Filing Position Bank / Thrift Charter Bank / Resolution Trust Corporation / Federal Savings / Loan Yes No Insurance Corporation / /
Country
United States / /
Currency
USD / /
IndustryTerm
foreign bank / bank / savings bank / industrial bank / federal deposit insurance application / cooperative bank / /
Organization
Comptroller of the Currency / Board of Governors of the Federal Reserve System / Any / Federal Deposit Insurance Corporation / office of Management and Budget / office of Supervision Policy / U.S. Securities and Exchange Commission / FDIC / Subject Institution / NASD / Legal Division / United States government / Licensing Activities Division / /
Person
Physician / /
Position
Executive Officer / Director Senior / Governor / officer / director / organizer / / trustee / or principal shareholder or owner / senior executive officer / Attorney / Physician / director / Manager / director / senior executive officer / Director Citizenship Waiver Charter Conversion Deposit Insurance Federal Branch / Comptroller / director of a depository institution / Management official / GENERAL INFORMATION AND INSTRUCTIONS This Interagency Biographical and Financial Report / senior executive officer / or similar position / Principal Shareholder Trustee Manager / Organizer Director / director position / representative / trustee / Secretary / honorary director / branch manager / Attorney / /
OMB No. for FDIC[removed]OMB No. for FRB[removed]OMB No. for OCC[removed]OMB Nos. for OTS[removed], -0015, -0047 Expiration Date: [removed]