Required Reports of Indebtedness
Executive Officers and Principal Shareholders
The enclosed form is for use in complying with
the reporting requirements of Title VIII of the Financial Institutions Regulatory and
Interest Rate Control Act of 1978 for calendar year 1995. The Act requires each bank's
executive officers and principal shareholders to submit an annual report to their board of
directors on their indebtedness, and that of their related interests, to correspondent
banks. Form FFIEC 004 is designed to assist executive officers and principal shareholders
of a bank in meeting this reporting requirement.
In addition, Part 349 of the FDIC's rules and
regulations requires a bank to disclose to the public, upon request, the names of its
executive officers and principal shareholders who have indebtedness to their own bank, or
to correspondent banks, that exceeds a specified amount. Form FFIEC 004 contains the
information to be used to make these disclosures on indebtedness to correspondent banks.
instructions for the preparation of form FFIEC 004 are included on the back of the report.
The reports should be retained by your bank and not forwarded to the FDIC. Any questions
you may have should be directed to your FDIC Division of Supervision regional office.