Final Notice Of Merger Or Consolidation Out Page 3

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Final Notice of Merger or Consolidation Out
Applicant
_______________________________________________________________
Name
Charter no.
_______________________________________________________________
Current street address
_______________________________________________________________
City
County
State
Zip code
Parent Company Identifying Information (if applicable)
_______________________________________________________________
Name
_______________________________________________________________
Street
_____________________________________________________________
City
State
Zip code
Contact Person
_______________________________________________________________
Name
Title
_______________________________________________________________
Employer
______________________________________________________________
Street
_______________________________________________________________
City
State
Zip code
_______________________________________________________________
Telephone no.
Fax no.
E-mail address
Provide the effective date of the merger or consolidation.
Include all OCC and/or OTS reports of examination, and any related correspondence. If not
returned, the applicant must certify that these documents have been destroyed. The notice must
also include the charter certificate or charter document, any branch authorizations, and any letter
of trust authority. If these documents cannot be located, the notice must certify that the
documents cannot be located.
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