Forms
Applications, Notices, & Reporting Forms
Bank Supervision: Reports & Notices
The forms are Adobe® PDF file or Microsoft® Word files. Information on downloading and using these files is at: PDF Help & Word Help. Unless otherwise notes, all files are less than 250k.
| Form Title | Available via FDICconnect? | ||
|---|---|---|---|
Form 3: Initial Statement of Beneficial Ownership of Securities |
PDF file (379k) |
Word file | yes |
| Form 4: Statement of Changes in Beneficial Ownership of Securities FDIC 6800/04 (Formerly Form F-8) Form 4 Instructions |
PDF file (274k) |
Word file | yes |
| Form 5: Annual Statement of Beneficial Ownership of Securities FDIC 6800/05 (Formerly Form F-8A) Form 5 Instructions |
PDF file (260k) |
Word file | yes |
|
Interagency Bank Merger Act Application FDIC 3064-0015 |
PDF file (129k) |
Word file (97k) |
|
| Interagency Biographical and Financial Report FDIC 3064-0006 |
PDF file (540k) |
Word file (450k) |
|
| Interagency Notice of Change in Control FDIC 3064-0019 |
PDF file (303k) |
Word file
(138k) |
|
| Interagency Notice of Change in Director of Senior Executive Officer FDIC 3064-0097 |
PDF file | ||
| Notice and Authorization Pertaining to Consumer Reports Pursuant to the Fair Credit Reporting Act of 1970, 15 U.S.C. § 1681, et seq. FDIC 1600/10 |
PDF file | Word file | |
| Notice by Financial Institutions of Government Securities Broker or Government Securities Dealer Activities G-FIN |
PDF file | ||
| Notice by Financial Institutions of Termination of Activities as a Government Securities Broker or Government Securities Dealer G-FINW |
PDF file | ||
| Notification of Performance of Bank Services FDIC 6120/06 |
PDF file | Word file | |
| Registered Transfer Agents Form for Registrations and Updating Amendments Form TA-1 |
PDF file | ||
| Registered Transfer Agent Request for Deregistration FDIC 6342/12 Form TA-W |
Word file | ||
| Disclosure form for persons associated with a Financial Institution Government Securities Broker or Dealer (www.treasurydirect.gov) G-FIN-4 |
PDF file | ||
| Uniform Termination Notice for Persons Associated with a Financial Institution Government Securities Broker or Dealer G-FIN-5 |
PDF file | ||
| Application for registration as a municipal securities dealer or amendment of the same (Form MSD) | PDF file | ||
| Form for reporting activities of transfer agents registered pursuant to Section 17A of the Securities Exchange Act of 1934 (TA-2) | PDF file | ||
| Uniform Application for Municipal Securities Principal or Municipal Securities Representative Associated With a Bank Municipal Securities Dealer MSD-4 |
PDF file (900k) |
||
| Uniform Termination Notice for Municipal Securities Principal or Municipal Securities Representative Associated with a Bank Municipal Securities Dealer MSD-5 |
PDF file (450k) |
||
| Notice of Withdrawal From Registration as a Municipal Securities Dealer Pursuant to Rule 15Bc3-1 (17 CFR 240.15Bc3-1) (www.sec.gov) |
PDF file | ||
| Suspicious Activity Report FDIC 6710/06 |
PDF file | Word file | |
| Notification of Branch Closing | yes | ||
| FDIC Post Examination Surveys | yes |