CA DFI SCHEDULE U

Document Sample
CA DFI SCHEDULE U Powered By Docstoc
					Department of Financial Institutions Form 506 (9/06)

SCHEDULE U - REPORT ON FIDUCIARY ACTIVITIES IN CALIFORNIA AND RELATED SECURITY DEPOSITED WITH THE STATE TREASURER OF CALIFORNIA (for use by national banks, federal savings banks, and foreign (other state) banks authorized to engage in trust business in California)

DFI File #………………………………………
1. Name of Institution…………………………… 2. Address of Principal Place of Business in 1.

California: a) Number and Street……………………… b) City………………………………………. c) Zip Code ………………………………… Indicate whether the population of the city 3. in which the institution's principal place of business in California is located exceeds 100,000 persons? (Yes or No) ……………………………………..
4. Home State……………………………………… 5. Primary Internet Web Address………………. 6. Primary Regulator…………………………...… 7. Person to Whom Inquiries May Be Directed:

2.a. 2.b. 2.c.

3. 4. 5. 6. 7.a. 7.b. 7.c. 7.d. 7.e. 7.f. 7.g. 7.h.

a) Name………………………………………. b) Title………………………………………… c) Telephone Number (Including Area Code) d) Number and Street……………………….. e) City…………………………………………. f) State………………………………………… g) Zip Code…………………………………... h) Email……………………………………….

Name of Institution Report As Of (Date)
-

Page 1of 2

Department of Financial Institutions Form 506 (2/03)

Trust Business for Which Money or Securities Are on Deposit with the State Treasurer of California
(Column A) (Column B)

Court Trusts
(as defined by Section 1581 of the California Financial Code)

Private Trusts
(as defined by Section 1581 of the California Financial Code)

(000's)
P.1. Total Value of Trust Funds and Property Held in the P.2. P.3. P.4.

(000's)
P.1. P.2. P.3.

P.5. P.6.

Institution's California Trust Business………...…….. Less: Real Property Held in the Institution's California Trust Business…………………………… Trust Funds and Property Held for Which Security is Required…………………………………………… Amount of Security Required To Be Deposited With the State Treasurer of California by Sections 1540 and 1541of the California Financial Code ………… Market Value of Money and Securities on Deposit With the State Treasurer of California ……………… Excess or Deficiency

P.4. P.5. P.6.

Certification - The undersigned,
Name Title

Name

Title

of the above named Institution, each declares, for himself alone and not for the other: I have personal knowledge of the matters contained in this report and I believe that each statement in this report is true. Each of the undersigned, for himself alone and not for the other, hereby certifies under penalty of perjury that the foregoing is true and correct.

Executed on (enter date)

Executed on (enter date)

in the County of in the State of Signature

in the County of in the State of Signature

Name of Institution 0 Report As Of (Date) 1/0/1900
Page 2 of 2


				
DOCUMENT INFO
Shared By:
Categories:
Stats:
views:95
posted:1/13/2008
language:English
pages:2