Voluntary Initiative Report

10-3-2024 Version 1

Please submit this form through the ECIP Reporting Portal.

Emergency Capital Investment Program

Impact Highlight

Instructions: ECIP participating institutions, on a voluntary basis, may use this form to highlight examples of how ECIP has positively impacted borrowers or the ECIP participant itself. This may include examples of new or expanded lending, new products, expanded markets, innovative investments, or other changes in practices made possible because of participation in ECIP.When completing this form DO NOT report the names or personal information of borrowers.

ECIP Participant Organization
Contact Name
Contact Email Address
Contact Phone #

Which of the following best describes the information being provided?

(-) Participant makes loan or investment that is:

+ Deep Impact

+ Qualified, NOT Deep Impact

(-) Consent to share:

+ I consent to use the information in this form, including the narrative, within Treasury and externally. This information may be publicly released.

+ I do not consent to use the information in this form outside of ECIP. This information will not be shared with other offices at Treasury or publicly.

(-) Participant makes a loan or investment for (choose all that apply);

              + consumer lending

              + small business lending

              + mortgage lending

              + commercial lending

+ other __________________________

(-) Participant expands its target market (choose all that apply);

              + geography

              + low-moderate income borrowers

+ racially-targeted populations

+Black American

+Native American

+Asian American

+Native Alaskan

+Native Hawaiian

+Pacific Islander

+Hispanic American

+ other __________________________

(-) Participant offers a new loan product or financial service (choose all that apply);

              + new loan product

              + expanded loan limits in an existing loan product

              + new financial service

+ new branch opened

+ other __________________________

(-) Participant leverages the ECIP investment (choose all that apply)

              + private sector balance sheet investment;

              + another public sector grant or investment;

              + off-balance sheet fund or investment vehicle managed by the ECIP participant;

              + co-investment by the ECIP participant in a particular transaction or portfolio of transactions managed by an unrelated party (including public welfare investments).

+ other __________________________

(-) Narrative below describes a loan or investment to (choose all that apply)

+Black American

+Native American

+Asian American

+Native Alaskan

+Native Hawaiian

+Pacific Islander

+Hispanic American

+Woman

+ Other __________________________

DO NOT include the names or any personal information (business name, address etc.) of borrowers.

Narrative (250 word limit)

Example Narratives:

• In April 2023, XYZ Bank recently closed a $XX million loan to finance a community facility in ZYX State, in partnership with ABC Organization, that also leveraged CBA Other Federal Program resource as seed funding for the facility. One impact of ECIP was to allow XYZ to increase its maximum loan size, so this loan would not have been possible prior to the ECIP investment.

• In July 2023, MDI Credit Union in XYZ State recently extended a working capital loan in the amount of $XX to a Black owned construction company that employs 30 people.

• In June 2023, AAA Credit Union in XYZ State made a mortgage loan in the amount of $XX to a Hispanic family to purchase their first home. The ECIP investment has allowed the Credit Union to approve more than 30 mortgage loans to Other Targeted Populations from January to June 2023.

• In May 2023, BCD Bank leveraged a $XX million deposit from DFG Major Corporation. ECIP made it possible for the Bank to accept this deposit and still maintain the appropriate balance sheet ratios.

(-) Would you like to add another impact highlight from an ECIP loan or investment? (if selected, brings up a copy of the form for the next activity the participant wants to report).

Paperwork Reduction Act Notice.

OMB Approval No. Pending Approval

Expiration Date: Pending Approval

The estimated burden associated with this collection of information is 1 hour per response. Comments concerning the accuracy of this burden estimate and suggestions for reducing this burden should be directed to the Office of Privacy, Transparency and Records, Department of the Treasury, 1500 Pennsylvania Ave., N.W., Washington, D.C. 20220. DO NOT send the form to this address. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a valid control number assigned by OMB.