Form FR Y-9ES FR Y-9ES Financial Statements for Employee Stock Ownership Plan B

FR Y-9 ES
OMB Number 7100–0128
Ave. hrs. per response: 0.50
Expires February 28, 2011

Board of Governors of the Federal Reserve System

Financial Statements for Employee Stock Ownership Plan Bank
Holding Companies—FR Y-9ES
Report at the close of business as of the last calendar day in December
This report is required by law: Section 5(c) of the Bank Holding
Company Act (12 U.S.C. 1844) and Section 225.5(b) of Regulation
Y [12 CFR 225.5(b)].
This report is to be filed by Employee Stock Ownership Plans that
also are bank holding companies. When such bank holding com-

panies are tiered bank holding companies, separate reports are
also to be filed by each of the subsidiary bank holding companies
as discussed in the instructions. The Federal Reserve may not
conduct or sponsor, and an organization (or a person) is not
required to respond to, a collection of information unless it displays a currently valid OMB control number.

NOTE: The Financial Statements for Employee Stock Ownership
Plan Bank Holding Companies must be signed by an authorized
officer of the Employee Stock Ownership Plan.

The Financial Statements for Employee Stock Ownership Plan
Bank Holding Companies is to be prepared in accordance with
the instructions provided by the Federal Reserve System.

I,

Date of Report:
Name and Title of Trustee or Other Authorized Representative of the ESOP

have reviewed the Financial Statements for Employee Stock Ownership Plan Bank Holding Companies filed by the named ESOP bank
holding company and believe that the report has been prepared in
accordance with instructions issued by the Federal Reserve.

Month / Date / Year (ESOP 9999)

Legal Title of ESOP BHC (TEXT 9010)

Signature of Trustee or Other Authorized Representative of the ESOP

(Mailing Address of the ESOP BHC) Street / P.O. Box (TEXT 9110)

Date of Signature

City (TEXT 9130)

State (TEXT 9200)

Zip Code (TEXT 9220)

Return to the appropriate Federal Reserve District Bank the completed original and the number of copies specified by that District Bank.
Person to whom questions about this report should be
directed:

Name / Title (TEXT 8901)

For Federal Reserve Bank Use Only
RSSD ID

Area Code / Phone Number (TEXT 8902)

C.I.
FAX Number (TEXT 9116)

E-mail Address of Contact (TEXT 4086)
Public reporting burden for this information collection is estimated to average .5 hours per response, including time to gather and maintain data in the required form and to
review instructions and complete the information collection. Comments regarding this burden estimate or any other aspect of this information collection, including suggestions
for reducing the burden, may be sent to Secretary, Board of Governors of the Federal Reserve System, Washington, D.C. 20551, and to the Office of Management and Budget,
Paperwork Reduction Project (7100–0128), Washington, D.C. 20503.

FR Y–9ES
Page 1

For Federal Reserve Bank Use Only
RSSD Number

Name of ESOP Bank Holding Company

C.I.

Financial Statements for
Employee Stock Ownership Plan Bank Holding Companies
The Statement of Changes in Net Assets is to be reported on a calendar year basis in thousands of dollars.

Schedule SC—Statement of Changes in Net Assets Available for Benefits
(for the Calendar Year)
Dollar Amounts in Thousands
ESOP

1. Net appreciation (depreciation) in fair value of investments:
a. Employer securities ...........................................................................................................
b. Other securities .................................................................................................................
2. Interest income ......................................................................................................................
3. Dividend income ....................................................................................................................
4. Employer contributions ..........................................................................................................
5. Participant contributions .........................................................................................................
6. Other additions .......................................................................................................................
7. Total additions (sum of items 1.a through 6) .......................................................................

Bil

Mil

Thou

C316
C317
C318
C319
C320
C321
3328
C323

1.a.
1.b.
2.
3.
4.
5.
6.
7.

C324
C330
C325
C326
C327

8.
9.
10.
11.
12.

13. Net increase (decrease) (item 7 minus item 12) .................................................................. C328
14. Beginning of year: net assets available for benefits ............................................................... C329
espt
15. End of year: net assets available for benefits (sum of item 13 and item 14) (must equal
C342
Schedule SB, item 15) ...........................................................................................................

13.
14.

8.
9.
10.
11.
12.

Interest expense ....................................................................................................................
Insurance expense .................................................................................................................
Distributions paid to participants ............................................................................................
Other deductions ....................................................................................................................
Total deductions (sum of items 8 through 11) ......................................................................

Schedule SB—Statement of Net Assets Available for Benefits

Dollar Amounts in Thousands
ESOP

ASSETS
1. Cash and cash equivalents (including money market instruments) .......................................
2. Bank holding company securities:
a. Equity securities ................................................................................................................
b. Debt securities ..................................................................................................................
3. Bank securities:
a. Equity securities ................................................................................................................
b. Debt securities ..................................................................................................................
4. Securities (other than securities reported in items 1, 2, 3, and 9) ..........................................
5. Employer’s contribution receivable ........................................................................................
6. Participants’ contribution receivable .......................................................................................
7. Dividends and interest receivable ..........................................................................................
8. Cash surrender value of life insurance ..................................................................................
9. Other assets ...........................................................................................................................
10. Total assets (sum of items 1 through 9)................................................................................

15.

Bil

Mil

Thou

C322

1.

C331
C332

2.a.
2.b.

C333
C334
C335
C336
C337
C363
C009
C338
2170

3.a.
3.b.
4.
5.
6.
7.
8.
9.
10.

C339
C340
C341
2948

11.
12.
13.
14.

NET ASSETS AVAILABLE FOR BENEFITS
15. Net assets available for benefits (item 10 minus item 14) .................................................. C342

15.

LIABILITIES
11. Loans payable ........................................................................................................................
12. Interest payable .....................................................................................................................
13. Other liabilities .......................................................................................................................
14. Total liabilities (sum of items 11 through 13) ........................................................................

12/02

FR Y–9ES
Page 2

Schedule SB-M—Memoranda
1. Sponsoring employer

M.1.
(TEXT 9152)

Number

ESOP
2. Shares held by ESOP:
a. Total number of bank shares held by ESOP .................................................................... C343

M.2.a.
Percentage

b. Percentage of bank shares held by ESOP included in 2.a................................................

7285

c. Number of bank shares allocated to ESOP participants ...................................................
d. Total number of bank holding company shares held by ESOP .........................................

C344
C345

e. Percentage of bank holding company shares held by ESOP included in 2.d ...................

7286

f. Number of bank holding company shares allocated to ESOP participants .......................

C346

.

% M.2.b.

Number

M.2.c.
M.2.d.
Percentage
.

% M.2.e.

Number

3. Amount of ESOP debt reported as contra-equity by the sponsoring employer or unearned
ESOP shares on:
a. Bank Report of Condition .................................................................................................. C347
b. Bank holding company balance sheet .............................................................................. C348

M.2.f.
Bil

Mil

Thou

M.3.a.
M.3.b.
Year (CCYY)

C349

4. Year ESOP was initially adopted ............................................................................................
a. Accounted for under AICPA Statement of Position 76-3 or Statement of Position 93-6
(Enter “1” for SOP 76-3; enter “2” for SOP 93-6) ...................................................................................... C350

M.4.
M.4.a.

Number

b. Total number of plan participants as of December 31 of the report year ..........................

C351

Bil
Mil
5. Estimated employer liability for payment of plan benefits/distributions within two (2) years
C352
after December 31 of the report year .....................................................................................
6. The net amount of plan participant balances eligible for diversification under the
diversification requirement ..................................................................................................... C353
7. Did the plan engage in any transaction with parties-in-interest during the current report year?
(Enter “1” for yes; enter “0” for no) ................................................................................................................. C354
8. Has there been a change in plan trustees or the plan administrative committee during the current
report year? (Enter “1” for yes; enter “0” for no) ............................................................................................ C355

M.4.b.
Thou

M.5.
M.6.
M.7.
M.8.

12/03

FR Y–9ES
Page 3

Notes to the Financial Statements for Employee Stock Ownership Plan Bank Holding Companies
Enter in the lines provided below any additional information on specific line items on the financial statements that the Employee Stock
Ownership Plan bank holding company wishes to explain, that has been separately disclosed in the bank holding company’s Reports to
Shareholders, in its press releases, or in its Form 5500.
Also include any transactions which previously would have appeared as footnotes to the Statement of Net Assets Available for Benefits and
the Statement of Changes in Net Assets Available for Benefits. Each additional piece of information disclosed should include the appropriate
reference to schedule and item number, as well as a description of the additional piece of information and the dollar amount (in thousands
of dollars) associated with that disclosure.
Example
Qualifying employer real estate that is not considered part of compensation expense by the employer is contributed to the ESOP.

TEXT

0000

ESOP

Bil

0000

Notes to the Financial Statements
1.

TEXT
C356

2.

C357

3.

C358

4.

C359

5.

C360

Mil

Thou

1

490

Schedule SC, item 4 (noncash contribution): Qualifying employer
real estate

Dollar amount in thousands
ESOP

Bil

Mil

Thou

C356

1.

C357

2.

C358

3.

C359

4.

C360

5.

12/02