Form Appointive Directo Appointive Directo Federal Home Loan Bank Appointive Director Application F

FEDERAL HOME LOAN BANK APPOINTIVE
DIRECTOR APPLICATION FORM

PERSONAL INFORMATION

Full name:

_________________________________________________________________

Address:

_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
__________________________________________________________________

Current employment:
______________________________________

___________________________________

Name of organization

Your title or position

______________________ ______________________

______________________________

Telephone number

E-mail address

Fax number

_________________________________

________________

__________

____________

Street

City

State

Zip code

__________________________________

________________

__________

___________

Mailing address (if different)

City

State

Zip code

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STATUTORY ELIGIBLITY REQUIREMENTS
An individual must satisfy certain statutory requirements in order to be eligible for appointment
to the board of a Federal Home Loan Bank (Bank). The requirements relate to citizenship,
residency, and, for prospective community interest directors, experience in that field. The statute
also prohibits an appointive director from having certain financial interests in an institution that
is a member of the Bank on whose board the director serves. The questions below address these
statutory requirements.
1. Citizenship. Are you a citizen of the United States?

Yes ___ No ___

2. Residency. In order to be an appointive director you must be a bona fide resident of a state
that is within the geographic district of the Bank on whose board you wish to serve. You will
satisfy this requirement if your principal residence is located within that geographic district (A),
or if you own or lease a second residence within the district and are employed within the district
(B). Please indicate the basis you are using to demonstrate bona fide residence.
A. Is your principal residence located within the Bank’s geographic district? Yes ___ No ___
B. If you answered No, do you own or lease a second residence within the Bank’s district
and are you employed within the district? Yes ___ No ___
If so, provide the address of your second home, the name and address of your employer, and
your title or position.
Second home address: _________________________________________________________

_____________________________________________________________________________
Employer information:
______________________________________

___________________________________

Name of organization

Your title or position

______________________ ______________________

______________________________

Telephone number

E-mail address

Fax number

_________________________________

________________

__________

____________

Street

City

State

Zip code

__________________________________

________________

__________

___________

Mailing address (if different)

City

State

Zip code

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3. Community Interest Directors. If you are seeking appointment as a community interest
director, you must be able to demonstrate that you are a director, officer, employee, or member
of an organization that has represented consumer or community interests on banking services,
credit needs, housing, or financial consumer protections for at least two years.
If you meet this requirement, provide the name and address of the organization, specify your
association with the organization, and describe how the organization has represented consumer
or community interests for the past two years.
______________________________________

___________________________________

Name of organization

Your title or position

__________________________________

________________

__________

____________

Street

City

State

Zip code

Describe how the organization represents consumer or community interests:
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________

4. Conflicts of interest. The statute prohibits an appointive director from serving as an officer
or director of any member of the Bank on whose board the appointive director serves. The
statute also prohibits an appointive director from owning shares or having certain other financial
interests in any such member. You will have to give up any conflicting position and divest any
conflicting financial interest before you can become a Bank director.
For purposes of this conflict of interest provision, the term:
“Member” includes the member institution itself and any subsidiary of the member. If the
member is owned by a holding company, the term “member” includes the holding company if 35
percent or more of the holding company’s assets, on a consolidated basis, are attributable to
institutions that are members of the Bank on whose board the appointive director serves. Thus,
you may not own stock in, or serve as a director or officer of, a holding company if one or more
members of your Bank constitute 35 percent or more of the holding company’s assets.

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“Financial interest” is broadly defined and includes any “direct or indirect financial interest in
any activity, transaction, property, or relationship that involves receiving or providing something
of monetary value,” and “any right, contractual or otherwise, to the payment of money.” It does
not include:
•

Financial interests that arise in the normal course of business with a member and are on terms
generally available to the public, such as having money on deposit with, or obtaining a loan
from, a member.

•

Ownership of shares of a registered investment company (mutual fund) that owns debt or
equity instruments issued by a member.

•

Ownership of shares through a managed account (held by an investment adviser registered
under the Investment Advisers Act of 1940), provided the adviser has complete investment
discretion and you neither are affiliated with the adviser nor have control over the selection
of securities.

•

Contractual rights to the payment of money if the amount due to you is less than 10 percent
of your adjusted gross income for a calendar year.

“Direct” financial interest includes any interest that you hold in your own name, either as a sole
or joint owner.
“Indirect” financial interest includes interests of your spouse or minor child(ren) and interests
held through a trust or similar arrangement that are attributed to you.
A. Please specify each position or financial interest you, your spouse, or minor child(ren)
have in any member of the Bank on whose board you would serve.
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
B. Do you agree to give up positions and divest interests that are deemed to be conflicting
financial interests before becoming an appointive director of that Bank? Yes ___ No ___

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SELECTION CRITERIA
The Banks are multi-billion dollar financial institutions, the principal business of which is to
borrow funds in the capital markets and then provide secured loans to their members. The size
and nature of the Banks’ business requires each Bank to have a board of directors that possesses
expertise in areas such as capital markets transactions, asset/liability management, the use of
derivatives, accounting and financial modeling, mortgage markets, affordable housing,
community investment, and legal/regulatory compliance. In making appointments to the boards
of the Banks, the Finance Board seeks individuals who have broad business leadership
experience, are financially literate, and have a commitment to serving on the board, as well as
experience in one or more of the above areas.
1. Leadership Experience. Bank directors should have experience in senior management or
policy-making in one or more fields of business, government, education, or community/civic
affairs, and should have a record of achievement in their chosen profession or field of business.
This experience should provide directors with the ability to understand the business of the Bank,
to act independently, and to ask Bank management appropriate questions about how they are
conducting Bank business.
A. If you have ever served as the CEO, CFO, COO, or in a similar capacity for a business
enterprise, or as a dean or senior faculty member at a prominent college or university, or as a
senior official for a federal or state government or prominent nonprofit organization, please
provide the details for those positions, including the dates of service and the positions held.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
B. If you have other experience dealing with issues such as developing or implementing
business strategies, overseeing regulatory compliance, corporate governance, or board
operations, or have previously served on the board of a large business enterprise, please
describe those experiences.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

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C. If you have other significant business or professional achievements that demonstrate your
ability to lead an organization please describe them.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
2. Business Knowledge. Bank directors must be financially literate, meaning they must be
familiar with how financial statements and various financial ratios are used in managing a
business enterprise, how basic accounting conventions apply to the Bank, and how internal
controls are used to manage risk. They also must have some knowledge about one or more of
the areas of the Bank’s business, such as mortgage finance, capital markets transactions,
accounting/modeling practices, affordable housing, community and economic development, and
legal and regulatory compliance.
A. Do you know how to read and understand a financial statement, and do you understand
how financial ratios and other indices are used for evaluating the performance of a business
enterprise? Yes ___ No ___
If you answered Yes, please describe the setting in which you gained that knowledge.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

B. Do you have a working familiarity with basic finance and accounting practices, including
internal controls and risk management? Yes ___ No ___
If you answered Yes, please describe the setting in which you acquired that knowledge.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
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C. Do you have experience with financial accounting and corporate finance, particularly
with a publicly traded company? Yes ___ No ___
If you answered Yes, please describe that experience.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
D. Do you have experience in capital market transactions?

Yes ___ No ___

If you answered Yes, please describe that experience.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
E. Do you have experience in an organization providing financing for residential mortgages,
housing for low or moderate income individuals and families, or real estate development?
Yes ___ No ___
If you answered Yes, please describe that experience.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
F. Have you served in any position that required an understanding of the legal and other
fiduciary obligations associated with being an independent director? Yes ___ No ___
If you answered Yes, please describe that experience.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

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G. The mission of the Banks is to support the housing finance activities of their members,
which includes residential mortgage finance and community and economic development
lending activities. Please describe any prior experience that is related to the mission of the
Banks.
______________________________________________________________________________
______________________________________________________________________________
__________________________________________________________________________
3. Commitment to Service. In order to serve effectively on the board of a Bank, a director must
be able to attend the meetings of the board of directors and subcommittees on which the director
serves, and to devote the time necessary to prepare for those meetings.
A. Do you have any other business or professional commitments that would hinder your
ability to prepare for and attend board of director and committee meetings? Yes ___ No ___
If so, please describe the constraints on your ability to serve.
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
B. If you serve on any other corporate boards, please provide the name and location of the
organization, your role (e.g., chair and committee assignments), and the term of service.

________________________________

________________________ ______________

Name of organization

Your role

Term

________________________________

________________________ ______________

Name of organization

Your role

Term

________________________________

________________________ ______________

Name of organization

Your role

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Term

4. Personal Integrity. Character is an important consideration in evaluating any prospective
Bank director. All directors must have high ethical standards and integrity in both their personal
and professional dealings. Please indicate whether you ever have been convicted of a felony,
been found to have violated any federal or state civil laws relating to the securities, banking,
housing or real estate industries, or have had a professional license suspended or revoked.
Yes ___ No ___ If you answered Yes, please explain.
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
5. Independence. It is essential that an appointive director be able to act independently of
management in overseeing the policy and operations of a Bank, and not have any relationships
that may create actual or apparent conflicts of interest. Please disclose whether you have any
familial or business relationships with any members of Bank management or the board of
directors of the Bank, and any other relationship(s) that might lead a reasonable person to
question your independence. Yes ___ No ___
If you answered Yes, please explain below.
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
6. Other Experience and Education. Please provide a copy of your resume that describes other
business, professional, or educational achievements that are not described in the responses to the
questions above.
BY EXECUTING AND SUBMITTING THIS APPLICATION FORM, YOU ARE
CERTIFYING THAT THE INFORMATION YOU PROVIDED IS TRUE, CORRECT,
AND COMPLETE TO THE BEST OF YOUR KNOWLEDGE AND THAT YOU AGREE
TO SERVE AS A DIRECTOR IF APPOINTED.

___________________________________
Signature

______________________________
Date
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