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Tic Form S - Monthly Report To The Federal Reserve Bank - Purchases And Sales Of Long-Term Securities By Foreigners

MONTHLY REPORT TO THE FEDERAL RESERVE BANK

International Capital Form S

Name of Reporting Entity:

DEPARTMENT OF THE TREASURY

Office of the Assistant Secretary for

International Affairs

PURCHASES AND SALES OF LONG-TERM

ID Number:

Revised January 2001

Form Approved

OMB Control No. 1505-0001

SECURITIES BY FOREIGNERS

No person is required to respond to any U.S.

As of date:

Government collection of information unless the

form displays a currently valid control number

assigned by the Office of Management and

Budget (OMB).

Legal basis and confidentiality statement:

Please type or print:

Important notes:

This report is required by law (22 U.S.C. 286f; 22 U.S.C.

3103; E.O. 10033; 31 C.F.R. 128.1 (a)).

Failure to report

Name of contact if we have questions:

•

Before preparing this report, please read the

can result in a civil penalty of not less than $2,500 and not

General and Specific Instructions carefully.

more than $25,000. Willful failure to report can result in

criminal prosecution and upon conviction a fine of not more

than $10,000; and, if an individual, imprisonment for not

Contact’s phone number:

•

This report is due no later than the fifteenth calendar

more than one year, or both. Any officer, director,

employee, or agent of any corporation who knowingly

day following the last day of the month.

participates in such violation may, upon conviction, be

punished by a like fine, imprisonment, or both (22 U.S.C.

Name and Title of Officer Authorized to Sign Report

3105 (a) and (b); 31 C.F.R. 128.4 (a) and (b)).

•

Amounts should be reported in millions of dollars as

Data reported on this form will be held in confidence by the

of the close of the last business day of the month.

Department of the Treasury, the Board of Governors of the

Please read carefully and sign below:

Federal Reserve System, and the Federal Reserve Banks

•

acting as fiscal agents for the Treasury.

The data reported

Additional copies of this form, the instructions, and

by individual respondents will not be published or otherwise

_____________________________________,

the answers to Frequently Asked Questions can be

publicly disclosed; information may be given to other

(Signature of Officer Authorized to Sign Report)

Federal agencies, insofar as authorized by applicable law

obtained at the following web site:

of the reporting institution do hereby declare that the

(44 U.S.C. 3501 et seq.; 22 U.S.C. 3101 et seq.).

Treasury International Capital S report for this report

Aggregate data derived from reports on this form may be

date has been prepared in conformance with the

published or otherwise disclosed only in a manner that will

instructions and is true to the best of my knowledge

not reveal the amounts reported by any individual

and belief.

respondent.

Tic Form S - Monthly Report To The Federal Reserve Bank - Purchases And Sales Of Long-Term Securities By Foreigners

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