LN. 110 (69) 670 145-017 F. R. Form U-1 'BOARD OF GOVERNORS OF THE FEDERAL RESERVE SYSTEM STATEMENT OF PURPOSE OF A STOCK-SECURED EXTENSION OF CREDIT BY A BANK (FEDERAL RESERVE FORM U-1) A FALSE OR DISHONEST STATEMENT BY THE CUSTOMER OR THE OFFICER OF THE BANK ON THIS FORM MAY BE PUNISHABLE BY FINE OR IMPRISONMENT (U.S. CODE, TITLE 15, SECTION 78 AND TITLE 18, SECTION 1001) Instructions: (1) Please print or type (if space is inadequate attach separate sheet). (2) The term "stock" is defined in 221.3 (1) of Regulation U. (3) Part I (3) and (4) need be filled in only if the purpose of the credit described in Part I.(1) is other than to purchase or carry margin stock. (4) In Part II "source of valuation" need be filled in only if such source is other than regularly published information: in Journal of general circulation. (5) Part II need not be 'completed in the case of a credit of $5,000 or less which is not for the purpose of purchasing or carrying margin stock. However, in such cases, Part I must be completed as if Part II were completed. PART I (to be completed by customer(s)) (1) The purpose of this credit in the amount of $50.000, secured in whole or in part by the stock listed in Part II (A) and (B) is (describe in detail) (2) This bank, Chemical Bank has outstanding, or has (Name of bank) agreed to extend, to the undersigned, the following credits in addition to the credit described on this form (itemize and describe briefly, including amounts and collateral if any). If none, so state (3) Is any of the collateral listed in Part II (A) or (B) to be delivered, or has any such collateral been delivered, from a bank, broker, dealer, or person other than the undersigned? No If yes, from whom? Against payment? Yes No (4) Has any of the collateral listed in Part II (A) or (B) been owned less than six months? Be The undersigned has (have) read this form and hereby certifies and arms that to the best of my (our) knowledge and belief the information contained on this form is tru acte, and (Print or type name) (Print or type name) હોમ સ PART (to be completed by bank) (A) Collateral consisting of stock, other than debt securities convertible into margin stock. The loan value of such stock under the current Supplement to Regulation U is per cent, (B) Collateral consisting of debt securities convertible into margin stock. The loan value of such securities under the current Supplement to Regulation U is per cent. ..... The undersigned, a duly authorized officer of the bankie aware that this stock-secured credit may be subject to Regulation U, has read this form, has accepted the customer's statement on Part I in good. faith as defined below, and hereby certifies and affirms that the best of his knowledge and belief all the information contained on this form is true, accurate, and complete. Date Chemical Bank • Regulation U requires that the customer's statement on this form be accepted by an officer of the bank acting in good) faith. Good faith requires that such officer (1) must be alert to the circumstances surrounding the credit, and (2) if he has any information which would cause a prudent man not to accept the statement without inquiry, has investigated and is satisfied that the statement is truthful. Among the facts which would require such investigation are receipt of the statement through the mail or from a third party. THIS FORM MUST BE RETAINED BY THE BANK FOR AT LEAST THREE YEARS AFTER THE TERMINATION OF THIS CREDIT Dean George: vivid ou Was good phose. Jorry I missed seeing The phone day. I Need you $265000 to make payments bark stick. Thought I would have frame fold by Now, but The best Thie! would like for it to be dove 12-31-76 At which Thie out I will Take it کے mote substantial Dayment. I Need The funds Bother you Hate to bother with This The National Bank of Georgia. 4 Peachtree Street N W. Atlanta. Ga 30301 |