Looking for a District Of Columbia Legal Forms And Templates? Download it for free!

Board of Governors of the Federal Reserve System

OMB Number 7100-0224 Approval expires October 31, 2016

OMB Number 3064-0093 Approval expires May 31, 2019

Federal Deposit Insurance Corporation

OMB Number 1557-0184 Approval expires July 31, 2019

Office of the Comptroller of the Currency

Page 1 of 1

OFFICIAL USE

Notice by Financial Institutions of Termination of Activities

as a Government Securities Broker or

Government Securities Dealer—Form G-FINW

This notice is required by law (15 U.S.C. §§ 78o-5(a)(1)(b)).

An 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.

1. Appropriate regulatory agency (check one):

Comptroller of the Currency

Board of Governors of the Federal Reserve System

Federal Deposit Insurance Corporation

Securities and Exchange Commission

2. A. Full name of the financial institution:

B. Address of principal office of financial institution:

C. Mailing address if different from B:

Address

City

State

Zip Code

City

State

Zip Code

3. Furnish the name and address of the person who has or will have custody or possession of the financial institution's books and records

with respect to the financial institution's activities as a government securities broker or government securities dealer:

Full Name

Address

City

State

Zip Code

4. Furnish the address of the place where such books and records will be located:

Address

City

State

Zip Code

5. The financial institution submitting this notice of termination of activities and the person executing it represent

that all of the information contained herein is true, current, and complete.

Please print name and title of person executing this notice:

Name (First, Middle, Last)

Title

Signature

Date

For further information on the requirements to file this notice, please refer to the instructions.

Public reporting burden for this collection of information is estimated to average 15 minutes per response, including the time for reviewing instructions, searching existing data sources, gath-

ering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of the collection of

information, including suggestions for reducing this burden, to the Office of Information and Regulatory Affairs, Office of Management and Budget, 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 (Administration), Room F-400,

Federal Deposit Insurance Corporation, 550 17th Street, NW, Washington, DC 20429; Legislative and Regulatory Analysis Division, Office of the Comptroller of the Currency, 400 7th Street,

SW, Washington, DC 20219; or to Securities and Exchange Commission, 450 Fifth Street, NW, Washington, DC 20549.

08/2016