Looking for a Washington State Legal Forms And Templates? Download it for free!

Board of Governors of the Federal Reserve System OMB Number 7100-0035

Federal Deposit Insurance Corporation

OMB Number 3064-0017

Office of the Comptroller of the Currency

OMB Number 1557-0100

Approval expires September 30, 2019

Page 1 of 34

Federal Financial Institutions Examination Council

Country Exposure Report—FFIEC 009

Report at the close of business

Month / Day / Year

This report is required to be filed pursuant to authority contained in the

All FFIEC 009 respondents must submit their completed report via the Federal

The Board of Governors of the Federal Reserve System, the Office of the

following statutes: 12 U.S.C. §§ 161 and 1817 (national banks), 12 U.S.C. § 1464

Reserve System's Reporting Central application within 45 days of the reporting

Comptroller of the Currency, and the Federal Deposit Insurance Corporation

(federal savings associations), 12 U.S.C. §§ 248(a), 1844(c), and 3906 (state

date for March 31, June 30, and September 30, and within 50 calendar days of the

are of the view that individual respondent information reported on this form is

member banks and bank holding companies); 12 U.S.C. §§ 1467a(b)(2) and

December 31 reporting date. Any FFIEC 009 respondent who needs guidance on

exempt from public disclosure under Section (b)(8) of the Freedom of

5412 (savings and loan holding companies); 12 U.S.C. 5365(a) (intermediate

Reporting Central is encouraged to visit the Federal Reserve System website

Information Act (5 U.S.C. § 552 (b)(8)). Accordingly, individual respondent

holding companies); and 12 U.S.C. §§ 1817 and 1820 (insured state

, for additional

information reported on this form will be considered confidential and will not be

nonmember commercial and savings banks and insured state savings

information.

voluntarily disclosed by the Office of the Comptroller of the Currency, the

associations).

Federal Reserve System, or the Federal Deposit Insurance Corporation.

Each report submitted should be signed and certified by an executive officer

of the reporting institution. "Executive Officer" is defined in 12 C.F.R. § 215.2

(e)(1). To fulfill the signature and attestation requirement for the Country

Exposure Report for this report date, attach a signed copy of this page (or a

Name (FCEX C490)

photocopy or a computer-generated version of this page) to the paper-copy

, an authorized officer

record of the completed report that the respondent places in its files.

Title (FCEX C491)

of the reporting institution named above, hereby certify on the

Name, title, and phone number of the person to whom inquiries regarding this

day of

, that this

report may be directed:

Charter Number (National Banks Only) (FCEX 9055)

Day (FCEX FT23)

Month (FCEX FT24)

Year (FCEX FT25)

report has been examined by me and is true and complete to the best of my

knowledge and belief.

Name (FCEX 8901)

Reporting Institution (FCEX 9017)

Title (FCEX C496)

Area Code / Phone Number (FCEX 8902)

City (FCEX 9130)

State (FCEX 9200)

Signature (FCEX H321)

Legal Entity Identifier (LEI) of the Reporting Institution(Report only if the reporting institution already

has an LEI.) (FCEX 9224)

Public reporting burden for this collection of information is estimated to average 131 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. A federal agency may not conduct or sponsor, and

an organization (or a person) is not required to respond to a collection of information, unless it displays a currently valid OMB control number. Comments concerning the accuracy of this burden estimate and suggestions for reducing this burden should be directed to the Office of Information and Regulatory Affairs, Office of Management

and Budget, Paperwork Reduction Project, Washington, DC 20503, and to one of the following: Secretary, Board of Governors of the Federal Reserve System, 20th and C Streets, NW, Washington, DC 20551; Assistant Executive Secretary, Federal Deposit Insurance Corporation, Washington, DC 20429; and Legislative and Regulatory

Analysis Division, Office of the Comptroller of the Currency, Washington, DC 20219.

09/2016