| FY 2009 CDFI Program Combined Application | ||
| Chart Workbook Table of Contents | ||
| Chart | Description | Who Needs to Complete… |
| Request Form | Applicant Request Form | All Applicants |
| A | Matching Funds Data Chart | Applicants seeking FA. Not Required for TA-Only Applicants |
| B | Matching Fund Retained Earnings Calculator Charts * B1 for Non-Regulated CDFIs * B2 for Credit Unions * B3 for Banks, Thrifts, & Holding Companies |
Applicants seeking FA. Not Required for TA-Only Applicants |
| C | Technical Assistance Request Summary Chart | Applicants seeking TA (alone or with FA) |
| D | Activities Level Chart | All Applicants |
| E | Community Development Impact Chart | All Applicants |
| F | Financial Data Input and Financial Ratios Chart * F1 for Non-Regulated Applicants * F2 for Credit Union Applicants * F3 for Banks, Thrifts, & Holding Companies |
All Applicants |
| G | Loan Portfolio Quality Chart | All Applicants with Loan Portfolios (Optional for Regulated Institutions) |
| H | Equity Investment Portfolio Valuation Chart | All Applicants with Equity Investment Portfolios |
| CERTIFICATION OF MATCHING FUNDS | ||
| By completing the attached Matching Fund charts, the Applicant certifies that the figures and information contained Charts A, B1, B2, and B3 of the FY 2009 application submitted by the Applicant (as applicable) are true, complete, and accurate to the best of the Applicant’s knowledge. The funds that the Applicant proposes to use as Matching Funds in Chart A have not been used by the Applicant to satisfy a legal requirement under another Federal grant or award program. All income received by the Applicant from Federal sources and from Matching Funds sources identified in Chart A during the applicable years is identified along with related expenses in Charts B1, B2, and B3 (as applicable). | ||
| FY 2009 CDFI Program Application Request Form | |||||||
| Instructions: Yellow cells are automatically calculated based on entries made in the green cells. Make entries in green cells only. Update TA totals on Chart C to see new totals on this chart. | |||||||
| Organization Name | |||||||
| Enter full name of Applicant organization: | |||||||
| Award Request | |||||||
| Total Award Request: | #VALUE! | ||||||
| Financial Assistance Budget | |||||||
| Intended Use of Funds | Form of Award | Total Request | |||||
| Loan | Grant | Equity | Shares/ Deposits |
Secondary Capital | |||
| Total FA Request | $0 | ||||||
| Technical Assistance Budget Populated from Data in Chart C. Changes to TA Budget must be made in Chart C |
|||||||
| Budget Category | Amount | ||||||
| A. Personnel (Salary) | $0 | ||||||
| B. Personnel (Fringe Benefits) | $0 | ||||||
| C. Training | $0 | ||||||
| D. Travel | $0 | ||||||
| E. Professional Services | #VALUE! | ||||||
| F. Materials / Supplies | $0 | ||||||
| G. Equipment and Other Capital Expenditures | $0 | ||||||
| H. Other Costs | $0 | ||||||
| Total TA Request | #VALUE! | ||||||
| A. Matching Funds Data Chart | |||||||
| Instructions: Detailed instructions and a sample chart can be found in the Application. Review those carefully and have Matching Funds documents available when completing this chart. Remember the following important points: 1) Fill in only one "Amount" column for each row. The date entry should correspond to the amount column and match status as explained in the Application instructions. 2) If the Matching Funds are from a state and/or local government agency, Applicants must provide the contact name, title, and phone number of the Matching Funds source in the far right column. Use same column for any additional comments relevant to the Matching Funds entry. 3) The appropriate Retained Earnings calculator (charts B1, B2, or B3) must be completed if the Applicant includes a Retained Earnings entry in this chart. 4) If additional rows are needed insert them in the middle of the table so that the "Total" formulas are automatically updated. |
|||||||
| Name of Source | Type | Amount In-Hand | Amount Committed | Amount to be Raised | Date | Comments & Contact Data | |
| Totals | 0 | 0 | 0 | ||||
| Equity Investment | |||||||
| Grant | |||||||
| Loan | |||||||
| Secondary Capital | |||||||
| Shares/Deposits | |||||||
| Retained Earnings | |||||||
| B1. Retained Earnings Calculator Chart (Non-Regulated Applicants) |
|||||
| Instructions: This chart must be completed by any non-regulated (for- or non-profit) Applicant proposing to use retained earnings as a matching funds source. The Applicant must demonstrate in this chart that the proposed retained earnings meet the following criteria: (1) No federal funds are being proposed as part of the retained earnings. (2) Applicant is not double-counting match fund sources in Chart A (list of match fund sources). (3) Matching Funds meet applicable FY guidelines (see NOFA). |
|||||
| The Applicant's electronic signature on SF-424 attests that all information reported in the Retained Earnings chart is accurate at the time of application. To the extent possible, the Fund will verify the table entries against the financial statements provided with the application. The information reported here is subject to audit; therefore, Applicant must be accurate in reporting Federal income and associated expenses. | |||||
| Non-regulated Applicants have two options for calculating Retained Earnings: (A) The increase in Retained Earnings over the Applicant's most recently completed fiscal year; or (B) The annual average increase in Retained Earnings over the Applicant's three most recently completed fiscal years. |
|||||
| Fill out the data for each of the fiscal years. | |||||
| ● Yellow cells automatically calculate based on entries made in the green cells. Complete green cells for each fiscal year using line items from the Applicant's financial statements and historical accounting records. | |||||
| ● The chart assumes the Applicant's most recently completed fiscal year is 2007. If the most recently completed fiscal year is 2008, adjust the fiscal years by changing 2007 to 2008 – the other years will update automatically. | |||||
| ● Rows A and E should be found on the Income Statements. Other rows may need to be calculated or researched from accounting records. | |||||
| ● Itemize income associated with federal sources under Line B. Itemize income that the Applicant is also using as a source of match (as reported on Chart A) on line C. If additional rows are needed for reporting itemized data (Line B and Line C), add rows from middle of the section in order to maintain the sum formula on line B or C. | |||||
| A positive result in either of line J Col 3 or Line K Col 3 can be proposed as "Retained Earnings" match in Chart A. | |||||
| Col 1 | Col 2 | Col 3 | Col 4 | ||
| Line | Financial Data | 2005 | 2006 | 2007 | |
| A | Total Operating Income/Revenue | ||||
| B | LESS Income from Federal Sources (Itemize source and amount in the lines below. Add additional lines as necessary) |
0 | 0 | 0 | |
| C | LESS Income listed as Matching Funds on Chart A (Itemize source and amount in the lines below. Add additional lines as necessary) |
0 | 0 | 0 | |
| D | Subtotal: Adjusted Operating Income/Revenue | 0 | 0 | 0 | |
| E | Total Operating Expenses | ||||
| F | LESS Total Expenses Associated with Lines B and C (Itemize source and amount in the lines below. Add additional lines as necessary) |
0 | 0 | 0 | |
| G | LESS Dividends Paid Out (For-profit CDFIs only) | ||||
| H | Subtotal: Adjusted Operating Expenses | 0 | 0 | 0 | |
| I | TOTAL RETAINED EARNINGS (D-H) | 0 | 0 | 0 | |
| Either Result Below Can Be Used for FY 2009 Application | |||||
| J | Retained Earnings Increase from Most Recent FYEnd | $0 | |||
| K | Three Year Average Retained Earnings Increase | $0 | |||
| Notes for Line Items | |||||
| (A): Operating income for a nonprofit CDFI is limited to unrestricted revenue. It includes revenue sources available for the day-to-day operating activities of the company, but excludes investment income. (C): Deduct the value of any grants, loans, etc., listed as match sources in Chart A and received in the applicable FY. (F): Only include those expense items charged against the income sources included on lines B and C. (I): "Retained Earnings" is a term used on for-profit balance sheets. For nonprofit CDFIs, the term is most equivalent to the unrestricted portion of Net Assets on the balance sheet. |
|||||
| B2. Retained Earnings Calculator Chart for Credit Unions | |||||
| Overview: This chart must be completed by any credit union Applicant proposing to use retaining earnings as a source of matching funds. The Applicant's electronic signature provided upon submission of the SF-424 (application form) attests that all information reported in the Retained Earnings chart is accurate at the time of application. To the extent possible, the Fund will verify the table entries against the Applicant's 5300 Report data, including the PCA Net Worth Calculation Worksheet. | |||||
| Options: Credit Unions have three options for calculating Retained Earnings: (A) The increase in Retained Earnings over the Applicant's most recently completed fiscal year; (B) The annual average increase in Retained Earnings over the Applicant's three most recently completed fiscal years; or (C) Retained Earnings accumulated since the Applicant's inception. |
|||||
| Eligibility: The Applicant must demonstrate in this chart that the proposed retained earnings meet the following criteria: (1) No federal funds are being proposed as part of the retained earnings. (2) Applicant is not double-counting match fund sources in Chart A (list of match fund sources). (3) Matching Funds meet applicable FY guidelines (see NOFA). |
|||||
| Tips on Filling out the Table | |||||
| ● The chart assumes the Applicant's most recently completed fiscal year is 2007. If the most recently completed fiscal year is 2008, adjust the fiscal years by changing 2007 to 2008 – the other years will update automatically. | |||||
| ● Complete green cells under each applicable column heading using line items from the Applicant's 5300 Call Reports and other historical accounting records. Yellow cells automatically calculate based on entries made in the green cells. | |||||
| ● For options (A) or (B) fill in all four fiscal years of data (Col 2, 3, 4, and 5). For option (C), the "Since Inception" option, the Applicant need only complete column 5, the most recent FYEnd data to calculate the "Since Inception" amount. | |||||
| ● Lines D and E are provided to help the Applicant back out the items mentioned in the Eligiblity section above. Itemize any federal sources on the lines below D. Itemize any funds that are reported on the Chart A Matching Funds request on lines below E. The entries will be totalled above. If additional rows are needed for reporting itemized data for Lines D and E, add rows from the middle of the section in order to maintain the sum formulas within the chart. | |||||
| Additional Requirement for Option (C): For Insured Credit Unions using option (C), the Applicant must ALSO increase its member and/or non-member shares or total loans outstanding by an amount that is equal to the amount of Retained Earnings that is committed as Matching Funds by the end of the Awardee’s second performance period, as set forth in its Assistance Agreement. For example, if Retained Earnings since inception is equal to $50,000 and the Applicant designates the entire amount as match, the Applicant must increase its total member/non-member shares or loans outstanding by $50,000. Note the following: | |||||
| ● The Fund will assess the likelihood of this increase during the application review process. An award will not be made to any Applicant that has not demonstrated that it has increased shares or loans by at least 25 percent of the requested FA award amount between December 31, 2007 and December 31, 2008, as demonstrated by the corresponding NCUA report. | |||||
| ● An Applicant using option (C) must discuss its strategy for raising the required shares or loans in Question #7 of the Comprehensive Business Plan component of the FY 2009 application. | |||||
| Col 1 | Col 2 | Col 3 | Col 4 | Col 5 | |
| Line | Call Report and other Financial Data | 2004 | 2005 | 2006 | 2007 |
| A | Total Net Worth (from PCA Net Worth Calculation Worksheet) | ||||
| B | LESS Uninsured Secondary Capital (from PCA…) | ||||
| C | Subtotal Retained Earnings (A-B) |
$0 | $0 | $0 | $0 |
| Adjustments | |||||
| D | LESS Federal Funds included in line C above. Itemize source and amount in the lines below. Add additional lines as necessary. |
$0 | $0 | $0 | $0 |
| E | LESS Matching Funds on Chart A included in line C above. Itemize source and amount in the lines below. Add additional lines as necessary. |
$0 | $0 | $0 | $0 |
| F | Subtotal of Adjustments (D+E) | $0 | $0 | $0 | $0 |
| G | Adjusted Retained Earnings (C-F) | $0 | $0 | $0 | $0 |
| H | Change Over Prior Year | N/A | $0 | $0 | $0 |
| Any of the Results Below Can Be Used As Match: | |||||
| I | Retained Earnings Increase from Most Recent FYEnd: | $0 | |||
| J | Three Year Average Retained Earnings Increase: | $0 | |||
| K | Retained Earnings Since Inception: | $0 | |||
| B3: Retained Earnings Calculator Chart for Banks, Thrifts, and Holding Companies |
|||||
| Instructions: This chart must be completed by any bank, thrift, holding company Applicant proposing to use retained earnings as a matching funds source. The Applicant must demonstrate in this chart that the proposed retained earnings meet the following criteria: (1) No federal funds are being proposed as part of the retained earnings. (2) Applicant is not double-counting match fund sources in Chart A (list of match fund sources). (3) Matching Funds meet applicable FY guidelines (see NOFA). |
|||||
| The Applicant's electronic signature on SF-424 attests that all information reported in the Retained Earnings chart is accurate at the time of application. The Fund will verify the table entries against the financial statements provided with the application or data on the FFIEC website. The information reported here is subject to audit; therefore, Applicant must be accurate in reporting Federal income and associated expenses. | |||||
| Bank, thrift, and holding company Applicants have two options for calculating Retained Earnings: (A) The increase in Retained Earnings over the Applicant's most recently completed fiscal year; or (B) The annual average increase in Retained Earnings over the Applicant's three most recently completed fiscal years. |
|||||
| Fill out the data for each of the fiscal years. | |||||
| Yellow cells automatically calculate based on entries made in the green cells. Complete green cells for each fiscal year using line items from the Applicant's financial statements and historical accounting records. | |||||
| The chart assumes the Applicant's most recently completed fiscal year is 2007. If the most recently completed fiscal year is 2008, adjust the fiscal years by changing 2007 to 2008 – the other years will update automatically. | |||||
| Rows A and E should be found on the Income Statements. Other rows may need to be calculated or researched from accounting records. | |||||
| Itemize income and expenses associated with federal sources under Line B. Itemize income that the Applicant is also using as a source of match (as reported on Chart A) on line A. If additional rows are needed for reporting itemized data (Line B and Line C), add rows from middle of the section in order to maintain the sum formula on line B or C. | |||||
| A positive result in either of line J Col 3 or Line K Col 3 can be proposed as "Retained Earnings" match in Chart A. | |||||
| Col 1 | Col 2 | Col 3 | Col 4 | Col 5 | |
| Line | Call Report Data | 2004 | 2005 | 2006 | 2007 |
| A | Retained earnings (Line 16c from Holding Company report FR Y-9SP; line 20d from FR Y-9LP; Schedule RC, line 26a from Bank Call Report) |
||||
| B | Accumulated other comprehensive income (Line 16d from Holding Company report FR Y-9SP; line 20e from TFR Y-9LP; Schedule RC, line 26b from Bank Call Report) |
||||
| C | Other noninterest income (Schedule RI, TFR, line 5l from Call Report) |
||||
| D | LESS Income from Federal Sources (Itemize source and amount in the lines below. Add additional lines as necessary) |
||||
| E | LESS Income listed as Matching Funds on Chart A (Itemize source and amount in the lines below. Add additional lines as necessary) |
||||
| F | Eligible Retained earnings for purposes of CDFI Program matching funds calculation | $0 | $0 | $0 | $0 |
| Either Result Below Can Be Used for FY 2009 Application | |||||
| G | Retained Earnings Increase from Most Recent Fiscal Year | $0 | |||
| H | Three Year Average Retained Earnings Increase | $0 | |||
| C. TA Budget Chart | |||||
| Identify all items and / or tasks to be financed with the TA grant. A detailed description, justification, and explanation of the calculation methodology for the amount requested for each entry must be included in the TA Proposal (TAP) section of the application. Provide the requested information for each requested use. Complete a separate entry for each individual use. Insert more rows above the appropriate subtotal line if additional rows are needed. Additional instructions (and a sample chart) can be found in the FY 2009 Combined CDFI Program application. | |||||
| Requested TA may not be expended prior to September 2008 | |||||
| A. Personnel (Salary) | |||||
| Under Name, list the staff person's name for which salary is requested. Under Position, identify the staff person's title. Under Computation, list the annual salary rate and the percentage to be covered by the requested TA grant (which should correspond to the percentage of time to be devoted to an identified project / task or for carrying out CDFI-related activities as described in the narrative justification). Under Cost, list the total salary amount calculated using the methodology described under Computation. List each staff person on a separate line. | |||||
| Name | Position | Computation | Cost | ||
| Personnel (Salary) Sub-Total: | $0 | ||||
| B. Personnel (Fringe Benefits) | |||||
| Fringe benefits are for personnel listed in cost category (A). Under Name, list the staff person's name for which fringe benefits are requested. Under Position, identify the staff person's title. Under Computation, identify the source of the calculation, list the annual amount of fringe benefits and the percentage to be covered by the requested TA grant (which should correspond to the percentage of time to be devoted to an identified project / task or for carrying out CDFI related activities as described in the narrative justification). Under Cost, list the total amount of fringe benefits calculated using the methodology described under Computation. List each staff person on a separate line. | |||||
| Name | Position | Computation | Cost | ||
| Personnel (Fringe Benefits) Sub-Total: | $0 | ||||
| C. Training | |||||
| List each training class or course funded by the TA grant separately by the name of the training. Under Name of Training, identify the name of the training event. Under Training Provider, identify the name of the training provider. Under Computation, identify all items to be covered by the TA grant including costs of tuition, fees, training materials, and text books (travel, subsistence, and salary for staff attending the training should be reflected in the Travel and Personnel categories). Under Cost, list the total cost computed for each training event calculated using the methodology described under Computation. | |||||
| Name of Training | Training Provider | Computation | Cost | ||
| Training Sub-Total: | $0 | ||||
| D. Travel | |||||
| List each travel expenses by purpose (e.g., consultant travel, staff to training, field interviews, advisory group meetings, etc.). Under Location, identify the location of travel, if known. Under Computation, show the basis of computation. The computation must include: the length of the trip, the number of people traveling, and the unit costs involved (i.e., the cost of transportation, the cost of lodging, and the cost of subsistence). Applicants that have indicated on Chart C that they will apply Federal travel policies must follow appropriate GSA rates. Under Cost, list the total cost of each trip calculated using the methodology described under Computation. | |||||
| The following type of travel policies will be used by the Applicant: | Federal | Internal | |||
| Purpose of Travel | Location | Computation | Cost | ||
| Travel Sub-Total: | $0 | ||||
| E. Professional Services | |||||
| Itemize each cost by task performed or service provided. Under Name of Provider, enter the name, if known, of the consultant/contractor. Under Task, enter a brief description of the services to be provided. Under Computation, show the basis for the total cost (e.g., hourly or daily fee times estimated time on the project). Professional Service fees covered by the TA grant cannot exceed the daily or hourly rate equivalent to the ES-4 federal salary if that service was not obtained through a competitive bid. The current rates can be found at the Office of Personnel Management website at www.opm.gov. | |||||
| The following type of procurement policies will be used by the Applicant: | |||||
| Name of Provider | Task | Computation | Cost | ||
| Professional Services Sub-Total: | $0 | ||||
| F. Materials and Supplies | |||||
| List items by type (office supplies, postage, training materials, copying paper, and expendable equipment items less than $5,000, such as books, hand held tape recorders). Under Computation, show the basis for the total cost (i.e., number of units times the per unit value). Under Cost, list the cost calculated under Computation. | |||||
| Item | Computation | Cost | |||
| Materials and Supplies Sub-Total: | $0 | ||||
| G. Equipment and Other Capital Expenditures | |||||
| List equipment to be purchased with the TA grant by each individual item. Under Item, list the equipment to be purchased. Under Vendor, list the name of the vendor, if known. Under Computation, list the per unit cost times the number of units to be purchased. Peripherals costing less than $250 should be added into the cost of the main item to be purchased (such as the computer or copier). List computer software separately from computer hardware. Under Cost, list the cost calculated under computation. | |||||
| Item | Vendor | Computation | Cost | ||
| Equipment Sub-Total: | $0 | ||||
| H. Other Costs | |||||
| List items by cost category as descibed in OMB Circular A-122. Under Expense, indicate the cost category as described in A-122. Under Description, enter a brief explanation of the proposed use to be funded by the TA grant. Under Computation, enter the basis of the computation including all associated direct costs. Under Cost, enter the requested amount obtained using the calculation methodology under Computation. | |||||
| Category | Description | Computation | Cost | ||
| Other Costs Sub-Total: | $0 | ||||
| Summary Totals by Category | |||||
| Budget Category | Amount | ||||
| A. Personnel (Salary) | $0 | ||||
| B. Personnel (Fringe Benefits) | $0 | ||||
| C. Training | $0 | ||||
| D. Travel | $0 | ||||
| E. Professional Services | $0 | ||||
| F. Materials / Supplies | $0 | ||||
| G. Equipment and Other Capital Expenditures | $0 | ||||
| H. Other Costs | $0 | ||||
| TOTAL TA Budget | $0 | ||||
| Credit Union Applicant Financial Data Input Chart | 2004 | 2005 | 2006 | 2007 | 2008 | 2009 | 2010 | 2011 | |||
| Assets | |||||||||||
| a | Cash on Hand | $- | $- | $- | $- | $- | $- | $- | |||
| b | Cash on Deposit | $- | $- | $- | $- | $- | $- | $- | |||
| c | Cash Equivalents | $- | $- | $- | $- | $- | $- | $- | |||
| d | Investments w/ Maturity or repricing period of less than 1 year | $- | $- | $- | $- | $- | $- | $- | |||
| e | Total Investments | $- | $- | $- | $- | $- | $- | $- | |||
| f | Total Loans and Leases | $- | $- | $- | $- | $- | $- | $- | |||
| g | Less: Allowance for Loan & Lease Losses | $- | $- | $- | $- | $- | $- | $- | |||
| h | Total Assets | $- | $- | $- | $- | $- | $- | $- | $- | ||
| Liabilities | |||||||||||
| I | Total Borrowings | $- | $- | $- | $- | $- | $- | $- | |||
| j | Accrued Dividends & Interest Payable in Shares and Deposits | $- | $- | $- | $- | $- | $- | $- | |||
| k | Accounts Payable and Other Liabilities | $- | $- | $- | $- | $- | $- | $- | |||
| l | Total Liabilities | $- | $- | $- | $- | $- | $- | $- | |||
| Shares/Deposits | |||||||||||
| m | Total Member Deposits | $- | $- | $- | $- | $- | $- | $- | |||
| n | Total Non-Member Deposits | $- | $- | $- | $- | $- | $- | $- | |||
| o | Total Shares and Deposits | $- | $- | $- | $- | $- | $- | $- | |||
| Equity | |||||||||||
| p | Undivided Earnings | $- | $- | $- | $- | $- | $- | $- | |||
| q | Regular Reserves | $- | $- | $- | $- | $- | $- | $- | |||
| r | Appropriation for Non-Conforming Investments (state-charted credit unions) | $- | $- | $- | $- | $- | $- | $- | |||
| s | Other Reserves | $- | $- | $- | $- | $- | $- | $- | |||
| t | Uninsured Secondary Capital | $- | $- | $- | $- | $- | $- | $- | |||
| u | Net Income (unless this amount is already included in Undivided Earnings) | $- | $- | $- | $- | $- | $- | $- | |||
| v | Total Net Worth | $- | $- | $- | $- | $- | $- | $- | |||
| Income and Expenses | |||||||||||
| w | Total Interest Income | $- | $- | $- | $- | $- | $- | $- | |||
| x | Total Interest Expenses | $- | $- | $- | $- | $- | $- | $- | |||
| y | Provision for Loan and Lease Losses | $- | $- | $- | $- | $- | $- | $- | |||
| z | Total Non-Interest Income | $- | $- | $- | $- | $- | $- | $- | |||
| aa | Total Non-Interest Expense | $- | $- | $- | $- | $- | $- | $- | |||
| bb | Net Income | $- | $- | $- | $- | $- | $- | $- | |||
| Financial Health and Viability - MPS Ratios | 2005 | 2006 | 2007 | 3-Year Historic Ratios | 2008 | 2009 | 2010 | 2011 | 3-Year Projected Ratios | ||
| cc | Net Worth Ratio | #DIV/0! | #DIV/0! | #DIV/0! | #DIV/0! | #DIV/0! | #DIV/0! | #DIV/0! | #DIV/0! | #DIV/0! | |
| dd | Deployment Ratio | #DIV/0! | #DIV/0! | #DIV/0! | #DIV/0! | #DIV/0! | #DIV/0! | #DIV/0! | #DIV/0! | #DIV/0! | |
| ee | Earnings | #DIV/0! | #DIV/0! | #DIV/0! | #DIV/0! | #DIV/0! | #DIV/0! | #DIV/0! | #DIV/0! | #DIV/0! | |
| ff | Asset Liability Management | #DIV/0! | #DIV/0! | #DIV/0! | #DIV/0! | #DIV/0! | #DIV/0! | #DIV/0! | #DIV/0! | #DIV/0! |
| Bank/Thrift/ Holding Co. Financial Data Input Chart | 2005 | 2006 | 2007 | 2008 | 2009 | 2010 | 2011 | |||
| Assets | ||||||||||
| a | Cash and balances due from depository institutions | $- | $- | $- | $- | $- | $- | $- | ||
| b | Short-term investments | $- | $- | $- | $- | $- | $- | $- | ||
| c | Total Investments | $- | $- | $- | $- | $- | $- | $- | ||
| d | Loans and Leases, net of unearned income | $- | $- | $- | $- | $- | $- | $- | ||
| e | Less: Allowance for Loan & Lease Losses | $- | $- | $- | $- | $- | $- | $- | ||
| f | Average Assets, year-to-date | $- | $- | $- | $- | $- | $- | $- | ||
| g | Long Term Assets | $- | $- | $- | $- | $- | $- | $- | ||
| h | Total Assets | $- | $- | $- | $- | $- | $- | $- | ||
| Liabilities | ||||||||||
| I | Interest-bearing deposits | $- | $- | $- | $- | $- | $- | $- | ||
| j | Total Deposits | $- | $- | $- | $- | $- | $- | $- | ||
| k | Total Notes Payable | $- | $- | $- | $- | $- | $- | $- | ||
| l | Non-Core Liabilities | $- | $- | $- | $- | $- | $- | $- | ||
| m | Other Liabilities | $- | $- | $- | $- | $- | $- | $- | ||
| n | Total Liabilities | $- | $- | $- | $- | $- | $- | $- | ||
| Equity Capital | ||||||||||
| o | Perpetual preferred stock | $- | $- | $- | $- | $- | $- | $- | ||
| p | Common Stock | $- | $- | $- | $- | $- | $- | $- | ||
| q | Surplus | $- | $- | $- | $- | $- | $- | $- | ||
| r | Undivided Profits | $- | $- | $- | $- | $- | $- | $- | ||
| s | Tier 1 Capital | $- | $- | $- | $- | $- | $- | $- | ||
| t | Tier 2 Capital | $- | $- | $- | $- | $- | $- | $- | ||
| u | Total Equity Capital | $- | $- | $- | $- | $- | $- | $- | ||
| Income and Expenses | ||||||||||
| v | Total Interest Income | $- | $- | $- | $- | $- | $- | $- | ||
| w | Total Interest Expenses | $- | $- | $- | $- | $- | $- | $- | ||
| x | Provision for Loan and Lease Losses | $- | $- | $- | $- | $- | $- | $- | ||
| y | Total Non-Interest Income | $- | $- | $- | $- | $- | $- | $- | ||
| z | Total Non-Interest Expense | $- | $- | $- | $- | $- | $- | $- | ||
| aa | Income (loss) before income taxes and extraordinary items and other adjustments | $- | $- | $- | $- | $- | $- | $- | ||
| bb | Net Income (loss) | $- | $- | $- | $- | $- | $- | $- | ||
| Financial Health and Viability - MPS Ratios | 2005 | 2006 | 2007 | 3-Year Historic Ratios | 2008 | 2009 | 2010 | 2011 | 3-Year Projected Ratios | |
| cc | Tier 1 Leverage Capital Ratio | #DIV/0! | #DIV/0! | #DIV/0! | #DIV/0! | #DIV/0! | #DIV/0! | #DIV/0! | #DIV/0! | #DIV/0! |
| dd | Deployment Ratio | #DIV/0! | #DIV/0! | #DIV/0! | #DIV/0! | #DIV/0! | #DIV/0! | #DIV/0! | #DIV/0! | #DIV/0! |
| ee | Earnings Ratio | #DIV/0! | #DIV/0! | #DIV/0! | #DIV/0! | #DIV/0! | #DIV/0! | #DIV/0! | #DIV/0! | #DIV/0! |
| ff | Asset Liability Management Ratio | #DIV/0! | #DIV/0! | #DIV/0! | #DIV/0! | #DIV/0! | #DIV/0! | #DIV/0! | #DIV/0! | #DIV/0! |
| G. Loan Portfolio Quality Chart | |||||||||||
| Instructions: Provide data for the overall total loan portfolio in the first table. Delinquency is defined as 90+ days past due for non-regulated Applicants and 12 + months past due for regulated Applicants. The other two tables are optional and allow the Applicant to provide portfolio data for up to two products within the portfolio. Applicants may choose to use these tables to demonstrate how a particular product's delinquency figures impact the overall portfolio. For example in one table the Applicant could summarize the business portfolio and in the 2nd the microenterprise portfolio. Enter information in the green shaded cells only. Insured Credit Unions and Insured Depository Institutions are NOT required to complete this chart. | |||||||||||
| Aggregate Portfolio | 2007 | 2006 | 2005 | 2004 | Weighted Average PAR: | ||||||
| # | $ | # | $ | # | $ | # | $ | ||||
| A | Portfolio Outstanding | ||||||||||
| B | Delinquent Portfolio | ||||||||||
| C | Total Portfolio-at-Risk (b / a) | 0.0% | 0.0% | 0.0% | 0.0% | 0.0% | 0.0% | 0.0% | 0.0% | #DIV/0! | |
| Optional Product: | 2007 | 2006 | 2005 | 2004 | Weighted Average PAR: | ||||||
| # | $ | # | $ | # | $ | # | $ | ||||
| A | Portfolio Outstanding | ||||||||||
| B | Delinquent Portfolio | ||||||||||
| C | Total Portfolio-at-Risk (b / a) | 0.0% | 0.0% | 0.0% | 0.0% | 0.0% | 0.0% | 0.0% | 0.0% | #DIV/0! | |
| Optional Product: | 2007 | 2006 | 2005 | 2004 | Weighted Average PAR: | ||||||
| # | $ | # | $ | # | $ | # | $ | ||||
| A | Portfolio Outstanding | ||||||||||
| B | Delinquent Portfolio | ||||||||||
| C | Total Portfolio-at-Risk (b / a) | 0.0% | 0.0% | 0.0% | 0.0% | 0.0% | 0.0% | 0.0% | 0.0% | #DIV/0! | |
| Loan Loss and Loan Reserve History for Aggregate Portfolio | 2007 | 2006 | 2005 | 2004 | Historic | ||||||
| A | Total Outstanding Loan Portfolio | ||||||||||
| B | Net Write-Offs or Net Charge-Offs | ||||||||||
| C | Annual Net Loan Loss Ratio (B/A) | 0.0% | 0.0% | 0.0% | 0.0% | 0.0% | |||||
| D | Loan Loss Reserve (cash) | ||||||||||
| E | Loan Loss Reserve (accrual) | ||||||||||
| F | Loan Loss Reserve Ratio ((D + E) / A)) | 0.0% | 0.0% | 0.0% | 0.0% | 0.0% | |||||
| H. Equity Investment Portfolio Valuation Chart | |||||||||
| Instructions: This table should be completed for all Equity Investments. Complete the green-shaded cells only. Enter information on your Equity Investment portfolio as of the last day of your organization's fiscal year for the last three years (if applicable), and the current year to date. Follow-on investments into the same company should be counted as unique investments. | |||||||||
| Investment Portfolio Measures | 2004 | 2005 | 2006 | 2007 | |||||
| Number | Dollars gained (lost) | Number | Dollars gained (lost) | Number | Dollars gained (lost) | Number | Dollars gained (lost) | ||
| A | Total number of Equity Investments and combined value of investments | $- | $- | $- | $- | ||||
| B | Equity Investments exited during the year | $- | $- | $- | $- | ||||
| C | Equity Investments written-off during the year | $- | $- | $- | $- | ||||
| D | Unrealized Gains (losses) | $- | $- | $- | $- | ||||
| E | Realized Gains (losses) | $- | $- | $- | $- | ||||
| F | Expected Rate of Return | ||||||||
| G | Actual Rate of Return (During period shown on chart). | ||||||||
| File Type | application/vnd.ms-excel |
| Last Modified By | mccalluma |
| File Modified | 2009-12-30 |
| File Created | 2003-01-30 |