SCHEDULE I - Survey of loans, $25,000 and over, secured by domestic bank or bank holding company stock. SCHEDULE II - Loans outstanding as of September 30, 1977 to Executive Officers, Major Stockholders and Directors of other banks. SCHEDULE III - Loans outstanding as of September 30, 1977 to Executive Officers, Major Stockholders and Directors of the reporting bank, their business interests and their immediate families. SCHEDULE IV Overdrafts Section I of SCHEDULE I must be completed and returned even if reporting bank has no loans which meet the reporting criteria. SCHEDULES II, III and IV, plus the attestation covering all Schedules, must also be completed and returned. Return all forms within 30 days of receipt to: Federal Deposit Insurance Corporation Room 3008 Washington, D. C. 20429 Before completing any Schedule, please read the appropriate instructions. Maintain for your records copies of completed Schedules and all worksheets as it may be necessary to contact a reporting bank for additional information. When submitting these Schedules, please insure that the following instructions were followed: Sign the attestation. Enclose all Schedules and the attestation. Report all dollar amounts in thousands. Report numbers of shares and numbers of loans in units. Report percents to 2 decimal places. Write FDIC certificate number (found in upper right of label) on all returned forms which have no address label affixed. (Name of officer authorized to sign statement) (Title) of the bank named herein do hereby certify that the information contained on SCHEDULES I, II, III, and IV (including all attachments) is true, to the best of my knowledge and belief. (Area code Phone number) (Date) (Signature of officer authorized to sign statement) 8330/01 (10-77) 8330/02 (10-77) DEFINITIONS AND SCHEDULE I Survey of loans, $25,000 and over, secured by domestic bank or bank holding company stock Definitions and Instructions for SCHEDULE I: SURVEY OF LOANS, $25,000 AND OVER, SECURED BY DOMESTIC BANK OR BANK HOLDING COMPANY STOCK All items in this Schedule should reflect transactions of the domestic offices of the reporting bank. Exclude any transactions of your foreign branches, foreign subsidiaries and Edge and Agreement subsidiaries. All banks must complete and return Section 1 (found on page 1) of SCHEDULE I even if the reporting bank has no loans which meet the criteria for reporting in SECTION 2 of Schedule I. If more loans are to be reported in SECTION 2 of the Schedule than the space provided on pages 1-4, photocopy page 3 for reporting these additional loans. SECTION 1 Item 2. 2. Enter number of shares in units. 3. Report percents to 2 decimal places. 4. The FDIC certificate number (found in the upper right of the label on page 1) must be entered on the top of pages 2-4 to identify your report. Total assets: Should equal your bank's September 30, 1977 Domestic Report of Condition, Assets, item 16. Should equal your bank's September 30, 1977 Domestic Report of Condition, Schedule A - LOANS, Item 3. Gross demand deposits "due from" other domestic commercial banks: Item 4. Item 5. Include in this item demand balances with banks in the United States, Puerto Rico and U.S. territories and possessions as defined in the Call Report Instructions for Schedule C, item 2 of the Domestic Report of Condition. Note that the amount to be reported here is "gross", i.e., before deductions of reciprocal balances, whereas Schedule C, item 2 is reported net of reciprocal balances. Exclude balances with U.S. branches and agencies of foreign banks, with foreign branches of U.S. banks and with foreign banks. Report the daily average for the month of September, 1977. Gross demand deposit "due to" other domestic commercial banks: Include in this item demand deposits of banks in the United States, Puerto Rico and U.S. territories and possessions as defined in the Call Report Instructions for Schedule F, item 5 of the domestic Report of Condition. Note that the amount to be reported here is "gross", i.e., before deductions of reciprocal balances, whereas Schedule F, item 5 is reported net of reciprocal balances. Exclude balances of U.S. branches and agencies of foreign banks, of foreign branches of U.S. banks and of foreign banks. Report the daily average for the month of September, 1977. Total number of loans reported in SECTION 2: Include in this item the total number of loans in SECTION 2, which are reported either on the printed forms or on additional copies. SECTION 2. Item: If the bank has any loans currently outstanding which, individually or in the aggregate, are collateralized by 10 percent or more of the currently outstanding shares of any class of voting stock of other domestic banks or bank holding companies, provide the information requested in this Section on any individual loan so collateralized which meets the following conditions: 1. The loan has a current balance of $25,000 or more, and 2. The bank or bank holding company stock is the primary collateral for the loan. LOAN NO. Number the loans to be reported consecutively, e.g., a 1 for the first loan, a 2 for the second loan, etc. Keep a record of the loan to which the loan no. refers so that you can provide clarifying or additional information on this loan if requested. Item A. Name: Enter the current name of the domestic bank or bank holding company whose stock was pledged. Please spell out all numerals that are part of the name, e.g., FIRST, SECOND or THIRD. Item B. City: Enter the city of the main office of the institution listed in item A. Item C. State: Enter the state of the main office of the institution listed in item A. Item D. Self-explanatory. Item F. Gross demand deposits "due from" institution listed in item A Enter the "gross" demand deposits, i.e., before deduction of reciprocal balances, held with the institution listed in item A by the reporting bank. If a holding company is listed in item A, enter the sum of "gross" demand deposits held with all directly and indirectly held domestic bank subsidiaries of the bank holding company by the reporting bank. Report the daily average for the month of September, 1977. Item G. Gross demand deposits "due to" institution listed in item A Enter the "gross" demand deposits, i.e., before deduction of reciprocal balances, held with the reporting If a holding company is listed in item A, enter the sum of "gross" demand deposits held with the reporting Item H. Self-explanatory. Item 1. Is the debtor currently an executive officer, major stockholder or director of the institution listed in item A or of any of its domestic affiliates? Executive Officer refers to every employee of a bank or of a bank holding company who currently participates in or has authority to participate in major policymaking functions of the bank or of the bank holding company, regardless of title, salary or other compensation, or lack of salary or other compensation. The chairman of the board, the president, every vice-president, the cashier, secretary, and treasurer are assumed to be executive officers, unless the bank's or the bank holding company's bylaws or a board resolution excludes any such officer from participation in major policy-making functions. Major Stockholder refers to a stockholder currently holding 10 percent or more of any class of voting securities. Director refers to a person who has been appointed to or elected to a seat on a bank's or a bank holding company's current board of directors. Item I 1. If item I is checked Yes, check appropriate box here: Check the box "Executive officer" if the debtor is an executive officer of the institution listed in item A, even if he is also a major stockholder or a director. Check the box "Major Stockholder" if the debtor is a major stockholder of the institution listed in item A, but not an executive officer, even if he is also a director. Check the box "Director" if the debtor is a director, but not an executive officer or a major stockholder, of the institution listed in item A. Item J. Date of note or evidence of debt: Enter the date (month/day/year) as it appears on the face of the note or other evidence of debt. Item K. Self-explanatory. Item L. Interest rate as of date of note: Enter the interest rate as of date of note. Enter the interest rate to 2 decimal places, e.g., 6.50%. Item L 1. Check appropriate box to indicate the type of interest rate recorded in item L: Check the box "Fixed rate" if the interest rate recorded in item L was fixed at the beginning of the loan and was known to both the bank and the borrower at that time. The "Fixed rate" may be either a single unchanging rate over the life of the loan or it may be a variable rate provided the amount and schedule of the changes are predetermined and known at the beginning of the loan. Check the box "Floating rate" if the interest rate recorded in item L may change over the life of the loan on other than predetermined schedule. Floating rates include rates tied to the bank's prime rate or to other market rates of interest. Item M. Total number of shares currently pledged as collateral for loan: Enter the total number of shares of any voting class of stock currently pledged to secure the loan. This number may differ from the number of shares pledged at the date of the note. Enter the number of shares in units. Item N. Total number of shares currently outstanding: Enter the total number of shares of any voting class currently outstanding of the stock listed above as being pledged as collateral for the loan. Enter the number of shares in units. Item O. Self-explanatory. Item 01. If item O is checked Yes, did a change of control result from the purchase?: Change in control is defined as any transaction that results in: a. the ownership, control or power to vote 25% or more of the voting securities of the bank or bank holding company listed in item A; or b. the control in any manner of the election of a majority of the directors of the bank or bank holding company listed in item A; or c. the power to exercise a controlling influence over the management or policies of the bank or bank holding company listed in item A. |