OMB No. 7100-0339
Expiration Date: 02/28/2013
Docket Number: ___________
OFFICE OF THRIFT SUPERVISION
NOTICE OR APPLICATION FOR CAPITAL DISTRIBUTION
PAPERWORK REDUCTION ACT STATEMENT
The Office of Thrift Supervision (OTS) will use this form to acquire information concerning the
amount of capital that an institution intends to distribute, pursuant to 12 C.F.R. § 563 Subpart E
of the OTS regulations.
Public reporting burden for this collection of information is estimated to average 16.5 minutes per
response, including the time for reviewing instructions 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
Thrift Supervision, Corporate & International Activities, 1700 G Street, N.W., Washington, D.C.
20552; and to the Office of Management and Budget, Paperwork Reduction Project (7100-0339),
Washington, D.C. 20503.
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Page 1 of 2
OTS Form 1583
Revised November 2008