FR 2030a

FR 2030a
OMB Number 7100-0042
Approval expires June 30, 2020
Page 1 of 2

FOR USE BY NONMEMBER STATE BANKS CONVERTING INTO NATIONAL BANKS.

Board of Governors of the Federal Reserve System

Application for Federal Reserve Bank Stock—FR 2030a
Report Dollar Amounts in Thousands

Date of Application:
Month / Day / Year

ABA Number:
Indicate whether total consolidated assets of the bank as shown on its most recent Report of Condition exceed $10.283 billion:
Yes
No
At a meeting of the Board of Directors of
Legal Name of Converting State Bank

, duly called and held on the
City or Town

State

day of
Day

,
Month

,
Year

the following resolution was adopted:
“WHEREAS, the Board of Directors, on behalf of this bank, has made application to the Comptroller of the Currency for approval of the
conversion of this bank into a national bank with the name of
Legal Name of Organizing National Bank

in accordance with the provisions of section 5154 of the Revised Statutes of the United States, as amended;
“WHEREAS, the Board of Directors of this bank, on behalf of the said national bank, desires to subscribe to the capital stock of the
Federal Reserve Bank of the district in which this bank is located in accordance with the provisions of the act of Congress approved
December 23, 1913, as amended, and known as the Federal Reserve Act;
“WHEREAS, the said national bank will have a paid-up capital of $
; and a paid-up surplus, less
retained earnings and accumulated other comprehensive income if such combined amount is negative, of
$
at the time it is authorized by the Comptroller of the Currency to commence business as a
a national bank; and
“WHEREAS, six percent of such paid-up capital and surplus will amount to $

;

“NOW, THEREFORE, BE IT RESOLVED, that the President, Chief Financial Officer, or Vice President and Cashier or Secretary of this
bank be, and they
are hereby, authorized, empowered, and directed, on behalf of the said national bank to make application for and to subscribe to the
appropriate number of shares, of the par value of $100 each, of the capital stock of the Federal Reserve Bank of
and to pay for1 such
stock in accordance with the provisions of the Federal Reserve Act.”
I hereby certify that the foregoing is a true and correct copy of a resolution duly adopted by the Board of Directors of this bank on the date
specified and still in full force and effect.
Cashier, Secretary, or Treasurer

Pursuant to the foregoing resolution, this bank hereby subscribes to and makes application for
shares2 of the capital stock of the Federal Reserve Bank of
, of a par value of $100 each,
if and when
amounting to $
, to be issued in the name of
it is authorized by the Comptroller of the Currency to commence business as a national bank, and agrees to pay for same in accordance
with the provisions of the Federal Reserve Act.
1. One-half of the amount of the bank's subscription shall be paid to the Federal Reserve Bank and the remaining half will be subject to call when
deemed necessary by the Board of Governors of the Federal Reserve System.
2. If six percent of the paid-up or authorized capital and surplus amounts to a sum not divisible by 100, the bank should apply for one additional share of
stock for any excess or fractional part of $100.
01/2018

This application should be sent to the FEDERAL RESERVE BANK of your district.
Public reporting burden for this collection of information is estimated to average 0.5 hours per response, including the 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 collection of information, including suggestions for reducing
this burden to: Secretary, Board of Governors of the Federal Reserve System, Washington, DC 20551; and to the Office of Management and Budget, Paperwork Reduction Project (7100–
0042), Washington, DC 20503. 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.

01/2018

FR 2030a
Page 2 of 2

By
Legal Name of Organizing Bank

President, Chief Financial Officer, or Vice President

[SEAL]3
ABA Number

Attest
City or Town

State

Cashier, Secretary, or Treasurer

Note: One of the signers of the form must be listed on the bank’s Official Authorization List (OAL) that is on file with the Federal Reserve
and hold one of the titles identified. It is recommended that banks periodically review and update this form. Instructions for submitting
Board Resolution and Authorized Approver packages are available online at https://www.frbservices.org/forms/accounting/index.html.
If a seal is not required under state law, it may be omitted from the application.

09/2011