Compliance
Examination Handbook
III. Compliance Examination Templates
RISK PROFILE AND SCOPE MEMORANDUM
COMPLIANCE EXAMINATION
Pre-Examination Planning Memorandum Data Sheet
Name of Institution:.............................................
City, State:.........................................................
Cert. No.............................................................
# of Open Offices (including Main Office)...............
SHARP Examination No......................................
Total Assets (xx/xx/xxxx)....................................
Field Office of Institution......................................
Field Office Performing Examination.....................
Examiner-In-Charge (Current Examination)............
LAST EXAMINATION INFORMATION
Type PROC Date Rating #Examiners Hours EIC
OUTSTANDING ENFORCEMENT ACTION INFORMATION
EA Type Division Issue Date Supervisory Area
CURRENT EXAMINATION INFORMATION
PEP Start Date.........................................................................
PEP Completion Date................................................................
Anticipated Examination Date.....................................................
Assigned Number of Examiners...................................................
Anticipated Compliance Hours.....................................................
Anticipated CRA Hours...............................................................
Proposed Number of Community Contacts to be Performed............
Consumer Complaints received since the previous
Examination?.............................................................................
Has data requested from the Institution been received?..................
Is HMDA Applicable?..................................................................
Current SAER Exam Comment:
REPORT OF CONDITION AND INCOME
Date...................................................
Net Loans...........................................
Gross Loans.......................................
BREAK-DOWN OF LOAN PORTFOLIO
Loan Type Dollar Volume % of Portfolio
Consumer Loans
Commercial Loans
Farm Loans
Multi-Family Loans
Residential Loans
Other
ASSET GROWTH
Call Date: Call Date:
Total Assets: Total Assets:
DEPOSIT INFORMATION
Non-Interest: Interest Bearing:
SUMMARY OF THE RISK PROFILE OF THE INSTITUTION
Risk Profile Matrix and Summary
Bank Name City, State |
CMS Elements Oversight | Program | Audit |
| Operational Areas: |
| Lending |
| Deposits | |
| Insurance Sales | |
| Investment Sales | |
| (Other) | |
|
|
| |
|
|
| |
|
|
| |
|
|
| |
|
|
| |
|
|
| Other Issues: |
| (__________) |
| (__________) |
|
|
| |
|
|
| |
|
|
| |
(L) = Low Risk; (M) = Moderate Risk; (H) = High Risk
CMS Elements:
Oversight
Program
Audit
Operational Areas:
Lending
Deposits
Insurance Sales
Investment Sales
Other Products or Issues
SCOPE OF THE EXAMINATION
Compliance Management System
Community Reinvestment Act (CRA)
Fair Lending Review
Complaints
Miscellaneous
ISSUES TO BE INVESTIGATED OR AREAS TO BE TARGETED
All issues of special concern discussed under the two previous sections will be targeted. In
addition, the following table indicates the specific regulations that will and will not be subject to
transactional testing or spot-checking.
| AREA |
Testing
(No/TT/SC)
LX | CX
|
Comments |
| LENDING |
Truth In Lending |
|
|
|
| Equal Credit
Opportunity Act |
|
|
|
| Fair Housing Act |
|
|
|
| Home Mortgage
Disclosure Act |
|
|
|
| Flood Insurance |
|
|
|
| Real Estate
Settlement
Procedures Act |
|
|
|
| Homeownership
Counseling |
|
|
|
| Homeowners
Protection Act |
|
|
|
| Preservation of
Consumer Claims
and Defenses |
|
|
|
| Credit Practices Rule |
|
|
|
| Fair Debt Collection
Practices Act |
|
|
|
| Consumer Leasing |
|
|
|
| DEPOSITS |
| Truth In Savings |
|
|
|
| Electronic Funds
Transfer |
|
|
|
| Expedited Funds
Availability,
including Check 21 |
|
|
|
| Interest on Deposits |
|
|
|
| OTHER PRODUCTS |
| Retail Insurance / Annuities Sales |
|
|
|
| Retail Investment Sales |
|
|
|
| Government Securities |
|
|
|
| PRIVACY/CONSUMER INFORMATION/GENERAL REQUIREMENTS |
Right to Financial
Privacy Act |
|
|
|
| Privacy of Consumer
Financial Info |
|
|
|
| Fair Credit
Reporting |
|
|
|
| Children’s On-line
Privacy Protection |
|
|
|
| CAN SPAM |
|
|
|
| Telephone
Consumer Protection |
|
|
|
| Electronic Banking,
including E-Sign |
|
|
|
| Advertising of
Membership |
|
|
|
| Unfair or Deceptive
Acts or Practices |
|
|
|
| COMMUNITY REINVESTMENT ACT |
CRA Technical
Requirements |
|
|
|
| Branch Closings |
|
|
|
| Interstate Banking
and Branching |
|
|
|
BACKGROUND
This document is a guide for an examiner’s initial discussion with a bank. It is designed to
gather current information for tailoring the CIDR to request only those items necessary to
conduct the examination. The interview sheet may also help with scoping the examination and
with on-site logistics (e.g., setting up the phone line, ensuring that appropriate bank personnel
will be available, etc.). The interview sheet should be used in conjunction with the Risk Profile
and Scope Memorandum (RPSM) for both the current and last examinations. Before using it to
plan and conduct a discussion with the bank an examiner should pull the RPSM from SOURCE
for the current examination, and review the final RPSM for the last examination. The examiner
should also locate documents available from within the FDIC and from public sources, in order
to avoid unnecessary requests to the bank. Such documents may also raise questions to discuss
with the bank.
This is a work paper; it is not necessary to type the banker’s responses. There may be questions
that are not relevant, depending on the bank being examined. Additions or changes may also be
appropriate to address field or regional office requirements. The work paper should be adjusted
as appropriate before holding a discussion with the banker.
Some of the items included on this interview sheet may be more appropriately included in the
Compliance Information and Document Request (CIDR). For instance, an examiner may wish to
have the bank respond in writing to a certain area. Such items should simply be moved from this
list to the CIDR. There may also be items in the CIDR that an examiner wishes to discuss with
the bank during the interview, and that is appropriate also.
The next pages are designed to help plan the examination and the interview.
Bank Name: |
Street Address: |
Bank Phone Number: |
Mailing Address: |
Bank President: |
Bank Website: |
Bank Compliance Officer: |
Bank CRA Officer: |
Type of exam: |
[ ] FULL EXAM
[ ] FULL EXAM–NEW BANK
[ ] FULL EXAM–CHARTER FLIP
|
[ ] COE
[ ] COE–NEW BANK
[ ] COE–CHARTER FLIP
|
[ ] New Bank Investigation
[ ] New Bank Visit
[ ] Charter Flip Visit
[ ] Problem Bank Visit
[ ] Other
|
| Telephone Ordered: / / |
Order Number |
| Install Date: / / |
Complete Date: / / |
| Call Report Run? [ Y ][ N ] |
Examination Request Letter Mailed
or Sent via FDICconnect: / /
(circle transmission method)
| Electronic Download Request |
Y |
N |
| CIDR |
Y |
N |
| CIDR diskette |
Y |
N |
| Return Mailing Label(s) |
Y |
N |
|
Bank has document imaging? [ Y ][ N ]
If yes, survey on e-exam website
completed: / /
By:
[http://fdic01/division/dsc/ebanking/
exampilot/index.html]
|
FDIC Relationship Manager:
PRIOR EXAM DATE:
|
Reviewed
at last
exam |
VIOLATIONS
at last exam |
COMMENTS |
| YES |
NO |
Significant |
Isolated & Technical |
|
Truth In Lending-(Federal Reserve Board’s
Regulation Z)
|
|
|
|
|
|
Equal Credit Opportunity (Federal Reserve Board
Regulation B)
|
|
|
|
|
|
Fair Housing Act (Part 338 of FDIC Rules &
Regs)
|
|
|
|
|
|
Home Mortgage Disclosure Act (Federal Reserve
Board Regulation C)
|
|
|
|
|
|
Flood Insurance (Part 339 of FDIC Rules & Regs)
|
|
|
|
|
|
Real Estate Settlement Procedures (Department of
Housing and Urban Development’s Reg X)
|
|
|
|
|
|
Home Ownership Counseling
|
|
|
|
|
|
Homeowners Protection Act
|
|
|
|
|
|
Preservation of Consumer's Claims and Defenses
|
|
|
|
|
|
Credit Practices Rule (Federal Reserve Board’s
Regulation AA)
|
|
|
|
|
|
Fair Debt Collection Practices Act
|
|
|
|
|
|
Consumer Leasing (Federal Reserve Board’s
Regulation M)
|
|
|
|
|
|
| |
|
|
|
|
|
Truth in Savings (Federal Reserve Board’s
Regulation DD)
|
|
|
|
|
|
Electronic Funds Transfer (Federal Reserve Board
Regulation E)
|
|
|
|
|
|
Expedited Funds Availability (Federal Reserve
Board Regulation CC)
|
|
|
|
|
|
Check 21
|
|
|
|
|
|
Interest On Deposits-Req Q (Part 329 of FDIC
Rules & Regs)
|
|
|
|
|
|
| |
|
|
|
|
|
Consumer Protection in Sales of INSURANCE
(Part 343 of FDIC Rules & Regs)
|
|
|
|
|
|
Consumer Protection in Sales of INVESTMENTS
(Part 344 of FDIC Rules & Regs)
|
|
|
|
|
|
Government Securities (Treasury Regulations Parts
403.5(d) and 450)
|
|
|
|
|
|
| |
|
|
|
|
|
Right to Financial Privacy
|
|
|
|
|
|
Privacy of Consumer Financial Information (Part
332 of FDIC Rules & Regs)
|
|
|
|
|
|
Fair Credit Reporting Act
|
|
|
|
|
|
Electronic Banking
|
|
|
|
|
|
E-Sign Act
|
|
|
|
|
|
Children's Online Privacy Protection Rule
|
|
|
|
|
|
CAN SPAM
|
|
|
|
|
|
Telephone Consumer Protection Act
|
|
|
|
|
|
Advertisement of Membership (Part 328 of FDIC
Rules & Regs)
|
|
|
|
|
|
Unfair or Deceptive Acts or Practices (FTC Act
Section 5)
|
|
|
|
|
|
| |
|
|
|
|
|
Community Reinvestment Act (Part 345 of FDIC
Rules & Regs)
|
|
|
|
|
|
Section 109 – Interstate Banking and Branching
Efficiency Act of 1994 (IBBEA)
|
|
|
|
|
|
Branch Closing Policy (Sec. 42)
|
|
|
|
|
|
INTERVIEW
Introduction/principal purpose of call:
- gather information so that the pre-examination request for written information and
documents is tailored to the bank’s operations, and
- help scope the examination.
|
| FDIC interviewer: |
Interview Phone Call Date: / / |
| |
|
| Bank Presonnel Interviewed: |
|
| |
|
EXAMINATION PLANNING
Discuss the time frame for the Compliance and CRA examination.
Discuss the examination focus – the compliance management system.
Discuss director participation in examination meetings/communication with examiners.
Discuss the entry letter and attached documents - the CIDR.
Request will indicate which items to “Send” or “Hold” – inform management that it is an
option to send some of the CIDR information to the office.
Caution bank against copying large documents such as Board Minutes. However, if
documents are available electronically, could provide on diskette.
Discuss with the bank whether it would be helpful to exchange documents electronically
through FDICconnect.
Caution bank against creating something that does not exist (for example, “do not draft a
resume’).
Caution against providing original documents, but if they do, to indicate such on the material.
[If bank does not offer particular product, just mark N/A on the returned CIDR hardcopy.]
Discuss the automated loan data download (requested in letter). [If request is to be made of bank, omit overlapping requests under Truth in Lending in the CIDR].
Discuss any vacations or known absences that may impact the timing of the examination
(examiner or banker).
Verify the names of senior management and the mailing address for the PEP package.
Discuss installing an FDIC telephone line, and request the name of the bank's contact person to
coordinate with the telephone company.
Ask whether the bank purchased another institution or branch since the previous examination.
CIDR CUSTOMIZATION
When the bank’s answer to a question below is “No” the examiner should eliminate or adjust the
corresponding request in the CIDR.
PART I: COMPLIANCE MANAGEMENT SYSTEM
|
| BOARD OF DIRECTORS AND SENIOR MANAGEMENT OVERSIGHT |
| |
| |
YES |
NO |
| Has there been any change in control of the bank? |
|
|
|
| Has there been any change in Directors? |
|
|
|
| Has there been any change in Senior Officers? |
|
|
|
| Does the Board have an audit committee? |
|
|
| Any compliance-related Board or management committee? |
|
|
| A credit committee? |
|
|
| A pricing committee? |
|
|
|
| Does the bank have a mission statement? |
|
|
| Business plan? |
|
|
| Strategic plan? |
|
|
|
| COMPLIANCE PROGRAM |
|
|
| |
YES |
NO |
| Has there been any change in bank personnel (e.g., compliance officer,
assisting personnel) performing compliance functions since the previous
examination? |
|
|
|
| Has the bank consulted an attorney (internal or external counsel) on any
compliance matters since the previous examination? |
|
|
|
| Does the bank use a consultant or consulting company to manage its
compliance program? [coordinate question with one below on third party
service providers] |
|
|
|
| TRAINING |
|
|
| |
YES |
NO |
| Does the bank conduct testing of the staff's compliance knowledge
subsequent to training, and maintain the results of such testing? |
|
|
|
| INTERNAL MONITORING |
|
|
| |
YES |
NO |
| Has the bank conducted compliance self assessments/reviews (for example,
loan quality control reviews and branch reviews) since the previous
examination? |
|
|
| If yes, are records of the results available? |
|
|
|
| CONSUMER COMPLAINT RESPONSE |
|
|
| |
YES |
NO |
| Has the bank received any written consumer complaints since the last
examination? |
|
|
|
| Has the bank been party to any consumer-related litigation since the
previous examination? |
|
|
|
| Has the bank been involved in any investigations by other agencies (DOJ,
HUD, EEOC, or state or local authorities) since the previous examination? |
|
|
|
| PERIODIC INDEPENDENT TESTING AND AUDITS
(INTERNAL/EXTERNAL) |
|
|
| |
YES |
NO |
| Has the bank or an external party conducted a compliance audit since the
previous examination? |
|
|
|
| THIRD-PARTY SERVICE PROVIDERS |
|
|
| |
YES |
NO |
| Does the bank use any third party or affiliated vendors to provide any of
the following compliance related services? |
|
|
| Compliance auditing |
|
|
| training |
|
|
| compliance consulting |
|
|
| flood determinations |
|
|
| disclosure forms |
|
|
| escrow account administration |
|
|
| other ______________________ |
|
|
| |
|
|
| INFORMATION SYSTEMS SUPPORT FOR COMPLIANCE |
|
|
| |
YES |
NO |
| Does the bank make use of any loan or deposit platform computer
applications? |
|
|
| If yes, are they new since the previous examination? |
|
|
Loan platform name:
|
Deposit platform name:
|
|
| Has there been any change in the bank's data processing servicer or in the
data processing system (conversions, upgrades, etc.) since the previous
examination? |
|
|
|
| Does the bank currently have loan document imaging capabilities? If no,
does the bank have any plans for implementing document imaging in the
future? |
|
|
|
| RECORDKEEPING |
|
|
| |
YES |
NO |
| Does the bank develop its own forms internally? |
|
|
|
PART II: LENDING COMPLIANCE
|
| |
YES |
NO |
| Has the bank introduced any new loan products since the previous
examination? |
|
|
|
| Has the bank purchased any loan portfolios since the previous
examination? |
|
|
|
| |
| TRUTH IN LENDING |
|
|
| |
YES |
NO |
| Does the bank offer any of the following open-end consumer credit
products? |
|
|
| Overdraft protection |
|
|
| personal lines of credit |
|
|
| home equity lines of credit |
|
|
| credit car |
|
|
| other ______________________ |
|
|
|
| Does the bank offer any adjustable rate mortgages? |
|
|
|
| Has the bank made any Regulation Z reimbursements since the previous
compliance examination? |
|
|
|
| EQUAL CREDIT OPPORTUNITY |
|
|
| |
YES |
NO |
| Does the bank extend credit to customers on the request of dealers or
merchants? |
|
|
|
| Does the bank use a credit scoring system? |
|
|
|
| Does the bank use any risk-based pricing? |
|
|
|
| FLOOD INSURANCE |
|
|
| |
YES |
NO |
| Does the bank use a third party for flood hazard determinations? |
|
|
|
| Has the bank made any loans secured by improved real property or a
mobile home located in a special flood hazard area? |
|
|
|
| REAL ESTATE SETTLEMENT PROCEDURES |
|
|
| |
YES |
NO |
| Does the bank make use of escrow accounts for its mortgage loans? |
|
|
|
| Is the bank involved in an affiliated business arrangement as defined in
RESPA? |
|
|
|
| HOME OWNERSHIP COUNSELING |
|
|
| |
YES |
NO |
| Does the bank provide a written notice to homeowners who are delinquent
on their home loans? |
|
|
| If yes, does the notice contain information about available homeownership
counseling? |
|
|
|
| HOMEOWNERS PROTECTION ACT |
|
|
| |
YES |
NO |
| Has the bank originated residential loans with private mortgage insurance
(PMI), either in-house or for sale or referral into the secondary market,
since the previous examination? |
|
|
|
| PRESERVATION OF CONSUMER'S CLAIMS AND DEFENSES |
|
|
| |
YES |
NO |
| Does the bank purchase any dealer paper (purchase money loans made by
dealers)? |
|
|
|
| FAIR DEBT COLLECTION PRACTICES |
|
|
| |
YES |
NO |
| Does the bank perform collection services for any defaulted consumer debts owed to third parties? |
|
|
|
| CONSUMER LEASING |
|
|
| |
YES |
NO |
| Has the bank financed any consumer leases since the previous
examination? |
|
|
|
PART III: DEPOSIT COMPLIANCE
|
| TRUTH IN SAVINGS |
|
|
| |
YES |
NO |
| Has the bank offered merchandise as a bonus or premium for certain
deposits? |
|
|
|
| Does the bank use the collected balance or the ledger balance method to accrue
interest? |
|
|
|
| INTEREST ON DEPOSITS |
|
|
| |
YES |
NO |
| Does the bank pay finders or broker fees on deposits? |
|
|
|
| ELECTRONIC FUND TRANSFERS (EFT) |
|
|
| |
YES |
NO |
| Has the bank implemented any new EFT services (including electronic
check conversion) since the previous examination? |
|
|
|
| EXPEDITED FUNDS AVAILABILITY |
|
|
| |
YES |
NO |
| Does the bank place holds on deposited items either on a case-by-case or on an exception basis? |
|
|
|
PART IV: INSURANCE AND INVESTMENTS
|
| INSURANCE |
|
|
| |
YES |
NO |
| Does the bank, or any other person at an office of the bank or on behalf of
the bank, offer insurance (including credit life) or annuities to consumers? |
|
|
|
| INVESTMENTS |
|
|
| |
YES |
NO |
| Does the bank directly or through an arrangement with a third party offer
investment products (including variable annuities) to retail customers
(including cash management sweep accounts and repurchase agreement
transactions)? |
|
|
|
| Does the bank offer to retail customers repurchase agreements involving U.S.
Government or Agency securities held in a custodial capacity to retail customers? |
|
|
|
| Is the bank a government securities broker or dealer? |
|
|
| If no, does the bank hold government securities (itself or through a third
party custodian bank) as a fiduciary, custodian or other capacity for retail
customers? |
|
|
|
PART V: PRIVACY AND CONSUMER INFORMATION
|
| RIGHT TO FINANCIAL PRIVACY |
| |
YES |
NO |
| Has the bank provided any Federal government authority access to the
financial records of any consumer (or partnership of 5 or fewer individuals)
since the previous examination? |
|
|
|
| PRIVACY OF CONSUMER FINANCIAL INFORMATION |
| |
YES |
NO |
| Does the bank disclose nonpublic personal information about consumers to
nonaffiliated third parties to market the bank's own products or services, or
to market financial products or services offered pursuant to joint marketing
agreements between the bank and another financial institution? |
|
|
|
| Does the bank disclose nonpublic personal information to nonaffiliated
third parties outside of the exceptions for normal business purposes and
joint marketing agreements? (e.g. is an opt-out choice provided to
consumers for non-affiliated third party sharing?) |
|
|
|
| Does the bank receive nonpublic personal information about consumers
from nonaffiliated financial institutions? |
|
|
|
| Does the bank disclose, directly or through affiliates, account numbers or
similar access numbers or codes for consumers' credit card accounts,
deposit accounts, or transaction accounts with nonaffiliated third parties
(other than a consumer reporting agency) for use in marketing? |
|
|
|
| FAIR CREDIT REPORTING ACT (FCRA) |
| |
YES |
NO |
| Does the bank obtain consumer reports for any purpose? |
|
|
|
| Does the bank disclose consumer report information to any of its affiliates? |
|
|
|
| Does the bank provide an opt-out choice to consumers for the sharing of
consumer report information with its affiliates? |
|
|
|
| Has the bank used medical information about a consumer in connection
with any determination of the consumer's eligibility, or continued
eligibility for credit? |
|
|
|
| Does the bank obtain consumer reports on prospective or current
employees? |
|
|
|
| Has the bank obtained and used prescreened consumer reports to offer preapproved
credit or insurance products? |
|
|
|
| Do electronic receipts issued by the bank for debit and credit card
transactions contain no more than the last 5 digits of the account or card
number? |
|
|
|
| Does the bank use credit scores when making or arranging mortgage loans? |
|
|
|
| Does the bank use credit scores to set terms and conditions of any type of
loans? (e.g. rates, fees, or length of repayment term, etc.) |
|
|
|
| Does the bank provide information to consumer reporting agencies? |
|
|
|
| CHILDREN'S ONLINE PRIVACY PROTECTION |
| |
YES |
NO |
| Does the bank operate an Internet Web site or online service that collects
or could collect or maintain personal information from children online? |
|
|
|
| CAN-SPAM |
| |
YES |
NO |
| Does the bank initiate, either directly or through a third party, e-mail
messages whose primary purpose is commercial? |
|
|
|
| If yes, has bank management considered the applicability of CAN-SPAM
and taken steps to ensure compliance? |
|
|
|
| TELEPHONE CONSUMER PROTECTION ACT |
| |
YES |
NO |
| Does the bank, or a third party on its behalf, engage in any form of
telephone solicitation, including through fax machines? |
|
|
|
| If yes, has bank management considered the application of TCPA and
taken steps to ensure compliance? |
|
|
|
PART VI: ELECTRONIC BANKING
|
| |
YES |
NO |
| Does the bank offer any form of electronic banking? |
|
|
| Internet banking |
|
|
| PC banking |
|
|
| Telephone banking |
|
|
| Automated loan machines |
|
|
| Does the bank accept customer inquiries/complaints via electronic mail? |
|
|
|
| E-SIGN Act |
| |
YES |
NO |
| Does the bank allow customers to receive any required account disclosures
only in an electronic format? |
|
|
|
PART VII: COMMUNITY REINVESTMENT ACT
|
|
| |
YES |
NO |
| Has there been any change in the bank’s assessment area since the previous
CRA evaluation? |
|
|
|
| Has the bank opened or closed any branches since the previous
examination? |
|
|
|
| Does the bank have any CRA Qualified Investments and Services it wants
reviewed during the evaluation? (Small Bank Only) |
|
|
|
| SECTION 109 – INTERSTATE BANKING AND BRANCHING EFFICIENCY ACT OF 1994 (IBBEA) |
|
|
| |
YES |
NO |
| Has the bank opened any new branches outside of its home state since the
previous examination? |
|
|
|
| Has the bank or any of its branches been controlled by an out-of-state bank
holding company for one year or more since the previous examination? |
|
|
|
The CIDR template contains more than 200 specific requests for information and
documents. It must be customized for each bank so that it includes only those items the
EIC considers necessary to perform a risk-based, top-down examination, and does not
request information or documents that the examiner could obtain from sources other than
bank management (e.g. information available through the FDIC Intranet, Internet, prior
exam workpapers, etc.). The bank must be consulted prior to completing the CIDR to
help narrow the request. In addition to deleting unnecessary requests, be aware that there
is some overlap between the information requests in the Interview Sheet and the CIDR.
Be sure to delete duplicative CIDR requests unless there is a specific reason to repeat
them.
Customizing the CIDR Template
- The CIDR template is a WORD document that can be downloaded from GENESYS.
Requests for information are presented first under each topic, followed by document
requests in tables. Use these steps to create the request for a particular bank:
- Save the CIDR to a new file:
- Left click on File
- Left click on Save As
- Select a folder and assign a unique name to the document.
- Insert the correct identifying information on the instruction page. If you are
corresponding with the bank via FDICconnect, modify the instructions as appropriate.
- Remove unnecessary requests:
- Highlight requests for information and then delete.
- For document requests, right-click in the cell with the unnecessary request item,
select delete cells, then select delete entire row.
- Add requests for information or documentation:
- Insert requests for information by typing them at the beginning of the item you
wish them to precede, then hit enter. The CIDR should re-number.
- For document requests, right-click in the cell above which you want the new
request to appear
- Select insert row; the row will appear above the current cell
- Manually input the desired question or request.
- Change, add, or delete the text of a request:
- Edit requests for information as you would any WORD document.
- For document requests, left click within the desired cell and edit as desired.
- For each document request, indicate whether management should Send the
documents to the field office, or Hold the documents at the bank for on-site review,
by placing an X in the appropriate box. The CIDR indicates that all requested
information should be sent to the field office. If you wish information to be held at
the bank, simply add a note to that effect in the request itself.
INSTRUCTIONS FOR COMPLETING THE COMPLIANCE INFORMATION
AND DOCUMENT REQUEST (CIDR) |
We hope the following instructions will help reduce the burden of compiling and
forwarding the information and documents requested in the CIDR:
- The CIDR is also in electronic form on the diskette provided with this request.
- The CIDR requests information and documents in a series of categories. If you open
the CIDR document on your computer, you can type most of your responses to the
information requests into the document itself. Hit “enter” twice after the request and
then begin typing. The document will expand as you type which allows you to type
as many lines as you need. Please type all your responses in “Bold” type.
- If information is not applicable to your bank, simply type "NA."
- In some cases it will be more convenient to attach a document instead of typing the
information. For those instances, please label the document with the number of the
request, and indicate in your response that a document is attached.
- Please send only copies of requested documents; do not send originals.
- Once you have completed the CIDR, print it, enclose all requested documents and
then mail them to the [insert geographic name] Field Office using the self-addressed
label provided with this information request. Please include the completed CIDR
on diskette and a printed hard copy of the document in the information package.
Compliance Examiner [insert EIC or other appropriate name] will contact you
prior to the start of the examination for final coordination. In the interim, however,
please feel free to contact [insert EIC or other appropriate name and phone
number] if you have any questions or concerns about the information and document
requested.
COMPLIANCE INFORMATION AND DOCUMENT REQUEST ver 2006
Part I: COMPLIANCE MANAGEMENT SYSTEM
Board of Directors and Senior Management Oversight
Please provide the following information:
- Name, title and phone number of the officer who is the principal contact for specific
information about the bank’s compliance management system.
- A current list of your bank's directors/trustees and officers, identified by name and
title. Note anyone who is new to the Board since the last examination.
Please send or hold the following documents, as indicated:
| Send |
Hold |
|
| |
|
3. Minutes of board of directors’ meetings held during the review period,
including those addressing your compliance management system, fair
lending, and other compliance matters. Include materials or exhibits
referred to in the minutes. |
| |
|
4. Minutes of the board’s audit committee and any compliance-related
Board or management committees operating at the bank (including a
list of committee members). Include materials or exhibits referred to in
the minutes. |
| |
|
5. Minutes of the credit committee and the pricing committee, along with
materials or exhibits referred to in the minutes and supporting
documentation. |
| |
|
6. Mission statement, business plan (one year and long term), and any
strategic plan. |
Compliance Program
Please provide the following information:
- Name and location of individual(s) who can provide access to any written compliance
program, procedures, or manuals.
- The identity of internal and/or outside counsel for compliance matters.
- A description of the compliance issues considered by counsel during the review period.
- A description of the assigned responsibilities for coordinating compliance in each of the
bank’s operating areas (functional, geographic, etc.).
- A list of the bank’s compliance resources and reference material, such as subscriptions to a
monthly compliance newsletter or to a compliance service website.
- A description of your bank’s review processes that ensure that policies and procedures
reflect current regulatory and legal requirements. Indicate any reviews performed or
changes made to policies and procedures during the review period.
- A description of your procedures for collecting and disseminating compliance-related
information and any amendments to or new compliance procedures.
Please send or hold the following documents, as indicated:
| Send |
Hold |
|
| |
|
14. All compliance or compliance-related policies and procedures updated
during the review period. If incorporated into general operational and
administrative procedures, an index or outline of compliance topics covered
would be helpful. Include any alternative or supplementary guidance (i.e.
desk procedures or systems support) for compliance. |
| |
|
15. Position descriptions and résumés for the compliance officer (s). |
| |
|
16. Position descriptions and résumés of other persons with compliance
responsibilities (including those in subsidiaries or divisions performing
compliance services or originating business for the bank). |
| |
|
17. Any correspondence from outside counsel relating to compliance matters. |
Training
Please provide the following information:
- The identity of those responsible for compliance-related staff training and a description of
your compliance training program.
- A description of training or other compliance-related professional development attended by
management and staff with compliance responsibilities.
- A description of any compliance training provided to the board of directors.
Please send or hold the following documents, as indicated:
| Send |
Hold |
|
| |
|
21. Training manuals and other training information related to compliance laws
and regulations. |
| |
|
22. Staff training records, including dates and participants, and topics covered. |
| |
|
23. The results of any testing for:
- Compliance training for new staff
- Training for existing staff in new compliance initiatives or requirements
- Periodic retraining of existing staff
|
Internal Monitoring
Please send or hold the following documents, as indicated:
| Send |
Hold |
|
| |
|
24. Reports of compliance self-assessments, with supporting documentation,
performed during the review period. |
| |
|
25. Reports of loan quality control reviews, whether performed by bank
personnel or by a third party. |
| |
|
26. Checklists for loan quality control reviews. |
| |
|
27. A loan quality control review frequency schedule. |
| |
|
28. Reports of branch reviews or certifications relating to compliance
regulations. |
Consumer Complaint Response
Please provide the following information:
- A description of all consumer-related litigation, pending litigation, or claims, judgments, and
assessments in which the bank is or is likely to become involved; provide access to related
records.
- A description of any such litigation resolved during the review period and the outcome;
provide access to related records.
- A description of any investigations by other agencies (Dept of Justice, Dept of Housing and
Urban Development, Equal Employment Opportunity Commission, or state or local
authorities) in which the bank has been involved during the review period and the outcome;
provide access to related records.
Please send or hold the following documents, as indicated:
| Send |
Hold |
|
| |
|
32. All complaints received by the bank (or by third-party service providers)
regarding loan originations, loan servicing, deposit services, or other
products or services, including any complaints alleging discrimination,
together with the bank’s responses. |
| |
|
33. Reports of any management reviews of the type, frequency, and distribution
of consumer complaints. |
Periodic Independent Testing and Audits (Internal/External)
Please send or hold the following documents, as indicated:
| Send |
Hold |
|
| |
|
34. Internal and external audit procedures, work programs, and risk assessment
plans. |
| |
|
35. Your most recent compliance audit (not your bank's last FDIC
examination). Please arrange examiner access to audit workpapers. |
| |
|
36. Audit schedules for the exam review period and the coming year. |
| |
|
37. Follow-up reports on audit exceptions and corrective actions and
management responses to the findings. |
Third-party Service Providers
Please provide the following information:
- A description of compliance assistance, consulting, or training provided by consultants or
third parties. Please make arrangements for access to supporting documentation of work
performed by third parties.
- A list of third-party or affiliated vendors or service bureaus providing compliance reviews,
loan quality reviews or other compliance-related services, such as tax service, flood
determinations, disclosure forms, and escrow account administration.
- A description of the oversight and review mechanisms used to determine whether third-party
performance meets expectations.
Please send or hold the following documents, as indicated:
| Send |
Hold |
|
| |
|
41. Contracts and agreements (including guarantees where applicable) with
third parties for compliance reviews and other compliance-related services,
including internal audits and loan quality control reviews and copies of
reports of the reviews. |
| |
|
42. Records of due-diligence performed prior to retaining these third parties,
and reports of performance reviews. |
Information Systems Support for Compliance
Please provide the following information:
- A description of any information system changes or conversions implemented or initiated
during the review period and steps taken to ensure compliance.
- A description of any project plans related to system changes or implementation.
- A description of the oversight and review mechanisms used to determine whether third-party
performance meets expectations and reports of any such reviews performed along with
supporting documentation.
Please send or hold the following documents, as indicated:
| Send |
Hold |
|
| |
|
46. Records of testing of information systems handling compliance and related
matters. |
| |
|
47. Records of due-diligence performed prior to retaining third party
information systems vendors, and reports of performance reviews. |
Recordkeeping
Please provide the following information:
- A description of forms control processes and mechanisms to disseminate new or revised
forms.
Please send or hold the following documents, as indicated:
| Send |
Hold |
|
| |
|
49. Record retention schedule and record retrieval procedures |
Product Development and Planning
Please provide the following information:
- A description of any pre-implementation planning procedures.
- Procedures for ensuring that compliance issues are addressed in acquisitions (whether of
another institution or a branch, product, or loan portfolio).
- The name and title of the officers and/or bank personnel who are appropriate contacts for
specific information about the bank’s marketing program.
Please send or hold the following documents, as indicated:
| Send |
Hold |
|
| |
|
53. Records of review of new products or services for compliance, including
records of any reviews by counsel. |
| |
|
54a. Records of pre-implementation testing of new products or services. |
| |
|
54b. Records of post-implementation testing of new products or services. |
| |
|
55. Marketing-related material, including:
- A copy of the bank's marketing and advertising budget.
- A copy of your bank's written marketing and advertising policy, if applicable.
- Access to the bank's advertising file, including:
- Newspaper advertisements
- Radio or TV scripts
- Lobby brochures
- Statement stuffers
- Internet advertisements
- Other forms of advertising
|
Part II: LENDING COMPLIANCE
Please provide the following information:
- The names, titles and phone numbers of the officers and/or bank personnel who are
appropriate contacts for specific information about the following products and related
compliance matters. Please advise these individuals that Examiners may be contacting
them before or during the examination, seeking general information regarding bank
processes.
- Consumer Real Estate Loans:
- Home Equity Loans:
- Consumer Construction Loans:
- Consumer Installment Loans:
- Credit Cards:
- Overdraft Protection:
- Commercial Loans:
- Dealer Loans:
- Government Guaranteed Loan Programs:
- Special Loan Programs (e.g., student loans, employee loans):
- Name and location of the individual(s) who can provide access to the daily statement
of assets and liabilities; and trial balances relating to all consumer loan categories (i.e.
installment, home equity, single payment, residential mortgage, etc.), leases and
deposits:
- A description of any loan products that have been introduced since the last
compliance examination.
Truth in Lending
Please provide the following information:
- A list of the open-end credit plan(s) offered by the bank (including overdraft protection,
personal and home equity lines of credit, credit cards, etc.).
Please send or hold the following documents, as indicated:
| Send |
Hold |
|
| |
|
60. Documentation on any Regulation Z reimbursement made pursuant to the
Truth in Lending Act since the last compliance examination. |
| |
|
61. The Consumer Handbook on Adjustable Rate Mortgages used for variablerate
loans. |
| |
|
62. A list of all indices used by the bank for adjustable rate loan products since
the last compliance examination. |
| |
|
63. Copies of actual periodic billing statements for all open-end credit products
sent to a customer where a finance charge was imposed for two consecutive
billing periods (copy both sides of the statements). |
| |
|
64. If the billing error notice is not included with the periodic billing statement,
a copy of the annual billing error notice sent to open-end credit customers. |
| |
|
65. Any bank policies regarding the sale of credit insurance. |
Equal Credit Opportunity
Please provide the following information:
- A description of any risk-based pricing and support for pricing tiers and costs.
- A description of the procedures or provide a copy of the procedures currently followed when
the bank takes adverse action on a verbal or written credit application submitted by:
- Consumers
- Businesses with gross revenues of $1 million or less
- Businesses with gross revenues of more than $1 million.
- A description of the bank’s procedures for maintaining credit information on married
customers.
- A description of the circumstances, if any, under which the bank requires a husband or wife
to guarantee or co-sign a loan to his or her spouse.
- A description of the procedures used to evidence whether loan applicants intend to be joint
applicants.
- A description of the notification given to an applicant by the bank or a dealer/ merchant in
situations where the dealer or merchant requests credit from the bank for a customer and
adverse action is taken on the application.
- A description of the procedures followed by the bank to provide an applicant with a copy of
an appraisal report used in connection with an application for credit to be secured by a lien
on a dwelling.
- Name and location of individual(s) who can provide access to documentation concerning
loan denials and withdrawals for all consumer and business loan applicants during the last
25 months and 12 months, respectively.
Please send or hold the following documents, as indicated:
| Send |
Hold |
|
| |
|
74. The bank’s loan and appraisal policies, and any separate underwriting
guidelines. |
| |
|
75. All credit application forms used by the bank or dealers. |
| |
|
76. Any instructions regarding credit scoring systems utilized by the bank, as
well as an explanation of how the systems were formulated. |
| |
|
77. All loan guaranty forms. |
| |
|
78. Loan worksheets, prequalification sheets or similar forms. |
| |
|
79. All other documents that the bank may use to request or record any personal
information concerning loan applicants. |
| |
|
80. Adverse action notice forms (both consumer and business) used during the
previous 25 months. |
| |
|
81. The form used to notify applicants of the right to receive a copy of the
appraisal report used in connection with an application for credit that is to
be secured by a lien on a dwelling. |
Fair Housing – Technical
Please send or hold the following documents as indicated:
| Send |
Hold |
|
| |
|
82. Any property appraisal forms used by the bank or outside appraisers. |
| |
|
83. Expense reports reflecting the cost of obtaining an appraisal from each
outside appraisal firm used by the bank. |
Home Mortgage Disclosure
Please provide the following information:
- Name and location of the individual who can provide access to any set of census tract maps
used by the bank and any source that the bank may use to convert a street address to a census
tract.
Please send or hold the following documents as indicated:
| Send |
Hold |
|
| |
|
85. Electronic downloads of your bank’s HMDA Loan Application Registers
for all years since [SPECIFY YEAR], including your current year-to-date
Loan Application Register. If your [SPECIFY YEAR, OR “current yearto-
date] register is not yet in electronic format, a hardcopy report will be
sufficient.
If your bank uses the FFIEC’s HMDA Data Collection Software, these
files can be created by using the “Export For Other Purpose” function
under the export option in the software. The “Export For Other Purpose”
option will create a submission for internal use only. |
| |
|
86. Documentation relating to any revisions made to the last three HMDA
LARs after their initial filing with the Federal Reserve Board. |
Flood Insurance
Please provide the following information:
- A description of the procedures used to determine whether improved real estate or a
mobile home securing a loan is located in a special flood hazard area and the name of
the individual responsible for compliance.
- A description of the procedures to ensure that borrowers receive timely notice of
special flood hazards, the requirement for flood insurance, and the availability of
federal disaster relief assistance.
- A description of the procedures to ensure that required flood insurance coverage is
obtained and maintained on a loan secured by improved real property or a mobile
home in a special flood hazard area.
- If a third party is used to determine flood hazard compliance:
- The name and address of the service providing flood determination.
- The initial fee for third party flood determination services.
- The portion of this fee, if any, which is for life of loan coverage, versus initial determination.
- A list of all loans located in Special Flood Hazard Areas.
Real Estate Settlement Procedures
Please provide the following information:
- If, in connection with granting residential mortgage credit, the bank charges a fee for
making an application, checking credit history, appraising or inspecting collateral, or
for any other type of real estate settlement service, including making a loan
commitment, then provide details.
- If the bank required the use of a particular settlement service provider (attorney, law
firm, title company, real estate broker, real estate appraiser, or others) and required
the borrower to pay any portion of the cost of such service, then list:
- Provider(s) names
- Types of services rendered
- Amount of customary charges imposed.
- If the bank gave or accepted any fee, payment, advance, loan, service, discount,
rebate or other consideration to or from any settlement service provider with whom
the bank does business in connection with real estate mortgage lending, then provide
details.
- If the bank is involved in an affiliated business arrangement as defined in Section 3(7)
of the Real Estate Settlement Procedures Act, then provide details.
- If the bank maintains escrow accounts for federally related mortgage loans as defined
in Section 3500.2 of the Real Estate Settlement Procedures, then describe the specific
items included in the bank's escrow.
Please send or hold the following documents as indicated:
| Send |
Hold |
|
| |
|
97. The disclosure pertaining to the assignment, sale, or transfer of loan
servicing provided to persons who apply for a mortgage-servicing loan as
defined in 24 C.F.R. Section 3500.21(a).
|
| |
|
98. The Special Information Booklet given to residential mortgage loan
applicants. |
Home Ownership Counseling
Please send or hold the following documents as indicated:
| Send |
Hold |
|
| |
|
99. The notice delivered to borrowers regarding the availability of
homeownership counseling.
|
Homeowners Protection Act
Please send or hold the following documents as indicated:
| Send |
Hold |
|
| |
|
100. Initial disclosures for fixed-rate, adjustable-rate, and high risk residential
mortgages. |
| |
|
101. Initial disclosures (at commitment) for residential mortgage loans with
lender paid private mortgage insurance (PMI). |
| |
|
102. Sample amortization schedules (showing actual transactions) for each
type of loan. |
| |
|
103. Annual disclosures for fixed-rate, adjustable-rate, and high risk residential
mortgages, loans with lender paid PMI, and loans consummated prior to
7/29/99. |
| |
|
104. Records of requests for cancellation. |
| |
|
105. Report of loans for which PMI was terminated. |
| |
|
106. Records of reviews and system testing (including computer program
documentation) to confirm that calculations of amortization and loan to
value ratios are accurate. |
Consumer Compliance Examination Data Sheet for Loans
- Please provide a loan report detailing loans originated (from [date] to [date]).
Please segregate the report by month and break down loan types applicable to
your bank. The list should include borrower name (short name is acceptable),
origination date, and original amount. If codes are used on the report, please
include the definition or meaning of each code. Fair lending examiners may
request additional loan information at a later time. The following is an example
of loan types broken down to specific categories.
Residential Consumer:
- Purchase Money Mortgage
- Refinance
- Residential Construction
- Home Equity Loans
- Home Improvement
- Home Equity Lines of Credit
- High Cost Mortgages
- Reverse Mortgages
Other Consumer:
- Overdraft Protection
- Installment Loans
- Credit Cards
- Indirect Auto
- Other Dealer Loans
Commercial:
- Secured by Real Estate
- Other Secured
- Credit Cards
- Unsecured
In addition, please provide the number of denied applications for each product
type for the months of [insert calendar months].
- Please check each feature applicable to your consumer loans:
| |
Purchase Money Mortgage |
|
Owner-occupied Construction |
| |
Refinance Mortgage |
|
|
Required Interest Reserves |
| |
Home Improvement |
|
|
Optional Interest Reserves |
| |
Home Equity Line of Credit |
|
|
No Interest Reserves |
| |
Private Mortgage Insurance |
|
Consumer Installment |
| |
Escrow |
|
Overdraft Protection |
| |
Variable Rate Mortgage* |
|
Credit Cards |
| |
Loans in Special Flood Hazard Area |
|
Simple Interest |
| |
Credit Life/Disability Insurance |
|
Rule of 78s |
| |
Loans secured by a Deposit Account where
Interest Rate on Deposit Account is less than
5% |
|
Add-on Interest |
| |
Vendor’s Single Interest Insurance (VSI) |
|
Guaranteed Automobile Protection Agreements (GAP) |
* If the bank originates variable rate loans, please provide a list of all indexes used and the loan types
applicable to each separate index.
Part III: DEPOSIT COMPLIANCE
- Please list the names, titles and phone numbers of the officers and/or bank
personnel who are appropriate contacts for specific information about compliance
matters involving deposit accounts (Savings, CDs, MMDAs, Regulation CC,
etc.).
Truth in Savings
Please provide the following information:
- A description of any deposit accounts offered to consumers, identifying any new
products introduced since the last compliance examination.
- If the bank offered merchandise as a bonus or premium for certain deposits, provide
details.
Please send or hold the following documents as indicated:
| Send |
Hold |
|
| |
|
119. Any written policies, procedures, practices and training materials relating
to Truth in Savings. |
| |
|
120. The initial disclosure form provided for each type of consumer deposit
account since the last compliance examination, such as checking, savings
and time deposits. |
| |
|
121. The advance disclosure form for each account in which adverse changes
in terms have occurred since the previous FDIC examination. |
| |
|
122. A copy of one complete periodic statement (dated subsequent to the
previous FDIC examination) for each type of interest bearing account
which incurred maintenance fees. |
| |
|
123. A copy of one complete periodic statement (dated subsequent to the
previous FDIC examination) for each type of consumer account. |
| |
|
124. The corresponding rate sheets for periods covered by periodic statements
above. |
| |
|
125. Notice forms used for maturing time accounts for both accounts with
maturities less than one year and exceeding one year. |
Interest on Deposits
Please provide the following information:
- A description of the bank’s procedures to monitor excessive activity in MMDAs,
providing details including activity reports.
- A description of the bank’s procedures to monitor eligibility for NOW accounts,
providing details including exception reports.
Please send or hold the following documents as indicated:
| Send |
Hold |
|
| |
|
128. Account agreements or other disclosures of limitations on transactions for
money market deposit accounts (MMDAs). |
| |
|
129. Records of customer notices and account closing or reclassification for
repeated excessive transactions in MMDAs. |
| |
|
130. The most recent trial balance for all NOW accounts, including full names,
account numbers, and balances. |
| |
|
131. Account agreements or other disclosure of early withdrawal restrictions or
penalties and procedures for handling. |
| |
|
132. Procedures and controls regarding finders or broker fees on demand
deposits. |
Electronic Fund Transfers (EFT)
Please provide the following information:
- A description of your controls for issuing access devices.
- A description of the terms and conditions for any bank loan programs involving
electronic payments.
- Please be prepared to provide access to records of error resolutions and consumer
complaints, including correspondence with consumers, documentation of investigations,
and tracking reports.
Please send or hold the following documents as indicated:
| Send |
Hold |
|
| |
|
136. A list of all EFT services performed by the bank, including, but not
limited to:
- Direct deposit (including Social Security transfers)
- Preauthorized withdrawal of funds
- Automated teller machine transfers
- Point-of-sale terminal transfers
|
| |
|
137. Disclosure forms given to customers when opening an account and when
adding EFT capabilities (ATM cards, Debit cards, etc.). |
| |
|
138. EFT agreement and error resolution notice given to customers. |
| |
|
139. A sample of periodic statements showing actual transaction activity
(including all types of transfers, e.g., ATM deposits, direct deposits,
preauthorized withdrawals, etc.); include any information printed on the
back of the statements. |
| |
|
140. A sample of ATM disclosures, fee notices, and receipts showing actual
transaction activity. |
| |
|
141. A sample of change in terms notices (if applicable) and records of
transmittal |
| |
|
142. Policies for liability on unauthorized electronic transfers, issuance of
access devices, and preauthorized debits and credits. |
| |
|
143. Any merchant agreements involving electronic fund transfers. |
Expedited Funds Availability
Please provide the following information:
- Describe your procedures for addressing Check 21 requirements, as incorporated into
Regulation CC.
- Describe to whom you provided the Check 21 disclosure.
Please send or hold the following documents as indicated:
| Send |
Hold |
|
| |
|
146. A copy of the Check 21 disclosure. |
| |
|
147. The bank's procedures and/or procedures given to employees for
providing funds availability and for placing holds. |
| |
|
148. The bank's funds availability policy disclosures. |
| |
|
149. Samples of the following showing transaction activity:
- Deposit receipts (or other notice) showing funds held and
availability schedules for deposits of local and non-local checks
- Exception hold notices for each type of exception
- Case-by-case hold notices
- Pre-printed deposit slips and any special deposit slips
|
Part IV. INSURANCE AND INVESTMENTS
Insurance
Please provide the following information:
- The name, title and phone number of the person who is the appropriate contact for
specific information about insurance related compliance matters.
- Is insurance sold in a physically distinct area from which deposits are taken?
_____ (yes/no)
- If “no”, explain:
__________________________________________________________
- How are insurance and annuities sold (select all that apply)?
| |
By the bank |
|
On behalf of the bank |
|
On bank premises |
| |
Yes/No |
If Yes, How Many? |
| 154. Do bank employees (employed solely by the bank) sell
insurance? |
|
|
| 155. Do bank subsidiary employees (employed solely by
subsidiary) sell insurance on behalf of the bank or on bank
premises? |
|
|
| 156. Do bank subsidiary employees (employed dually by the
bank and the subsidiary) sell insurance on behalf of the
bank or on bank premises? |
|
|
| 157. Do affiliate employees (employed solely by the affiliate)
sell insurance on behalf of the bank or on bank premises? |
|
|
| 158. Do affiliate employees (employed dually by the bank and
the affiliate) sell insurance on behalf of the bank or on
bank premises? |
|
|
| 159. Do unaffiliated third parties (employed solely by the third
party) sell insurance on behalf of the bank or on bank
premises? |
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| 160. Do unaffiliated third parties (employed dually by the bank
and the third party) sell insurance on behalf of the bank or
on bank premises? |
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- Describe how bank employees who sell insurance or annuities are compensated:
- Do bank employees who do not sell insurance receive compensation for referring
customers to someone who does? If yes, describe the compensation plan:
- Primary Insurance or Annuity Vendor (Name):
___________________________________________________________________
(check one) [ ] First Vendor Used [ ] Same Vendor as last exam [ ] Different vendor
- Insurance Products Offered (select all that apply)
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Auto |
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Health |
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Casualty |
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Life (including variable life) |
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Credit Life |
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Private Mortgage |
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