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Report Of Changes In Organizational Structure Form. This is a Official Federal Forms form and can be use in Applications Structure Change Federal Reserve System.
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Tags: Report Of Changes In Organizational Structure, FR Y-10, Official Federal Forms Federal Reserve System, Applications Structure Change
FR Y-10 OMB Number 7100-0297 Approval expires November 30, 2019 Page 1 of 12Board of Governors of the Federal Reserve System Report of Changes in Organizational Structure227FR Y-10 This report is required by law: Sections 4(k) and 5(c)(1)(A) of the Bank Holding Company Act (12 U.S.C. 247247 1843(k) and 1844(c)(1)(A)); section 8(a) of the International Banking Act (12 U.S.C. 247 3106(a)); sections 11(a)(1), 25(7), and 25A of the Federal Reserve Act (12 U.S.C. 247247 248(a)(1), 321, 601, 602, 611a, 615, and 625); and sections 113, 165, 312, 618, and 809 of the Dodd-Frank Act (12 U.S.C. 247247 5361, 5365, 5412, 1850a(c)(1), and 5468(b)(1)); and section 10(c)(2)(H) of the Home Owners' Loan Act (12 U.S.C. 247 1467a(c)(2)(H)).Reporter's Name, Street, and Mailing Address Legal Name Physical Street Address City and County State / Province, Country Zip / Postal Code Reporter's Mailing Address (if different from physical street address) Mailing City Mailing State / Province, Country Zip / Postal CodeContact's Name and Mailing Address for this Report Name Title Area Code / Phone Number / Extension Area Code / FAX Number E-mail Address Contact's Mailing Address (if different from reporter's) Mailing City Mailing State / Province, Country Zip / Postal CodeAuthorized OfficialI, Printed Name Title,am an authorized official of this company named above, and hereby declare that this report is true and complete to the best of my knowledge and belief. Signature of Authorized Official Date of Signature For Federal Reserve Bank Use OnlyRSSD ID 20-Character LEI CodeReporter's Legal Entity Identifier (LEI) In accordance with the General Instructions for this report (check only one),a letter justifying this request is being provided along with the report........................................................ 0=No 1=Yes1.a letter justifying this request has been provided separately...2.NOTE: Information for which confidential treatment is being requested must be provided separately and labeled as "confidential." Is confidential treatment requested for any portion of this report submission?....................................Date of Report: (Month / Day / Year)Public reporting burden for the information collection is estimated to average 2.50 hours per response, including time to gather and maintain the data and complete the information collection. The Federal Reserve may not conduct or sponsor, and a person is not required to respond to any information collection unless it displays a currently valid OMB control number. Send com-ments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to: Secretary, Board of Governors of the Federal Reserve System, 20th and C Streets, NW, Washington, DC 20551, and to the Office of Management and Budget, Paperwork Reduction Project (7100-0297), Washington, DC 20503.03/2018 American LegalNet, Inc. www.FormsWorkFlow.com FR Y-10 Page 2 of 12 Ownership Section (report at direct holder level unless otherwise noted)12.Direct Holder's Name and Location: Legal Name City, State/Province, Country13.a.Percentage of a Class of Voting Shares:%13.b. Percentage of Nonvoting Equity: % 13.c.Other Interest: Yes No13.d.If the reportable company is a type of partnership or limited liability company as indicated in Item 10 above, please indi-cate the appropriate ownership interest of the direct holder: General Partner/Managing Member Limited Partner/Non-Managing Member14.Control by Direct Holder: Yes No15.Control by Reporter: Yes No16.Former Direct Holder's Name and Location (if applicable): Legal Name of Former Direct Holder City, State / Province, Country Characteristics Section2.a. Legal Name of Banking Company2.b. If Name Change or Correction, Prior Legal Name of Banking Company3.a. Current Street Address (Physical Location) City and County State / Province, Country, and Zip / Postal Code3.b. If Relocation or Correction, Prior Street Address (Physical Location) If Relocation or Correction, Prior City and County If Relocation or Correction, Prior State / Province, Country, and Zip / Postal Code State or Country (if foreign) of Incorporation If Relocation or Correction, Prior State or Country (if foreign) of Incorporation4.Date Opened: (MM / DD / YYYY)5.Fiscal Year End (BHCs, IHCs, FBOs Only): (MM/DD) 8.a.Tax ID Number: 226 6.SEC Reporting Status: Not Applicable Subject to 13(a) or 15(d) of SEC Act of 1934 and Section 404 of SOX Act Subject to 13(a) or 15(d) of SEC Act of 1934, but not Section 404 of SOX Act Terminated or suspended reporting requirements under 13(a) or 15(d) of the SEC Act of 1934 7.CUSIP Number:not required for FBOsleading six digits only9.Banking Company Type: BHC IHC U.S. Commercial Bank U.S. State Chartered Savings Bank Other, describe: 11.Is the banking company consolidated in the reporter's financial statements?(only reportable for foreign investments) Yes No10.Business Organization Type: Corporation Business Trust Cooperative Mutual General Partnership Sole Proprietorship Limited PartnershipLimited Liability Partnership Other, describe: 8.b.Legal Entity Identifier (LEI): Limited Liability Limited Partnership Limited Liability Co./Corp.FBO 10/2016 For Federal Reserve Bank Use Only IDRSSDE1 (direct holder)IDRSSDE2 (reportable company)If applicable, former d/hBanking ScheduleUse this schedule to report information about a reporter that is a Banking Company, and about a reporter's directly or indirectly held interests in a Banking Company.Check box if correction 1.a.Event Type (check all that apply):1.b.Date of Event: (MM / DD / YYYY) Acquisition of a Going Concern De Novo Formation External Transfer Internal Transfer Change in Ownership Liquidation Change in Characteristics Change in Activity or Legal Authority No Longer Reportable Became Inactive Debts Previously ContractedBecame Reportable Other, describe: American LegalNet, Inc. www.FormsWorkFlow.com FR Y-10 Page 3 of 12Banking Schedule227Continued Activity and Legal Authority Section (for list of FRS legal authority codes, see the Appendix of these instructions.)Activity TypeFRS Legal Authority Code NAICS Activity Code Description of Activity 17.a.Primary Activity 17.b.Secondary Activity (FBOs and BHCs only) 17.c.Termination of Activity 10/2016 American LegalNet, Inc. www.FormsWorkFlow.com FR Y-10 Page 4 of 12Savings and Loan ScheduleUse this schedule to report information about a reporter that is a savings and loan holding company (SLHC), and about any reporter's (including a BHC's) directly or indirectly held interest in all SLHCs and savings associations.Check box if correction 1.a.Event Type (check all that apply):1.b.Date of Event: (MM / DD / YYYY) Acquisition of a Going Concern De Novo Formation External Transfer Internal Transfer Change in Ownership Liquidation Change in Characteristics Change in Activity or Legal Authority No Longer Reportable Became Inactive Debts Previously ContractedBecame Reportable Other, describe: Characteristics Section2.a. Legal Name of Savings and Loan Company2.b. If Name Change or Correction, Prior Legal Name of Savings and Loan Company3.a. Current Street Address (Physical Location) City and County State / Province, Country, and Zip / Postal Code3.b. If Relocation or Correction, Prior Street Address (Physical Location) If Relocation or Correction, Prior City and County If Relocation or Correction, Prior State / Province, Country, and Zip / Postal Code State or Country (if foreign) of Incorporation If Relocation or Correction, Prior State or Country (if foreign) of Incorporation4.Date Opened: (MM / DD / YYYY)5.Fiscal Year End (SLHCs Only): (MM/DD)6.SEC Reporting Status: Not Applicable Subject to 13(a) or 15(d) of SEC Act of 1934 and Section 404 of SOX Act Subject to 13(a) or 15(d) of SEC Act of 1934, but not Section 404 of SOX Act Terminated or suspended reporting requirements under 13(a) or 15(d) of the SEC Act of 1934 7.CUSIP Number:See instructions for when applicable Leading six digits only9.Savings and Loan Type:10.Business Organization Type: Corporation Business Trust Cooperative Limited Liability Limited Partnership General Partnership Sole Proprietorsh