Interagency Notice of Change inControl

• Legal Form Number: FDIC6822/01
• Section: Federal Deposit Insurance Corporation

FDIC 6822/01 (7-21)

FDIC OMB No. 3064-0019; Expiration Date: 07/31/2024

Federal Reserve OMB No. 7100-0134; Expiration Date: 05/31/2024

OCC OMB No. 1557-0014; Expiration Date: 01/31/2024

Federal Deposit Insurance Corporation

INTERAGENCY NOTICE OF CHANGE IN CONTROL

Public reporting burden for the collection of information for this notice is estimated to average 30.5 hours, including the

time to gather and maintain data in the required form, to review instructions, and to complete the information collection.

Send comments regarding this burden estimate or any other aspect of this collection of information, including

suggestions for reducing this burden to: Paperwork Reduction Act, Legal Division, Federal Deposit Insurance

Corporation (FDIC), 550 17th Street, NW, Washington, DC 20429; Secretary, Board of Governors of the Federal

Reserve System (Board), 20th St. and Constitution Ave., NW, Washington, DC 20551; Licensing Activities Division,

Office of the Comptroller of the Currency (OCC), 400 7th Street, SW, Washington, DC 20219; and to the Office of

Management and Budget (OMB), Paperwork Reduction Project, Washington, DC 20503.

An organization or a person is not required to respond to a collection of information unless it displays a currently valid

OMB control number.

GENERAL INFORMATION AND INSTRUCTIONS

Preparation and Use

This form is used to file notice to acquire control of a depository institution or a holding company, pursuant to the Change

in Bank Control Act, as amended (12 U.S.C. §1817(j)). As used in this form, “holding company” means a bank holding

company, a savings and loan holding company, or other company that controls a depository institution. The information

must be submitted to the appropriate federal banking agency of the institution whose shares are to be acquired. All

inquiries on preparation of the notice should be directed to that agency which, in some circumstances, may modify the

information requested.

The federal banking agency will review the submitted notice to determine if it is complete. If the submitted notice is not

complete, the federal banking agency may either request additional information or it may return the notice. If the required

information is not available, please explain. When the notice is complete, the federal banking agency will confirm its

determination in writing. The questions are not intended to duplicate information supplied on another form or in an

exhibit; a cross-reference to the information is acceptable. Any cross-reference must be made to a specific location in

the documents, so the information can be found easily. If additional space is needed to provide complete answers,

please attach additional sheets or exhibits.

For additional information regarding the processing procedures and guidelines, and any supplemental information that

may be required, refer to the appropriate federal banking agency's procedural guidelines (for example, the OCC's Rules

and Regulations (12 C.F.R. Part 5), the Comptroller's Licensing Manual, the FDIC's Rules and Regulations (12 C.F.R.

Part 303), the Board's Regulations Y and LL (12 C.F.R. Part 225 and 12 C.F.R. Part 238, respectively)) and relevant

policy statements. Contact the agency directly for specific instruction, or visit its website at www.occ.treas.gov,

www.fdic.gov, or www.federalreserve.gov.

Biographical and Financial Report

To assist the appropriate Federal banking agencies in evaluating the factors specified in the Change in Bank Control Act,

an Interagency Biographical and Financial Report is generally required for each person named in the notice.

Supporting Information

The questions in the notice are not intended to limit the acquirer's responses, and the federal banking agency may

request additional necessary information. If any information furnished in the notice changes materially during the

processing of the notice or prior to consummation, such changes should be communicated promptly to the federal

banking agency with which the notice was filed.