THIS FORM HAS
BEEN APPROVED WITH THE UNDERSTANDING THAT A REQUEST OF EXTENSION
WILL BE SUBMITTED ONLY IF THIS FORM IS CONSOLIDATED WITH OTHER
FORMS RELATED TO CONVERSION OF A NATIONAL BANK ASSOCIATION. A
Inventory as of this Action
Requested
Previously Approved
06/30/1983
06/30/1983
12/31/1981
10
0
200
200
0
200
0
0
0
CONTAINS DATA NEEDED TO EVALUATE
SUBJECT APPLICATION.
On behalf of this Federal agency, I certify that
the collection of information encompassed by this request complies
with 5 CFR 1320.9 and the related provisions of 5 CFR
1320.8(b)(3).
The following is a summary of the topics, regarding
the proposed collection of information, that the certification
covers:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a
benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control
number;
If you are unable to certify compliance with any of
these provisions, identify the item by leaving the box unchecked
and explain the reason in the Supporting Statement.