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Date of Examination

By Dale Mason,2014-12-06 12:28
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Date of Examination

DIVISION OF BANKING CONVERSION EXAMINATION INFORMATION REQUEST

     Asset Review Date:

     Financial Information Date (Quarter End):

    Examiner-in-Charge:

    The information requested should be ready by:

NOTE: Any records taken off bank premises by the examiners will need to be on a disk,

    photocopies or printouts generated for the examiners. An examiner will pick up this

    information, along with the completed formal and informal questionnaires, after phoning

    to arrange a compatible date. If so arranged, you may be asked to mail or ship the data.

    Please label and sort the information according to the corresponding letter and number

    (i.e., L-1 thru P-10).

Loan and lease information as of the Asset Review Date

     L-1 Loan download disk in unedited format.

     L-2 Complete the separate “Loan Data Request Form” or provide similar data to describe

    the fields if your bank is providing loan data on disk. Do not duplicate work being done

    by the servicer.

     L-3 A loan reconcilement explaining the way loan sold participations are handled on the

    bank’s system. Include the general ledger as of the Asset Review Date as referenced in

    G-1.

     L-4 Provide an index to any codes used within the loan download.

     L-5 Copy of the most recent bank watch loan list/problem loan list.

     L-6 Large Line or Loan Relationship Report.

     L-7 Copy of the most recent Allowance for Loan and Lease Loss analysis & methodology.

     L-8 Overdue loans and leases (all loan types) (including credit cards, if applicable).

     L-9 Nonaccrual loans and leases (all loan types).

     L-10 If borrower statements are available in Excel or by Farm Equity Manager program,

    please provide a disk with the most recent statements.

     L-11 Only if requested by examiner verbally should you provide hard copies of loan trial

    balance or mortgage trial balance.

Other Real Estate/Other Assets Include this data as of the Asset Review Date and Financial

    Information Date (quarter end)

     O-1 Other real estate owned (include balances and properties carried at zero balance).

    Securities Provide this data as of the Financial Information Date:

     S-1 Complete listing of individual securities (security inventory). Include the reconcilement.

    Provide amortized and market values, including the source or support for market values.

    1 (March 2006)

DIVISION OF BANKING CONVERSION EXAMINATION INFORMATION REQUEST

General Ledger Accounts Provide this data as of date requested

     G-1 General ledger/balance sheet for the Asset Review Date, the Financial Information Date,

    and the prior two year ends.

     As of the Financial Information Date, please provide details of any items in Other

    Assets or Other Liabilities that cannot be identified from the trial balance.

     G-2 Income statement for the Asset Review Date, the Financial Information Date, and the

    prior two year ends. If any income or expense accounts are more fully described on a

    subsidiary ledger, please provide this information.

Affiliates

     A-1 Most current balance sheet and income statement of the bank’s holding company and

    any consolidated subsidiaries.

     A-2 A current list of shareholders, officers, and directors of the bank’s holding company and

    any other affiliates.

     A-3 All contracts or information on fee or rental relationships with affiliates.

     A-4 Details on holding company debt holder, terms, and balance.

Policies and Other Management Reports

We would prefer to obtain and retain a copy of the following on disk or on paper.

     P-1 The rate sensitivity/gap analysis (as of the Financial Information Date, if possible).

     P-2 Minutes from the prior two years. We prefer to obtain these on disk or a copy for our

    retention. We do not need copies of supplementary pages, just the secretary’s minutes.

    At a minimum, please provide a copy of the last annual shareholder and director

    meetings.

     P-3 A list of bank committees if not included in the copy of minutes provided to us.

     P-4 Oath of Directors and List of Elected Officials from last annual shareholder meeting and

    current list of bank shareholders.

     P-5 Please complete the biographical information sheet included in the packet on Directors

    and Officers.

     P-6 The latest amended or approved policies covering the following:

    ? Loan

    ? Investment ? ALLL ? Liquidity, Funds or Asset/Liability Management

    ? Dividend ? Wire Transfer

    ? BSA ? OFAC

    ? Customer Identification Program

     P-7 The bank’s strategic plan or plans provided by consultants.

     P-8 If the bank’s holding company has performed any internal reviews, provide report.

     P-9 CPA examinations or special loan reviews from the prior two years. Include:

     ? The engagement letter from external firm.

     ? Any management letter provided with the results.

    ? Internal Auditors’ reports to the Board.

     P-10 The bank’s organizational chart.

     P-11 A Board of Directors’ monthly meeting packet on disk or hard copy.

    2 (July 2004)

DIVISION OF BANKING CONVERSION EXAMINATION INFORMATION REQUEST

    Additional Information Requested

     A. If the bank is a defendant in any lawsuits, including counterclaims, obtain a recent letter

    from the attorney handling the suit summarizing the case, giving names of plaintiffs,

    amount sued for, nature or basis of the litigation, and probable results with estimated

    loss, if any.

     B. Provide details surrounding Other Borrowed Money: source, amounts, terms, rates, and

    collateral pledged, along with the verification of balances from the creditor. If FHLB

    borrowings are held, please provide a copy of the Advance Monthly Statement report.

     C. List any off-premise electronic data processing services being utilized.

    3 (July 2004)

DIVISION OF BANKING CONVERSION EXAMINATION INFORMATION REQUEST

    D. Indebtedness to this Bank of Officers, Principal Shareholders and Directors

     of this Bank and Bank Holding Company Executive Officers or Directors

     (As of Asset Review Date)

     (Designate Indirect Debt with an *)

     Terms (Origination & Maturity Direct/Indirect* Interest Dates, Payment Provision, Name & Position or Title Amount Rate Security & Purpose)

    4 (July 2004)

DIVISION OF BANKING CONVERSION EXAMINATION INFORMATION REQUEST

E. DIRECTORS

     AST LITLE/ TITY/ URRENT POUSES CCSNAME YEARS NSTATE SALARY AME OCCUPATION BONUS

    5 (December 2007)

FFICERS AND EMPLOYEES (NOT DIRECTORS) O

AST L URRENT POUSES CSNAME TITLE CITY/STATE YEARS N SALARY AME BONUS

6 (July 2004)

FFICERS AND EMPLOYEES (NOT DIRECTORS) O

AST L URRENT POUSES CSNAME TITLE CITY/STATE YEARS N SALARY AME BONUS

7 (July 2004)

    Biographical Information Complete on all Directors and Officers

NAME:

TITLE:

1. Date of election to the board or date employment began.

2. Year of birth.

3. Responsibilities within the bank.

    4. Past work experience (dates of employment, positions held, names and locations of

    employers, etc.).

5. Educational background (include banking schools, etc.).

6. Length of residence in community and/or area.

7. Names and descriptions of other business interests.

8. Any other pertinent information.

    8 (July 2004)

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