Request For Release/substitution Of Depository Bank Collateral Form Page 2
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1
2State Treasurer of Ohio
Securities Held by Trustee for Financial Institution
Instructions for completing the Request for Release/Substitution of Depository Bank Collateral form
E-mail completed form to:
bank.collateral@tos.ohio.gov
or fax to: (614) 466-9948
Request Date
The date the form is being completed.
To the Trustee
The name of the institution holding the security.
Account #
The account number for which securities are held at the Trustee.
Financial Institution (Pledgor)
The name of the depository bank submitting the request.
ABA #
American Bankers Association assigned routing number.
Contact Name
The person from the Financial Institution requesting the
release/substitution.
Contact e-mail
Email address for the Financial Institution contact.
Telephone
Phone number for the Financial Institution contact who is sending the
request.
RELEASE section
The date the funds are to be released (i.e., at maturity or before
maturity).
For Treasurer Use Only
Please leave this column blank.
CUSIP
The security identifier.
Asset Description
The type of security or security name (i.e., FNMA mortgage).
PAR (Original Face) to be released The par amount or original face amount (do not use market value) of the
security to be released.
Maturity Date
Maturity date or call date of the security.
SUBSTITUTION section
Enter the required information for any security(s) that will be pledged in
addition to the release(s). Please send pledge information to Trustee and
request that the Trustee forward confirmation of the pledge to the
Treasurer as soon as it is available.
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