plans and ASC Subtopic 105-10,
Generally Accepted Accounting Principal—Overall for additional information.

12/2013

FR Y-9ES
Page 4 of 4

Notes to the Financial Statements for Employee Stock Ownership Plan Holding Companies
Enter in the lines provided below any additional information on specific line items on the financial statements that the Employee Stock
Ownership Plan holding company wishes to explain, that has been separately disclosed in the holding company's Reports to Shareholders,
in its press releases, or in its Form 5500.
Also include any transactions which previously would have appeared as footnotes to the Statement of Net Assets Available for Benefits
and the Statement of Changes in Net Assets Available for Benefits. Each additional piece of information disclosed should include the
appropriate reference to schedule and item number, as well as a description of the additional piece of information and the dollar amount
(in thousands of dollars) associated with that disclosure.

Example
Qualifying employer real estate that is not considered part of compensation expense by the employer is contributed to the ESOP.
TEXT

ESOP

Amount

0000 Schedule SC, item 4 (noncash contribution): Qualifying employer
real estate
0000

1,490

Notes to the Financial Statements
TEXT

1.

C356

2.

C357

3.

C358

4.

C359

5.

C360

Dollar Amounts in Thousands

ESOP

Amount

C356

1.

C357

2.

C358

3.

C359

4.

C360

5.

12/2013