REG B_Apx B to 1002_Model Forms (1-1-19 ED)

Recordkeeping and Disclosure Requirements Associated with Regulations B, E, M, and CC

REG B_Apx B to 1002_Model Forms (1-1-19 ED)

OMB: 3133-0103

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Bur. of Consumer Financial Protection

Pt. 1002, App. B
itor operates or Federal Trade Commission,
Equal Credit Opportunity, Washington, DC
20580.
2. To the extent not included in item 1
above:
a. National banks, Federal savings associations, and Federal branches and Federal agencies of foreign banks: Office of the Comptroller of the Currency, Customer Assistance
Group, 1301 McKinney Street, Suite 3450,
Houston, TX 77010–9050
b. State member banks, branches and agencies
of foreign banks (other than Federal branches,
Federal agencies, and insured state branches of
foreign banks), commercial lending companies
owned or controlled by foreign banks, and organizations operating under section 25 or 25A of
the Federal Reserve Act: Federal Reserve Consumer Help Center, P.O. Box 1200, Minneapolis, MN 55480.
c. Nonmember Insured Banks, Insured State
Branches of Foreign Banks, and Insured State
Savings Associations: FDIC Consumer Response Center, 1100 Walnut Street, Box #11,
Kansas City, MO 64106.
d. Federal Credit Unions: National Credit
Union Administration, Office of Consumer
Protection, 1775 Duke Street, Alexandria, VA
22314.
3. Air carriers: Assistant General Counsel
for Aviation Enforcement and Proceedings,
Department of Transportation, 400 Seventh
Street SW., Washington, DC 20590.
4. Creditors Subject to Surface Transportation
Board: Office of Proceedings, Surface Transportation Board, Department of Transportation, 1925 K Street NW., Washington, DC
20423.
5. Creditors Subject to Packers and Stockyards
Act: Nearest Packers and Stockyards Administration area supervisor.
6. Small Business Investment Companies: Associate Deputy Administrator for Capital
Access, United States Small Business Administration, 409 Third Street SW., 8th
Floor, Washington, DC 20416.
7. Brokers and Dealers: Securities and Exchange Commission, Washington, DC 20549.
8. Federal Land Banks, Federal Land Bank
Associations,
Federal
Intermediate
Credit
Banks, and Production Credit Associations:
Farm Credit Administration, 1501 Farm
Credit Drive, McLean, VA 22102–5090.
9. Retailers, Finance Companies, and All
Other Creditors Not Listed Above: FTC Regional Office for region in which the creditor
operates or Federal Trade Commission,
Equal Credit Opportunity, Washington, DC
20580.

(5) If the Comptroller of the Currency, the Federal Deposit Insurance
Corporation, the Board of Governors of
the Federal Reserve System, or the National Credit Union Administration has
reason to believe (as a result of a consumer complaint, a consumer compliance examination, or some other basis)
that a violation of the Act or this part
has occurred which is also a violation
of the Fair Housing Act, and the matter is not referred to the Attorney General, the agency shall:
(i) Notify the Secretary of Housing
and Urban Development; and
(ii) Inform the applicant that the
Secretary of Housing and Urban Development has been notified and that remedies may be available under the Fair
Housing Act.
(c) Failure of compliance. A creditor’s
failure to comply with § 1002.6(b)(6),
§ 1002.9, § 1002.10, § 1002.12 or § 1002.13 is
not a violation if it results from an inadvertent error. On discovering an
error under §§ 1002.9 and 1002.10, the
creditor shall correct it as soon as possible. If a creditor inadvertently obtains the monitoring information regarding the ethnicity, race, and sex of
the applicant in a dwelling-related
transaction not covered by § 1002.13, the
creditor may retain information and
act on the application without violating the regulation.

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APPENDIX A TO PART 1002—FEDERAL
AGENCIES TO BE LISTED IN ADVERSE
ACTION NOTICES
The following list indicates the Federal
agency or agencies that should be listed in
notices provided by creditors pursuant to
§ 1002.9(b)(1). Any questions concerning a particular creditor may be directed to such
agencies. This list is not intended to describe
agencies’ enforcement authority for ECOA
and Regulation B. Terms that are not defined in the Federal Deposit Insurance Act
(12 U.S.C. 1813(s)) shall have the meaning
given to them in the International Banking
Act of 1978 (12 U.S.C. 3101).
1. Banks, savings associations, and credit
unions with total assets of over $10 billion and
their affiliates: Bureau of Consumer Financial
Protection, 1700 G Street NW., Washington
DC 20006. Such affiliates that are not banks,
savings associations, or credit unions also
should list, in addition to the Bureau: FTC
Regional Office for region in which the cred-

APPENDIX B TO PART 1002—MODEL
APPLICATION FORMS
1. This appendix contains five model credit
application forms, each designated for use in
a particular type of consumer credit transaction as indicated by the bracketed caption

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12 CFR Ch. X (1–1–19 Edition)

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on each form. The first sample form is intended for use in open-end, unsecured transactions; the second for closed-end, secured
transactions; the third for closed-end transactions, whether unsecured or secured; the
fourth in transactions involving community
property or occurring in community property States; and the fifth in residential
mortgage transactions which contains a
model disclosure for use in complying with
§ 1002.13 for certain dwelling-related loans.
This appendix also contains a data collection
model form for collecting information concerning an applicant’s ethnicity, race, and
sex that complies with the requirements of
§ 1002.13(a)(1)(i)(A) and (ii). Appendix B to 12
CFR part 1003 provides a data collection
model form for collecting information concerning an applicant’s ethnicity, race, and
sex that complies with the requirements of
§ 1002.13(a)(1)(i)(B) and (ii). All forms contained in this appendix are models; their use
by creditors is optional.

2. The use or modification of these forms is
governed by the following instructions. A
creditor may change the forms: by asking for
additional information not prohibited by
§ 1002.5; by deleting any information request;
or by rearranging the format without modifying the substance of the inquiries. In any
of these three instances, however, the appropriate notices regarding the optional nature
of courtesy titles, the option to disclose alimony, child support, or separate maintenance, and the limitation concerning marital status inquiries must be included in the
appropriate places if the items to which they
relate appear on the creditor’s form.
3. If a creditor uses an appropriate appendix B model form, or modifies a form in accordance with the above instructions, that
creditor shall be deemed to be acting in compliance with the provisions of paragraphs (b),
(c) and (d) of § 1002.5 of this part.

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Pt. 1002, App. B

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Pt. 1002, App. B

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Pt. 1002, App. B

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Pt. 1002, App. B

Bur. of Consumer Financial Protection

Pt. 1002, App. C

[76 FR 79445, Dec. 21, 2011, as amended at 82
FR 45694, Oct. 2, 2017]

requirements of § 1002.13(a)(1)(i)(B) and (ii).
All forms contained in this appendix are
models; their use by creditors is optional.

EFFECTIVE DATE NOTE: At 82 FR 45695, Oct.
2, 2017, appendix B to part 1002 was amended
by revising paragraph 1 and under paragraph
3 removing the form ‘‘Uniform Residential
Loan Application’’, effective Jan. 1, 2022. For
the convenience of the user, the revised text
is set forth as follows:

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APPENDIX C TO PART 1002—SAMPLE
NOTIFICATION FORMS
1. This Appendix contains ten sample notification forms. Forms C–1 through C–4 are
intended for use in notifying an applicant
that adverse action has been taken on an application or account under §§ 1002.9(a)(1) and
(2)(i) of this part. Form C–5 is a notice of disclosure of the right to request specific reasons for adverse action under §§ 1002.9(a)(1)
and (2)(ii). Form C–6 is designed for use in
notifying an applicant, under § 1002.9(c)(2),
that an application is incomplete. Forms C–
7 and C–8 are intended for use in connection
with applications for business credit under
§ 1002.9(a)(3). Form C–9 is designed for use in
notifying an applicant of the right to receive
a copy of appraisals under § 1002.14. Form C–
10 is designed for use in notifying an applicant for nonmortgage credit that the creditor is requesting applicant characteristic
information.
2. Form C–1 contains the Fair Credit Reporting Act disclosure as required by sections 615(a) and (b) of that act. Forms C–2
through C–5 contain only the section 615(a)

APPENDIX B TO PART 1002—MODEL
APPLICATION FORMS
1. This appendix contains four model credit
application forms, each designated for use in
a particular type of consumer credit transaction as indicated by the bracketed caption
on each form. The first sample form is intended for use in open-end, unsecured transactions; the second for closed-end, secured
transactions; the third for closed-end transactions, whether unsecured or secured; and
the fourth in transactions involving community property or occurring in community
property States. This appendix also contains
a data collection model form for collecting
information concerning an applicant’s ethnicity, race, and sex that complies with the
requirements of § 1002.13(a)(1)(i)(A) and (ii).
Appendix B to 12 CFR part 1003 provides a
data collection model form for collecting information concerning an applicant’s ethnicity, race, and sex that complies with the

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File Typeapplication/pdf
File TitleCFR-2019-title12-vol8-part1002.pdf
AuthorDWOLFGANG
File Modified2020-01-22
File Created2020-01-22

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