State Of New Hampshire - Annual Report To The Bank Commissioner

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State Of New Hampshire - Annual Report to the Bank Commissioner
As of December 31, 20
Institution:
Main Office Location:
Mailing Address:
(if different than above)
Telephone Number:
Fax Number:
E-mail Address (for public use)
Website Address
Branches (full address) Include out-of-state and international branches. List alphabetically by town.
Attach a list of all remote service units, indicating whether it is an “ATM” or “cash dispensing” machine.
Branches closed during the year (full address and date closed). List alphabetically by town.
Officers, SVP and above (full name and title)
Directors/Trustees. List full name. On a separate page, list committees serving on (i.e. Audit,
Investment, Trust, etc.)
Chairman:
Subsidiaries/CUSOs:
Holding company affiliation:
Fidelity Bond:
$
Pledge/surety/funds f/b/o
$
the Commissioner
The information detailed on this form is correct to the best of my knowledge as of December 31, 20
.
Signature and Title of Authorized Officer: ________________________________________________
Printed Name
Date signed:
Annual Report Form
Page 1 of 1
Rev 7/2010

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