Form Summary of Deposit Summary of Deposit Summary of Deposits

OMB Number: 3064-0061
Expires: 07/31/2017

SUMMARY OF DEPOSITS
As of Close of Business June 30, 2016

State

Cert

Institution

Uninum

Instructions: Please read the attached instructions before you fill out this form. Report amounts of deposits in thousands. Total deposits for all offices must equal total deposits on
the June 30, 2016 Report of Condition sent to your main regulatory agency. Make a copy for your files.
SUMMARY OF DEPOSITS

REPORT OF CONDITION

US BRANCHES OF FOREIGN BANKS

TOTAL DEPOSITS =

SCHEDULE RC ITEM 13.A + DEPOSITS IN OTHER AREAS

SCHEDULE E ITEM 6 A & C

Office Number

Change
Code

Effective Date
CCYY/MM/DD

Service Type

Office Name & Address
County

(CONTINUED ON NEXT PAGE)

CEN
Code

MAILING ADDRESS

Consolidated
Office

Total Deposits

OMB Number: 3064-0061
Expires: 07/31/2017

SUMMARY OF DEPOSITS
As of Close of Business June 30, 2016

Office Number

Change
Code

Effective Date
CCYY/MM/DD

State

Cert

Institution

Uninum

Office Name & Address
Service Type

CEN Code
County

(CONTINUED ON NEXT PAGE)

Consilidated
Office

Total Deposits

OMB Number: 3064-0061
Expires: 07/31/2017

SUMMARY OF DEPOSITS
As of Close of Business June 30, 2016

Office
Number

Change
Code

Effective Date
CCYY/MM/DD

State

Cert

Institution

Uninum

Office Name & Address
Service Type

9999

County

CEN
Code

Consolidated
Office

Total Deposits

TOTAL DEPOSITS FOR ALL OFFICES

I have verified this statement according to the instructions provided, and attest that it is correct and complete to the best of my knowledge and belief and that the deposit totals agree
with those reported on the June 30, 2016 Report of Condition.

Preparer / Contact Name and Telephone Number (Please Print)

Authorized Official Signature

Date