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Provisional Hold Information Sheet

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January 14, 2009

Anytown Bank and Trust
Anytown, Anystate




Account Type Account Balance Threshold Provisional Hold Percent
Domestic Deposits    
   1. Consumer DDA, NOW and MMDA $XX,XXX YY%
   2. Other Consumer Deposit Accounts $XX,XXX YY%
   3. Non-Consumer DDA, NOW and MMDA $XX,XXX YY%
   4. Other Non-Consumer Deposit Accounts $XX,XXX YY%
 
Other Deposits
   5. Foreign deposits None YY%
   6. International Banking Facility Deposits None YY%
 
Sweep Investment Vehicles
   7. Eurodollar/Offshore $XX,XXX YY%
   8. International Banking Facility $XX,XXX YY%
   9. Repo $XX,XXX YY%
   10. Fed Funds $XX,XXX YY%
   11. Holding Company Commercial Paper $XX,XXX YY%
 
Automated Credit Accounts
   12. Eurodollar/Offshore $XX,XXX YY%
   13. International Banking Facility $XX,XXX YY%
   14. Repo $XX,XXX YY%
   15. Fed Funds $XX,XXX YY%
   16. Holding Company Commercial Paper $XX,XXX YY%



Last Updated 01/06/2010 regs@fdic.gov