NCUA 4501 A NCUA Profile

NATIONAL CREDIT UNION ADMINISTRATION
ALEXANDRIA, VA 22314-3428
OFFICIAL BUSINESS

Credit Union Profile
Form 4501A
Effective December 31, 2023 Until Superseded
Version 2023.1

TO THE BOARD OF DIRECTORS:
This booklet contains the NCUA Form 4501A, Credit Union Profile. The effective date of this form is December
31, 2023 and will remain in effect until superseded. Instructions and quarterly filing dates are available on the
NCUA's website at www.ncua.gov. Credit union contacts of record will continue to receive quarterly email
notifications of the cycle highlights.
The Profile Reporting Instructions page contains the filing requirements. Please note, the Profile must be
certified in conjunction with the filing of the Form 5300 Call Report. 

If you have any non-technical questions, please contact your NCUA Regional Office or your state credit union
supervisor, as appropriate. Please direct technical questions to OneStop, the NCUA's IT Service Desk, by
email at OneStop@ncua.gov or phone at 1-800-827-3255.

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Effective December 31, 2023
Previous Editions are Obsolete

Report Date: ______________
Federal Charter/Certificate Number:___________

Credit Union Name:___________________
Reporting Requirements

Provide Updated Information: In accordance with NCUA regulations part 741, insured credit unions are required to update their profile
information within 10 days of the election or appointment of senior management and volunteer officials, or within 30 days of any change.

Records Retention: Credit unions should retain a copy of the information used to complete the profile as a part of the permanent records of
the credit union.
The instructions to prepare this form meet the requirement to provide guidance to small credit unions under Section 212 of the Small
Business Regulatory Enforcement Fairness Act of 1996.

Paperwork Reduction Act Statement
The estimated average public reporting burden associated with this information collection is 2 hours per response. Comments concerning
the accuracy of this burden estimate and or any other aspect of this information collection, including suggestions for reducing this burden
should be addressed to the:
National Credit Union Administration
Office of General Counsel
Attn: PRA Clearance Officer
1775 Duke Street
Alexandria, VA 22314-3428
An agency may not conduct or sponsor, and a person is not required to respond to, an information collection unless it displays a valid OMB
control number.

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NCUA Profile Form 4501A
Effective December 31, 2023
Previous Editions Are Obsolete

Report Date: ______________
Federal Charter/Certificate Number:___________

Credit Union Name:___________________
Certification

I understand each operating insured credit union must update their credit union profile within 10 days after the election or appointment of
senior management or volunteer officials, or within 30 days of any change of the information in the profile. I hereby certify to the best of my
knowledge and belief the information provided is current and accurate. I make this certification pursuant to sections 106, 120, and 204 of the
Federal Credit Union Act (12 U.S.C. 1756, 1766, and 1784).

Certified By

Last Name:

First Name:
Certified Correct By

Date:

Please Print

Full Name :
Certified Correct By (Signature)

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Page 1

Report Date: ______________
Federal Charter/Certificate Number:___________

Credit Union Name:___________________

Certify Compliance
Minimum Security Devices and Procedures - NCUA Regulations Part 748
Federally Insured Credit Unions Only
I hereby certify to the best of my knowledge and belief that this credit union has developed and administers a security program that equals or
exceeds the standards prescribed by part 748.0 of the NCUA regulations; that such security program has been reduced to writing, approved
by this credit union's Board of Directors; and this credit union has provided for the installation, maintenance, and operation of security devices,
if appropriate, in each of its offices. Further, I certify that I am the president or managing official of the credit union or that the president or
managing official has authorized me to make this submission on his/her behalf.

Certified By
Last Name:

First Name:

Date:

Certified By (Please Print)
Job Title :
Please Print
Full Name :
Certified By (Signature)

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Report Date: ______________
Federal Charter/Certificate Number:___________

Credit Union Name:___________________
General Information
1. Select the type of credit committee the credit union has:
a. Elected

b. Appointed

c. No Committee

2. Provide the credit union's Employer Identification Number (EIN) :
3. Provide the Research Statistics Supervision and Discount (RSSD) ID number issued by
the Board of Governors of the Federal Reserve System.
4. Provide the credit union's Legal Entity Identifier (LEI):
5. Is your credit union a member of the Federal Home Loan Bank?
a. Yes

b. No

6. Has your credit union filed an application to borrow from the Federal Reserve Bank Discount Window?
a. Yes

b. No

7. Has your credit union pre-pledged collateral with the Federal Reserve Bank Discount Window?
a. Yes

b. No

8. Does your credit union sponsor a qualified defined benefit plan?
a. Yes

b. No

9. Does your credit union participate in a multiemployer defined benefit plan?
a. Yes

b. No

10. Is your credit union's anti-money laundering monitoring system automated, manual, or a combination of these?
a. Automated

b. Manual

c. Combined

11. Minority Depository Institution Questions
Are more than 50% of your credit union’s current and eligible potential members Asian American, Black American, Hispanic American, or Native
American? If yes, please identify the minority group(s) that apply:
a. Asian American

b. Black American

c. Hispanic American

d. Native American

Is more than 50% of your credit union’s board of directors Asian American, Black American, Hispanic American, or Native American? If yes, please
identify the minority group(s) that apply:
a. Asian American

b. Black American

c. Hispanic American

d. Native American

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Report Date: ______________
Federal Charter/Certificate Number:___________

Credit Union Name:___________________
Contacts and Roles

The credit union must provide information for the Mandatory Job Titles and Mandatory Roles listed below. These individuals may be officials, volunteers, or
employees of the credit union. NCUA will not release information regarding mailing addresses, email addresses, phone numbers, and fax numbers to the
public. Please reference the Profile Instructions for additional guidance.

Provide information for the following:
Mandatory Job Titles
Manager or CEO
Board Chairperson
Board Vice Chairperson
Board Treasurer
Board Members

Mandatory Roles

Supervisory Committee Chairperson
Supervisory Committee Members
Credit Committee Chairperson
Credit Committee Members

Call Report Contact
Profile Contact
Primary Emergency Contact
Secondary Emergency Contact
Information Security Contact

Primary Patriot Act Contact
Secondary Patriot Act Contact
Third Patriot Act Contact (optional)
Fourth Patriot Act Contact (optional)

1. Salutation*
2. First Name*

4. Last Name*

3. Middle Initial

5. Job Titles - * Indicates the credit union is required to provide information for these mandatory job titles .
a. Manager or CEO*

b. Board Chairperson*

c. Board Vice Chairperson*

d. Board Secretary

e. Board Treasurer*

f.

g. Supervisory Committee Chairperson*

h. Supervisory Committee Member*

i. Credit Committee Chairperson, if applicable*

j.

Credit Committee Member, if applicable*

k. Chief Financial Officer

l.

Chief Information Officer

m. Internal Auditor

n. Other

6. Does the manager or CEO also manage a different credit union?

Board Member*

a. Yes

b. No

7. Roles - * Indicates the credit union is required to provide information for these mandatory roles .
a. Volunteer

b. General Credit Union Contact

c. Call Report Contact*

d. Profile Information Contact*

e. Primary Patriot Act Contact*

f.

g. Third Patriot Act Contact, optional

h. Fourth Patriot Act Contact, optional

i. Primary Emergency Contact*

j.

Secondary Emergency Contact*

k. Credit Union Employee

l.

Information Security Contact*

m. Cyber Incident Notication Contact, primary*

n. Cyber Incident Notication Contact, secondary*

Secondary Patriot Act Contact*

8. Credit Union Employment Type* - The credit union is required to provide the employment type for all Mandatory Job Titles and Roles .
a. Full-time

b. Part-time

c. Volunteer

9. Home Address Information* - The credit union is required to provide this information for all Mandatory Job Titles
Address Line 1:
Address Line 2:
City:

State:

Home country:

Home email:

Home phone:

Home cell:

Postal Code:
Home fax:

10. Work Address Information - The credit union is required to provide a work phone number for all Mandatory Roles
Address Line 1:
Address Line 2:
Postal Code:

City:

State:

Work country:

Work email:

Work cell:

Work phone*:

Work extension:

Work fax:

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Report Date: ______________
Federal Charter/Certificate Number:___________

Credit Union Name:___________________
Sites

The section of the profile is a mandatory section and must include the following site types and site functions:
Site Types
· Corporate Office
· Branch Office(s)

Site Functions
· Vital Records Center
· Location of Records
· Disaster Recovery

Mandatory fields are identified with an asterisk (*). Please reference the instructions for additional guidance.
1. *Site Name:
2. *Operational Status:

a. Normal

b. Planned

c. Suspended - Emergency

3. *Site Type:

a. Corporate Office

b. Branch Office

c. Other (Please Specify)

4. *Is Main Office:

a. Yes

b. No

5. *Hours of Operation:
6. *Physical Address:

Address Line 1:
Address Line 2:
City / State / Postal Code:
County

Country

Same as Physical Address

7. *Mailing Address:

Same as Main Office address

Address Line 1:
Address Line 2:
City / State / Postal Code:

8. *Phone Numbers:

County

Country

Phone

Extension

Fax
9. *Site Function(s):

Non-Public Site Functions

Public Site Functions (published in
the Credit Union Locator)

a. Disaster Recovery Location

i. Shared Service Center/Network

b. Location of Records

j. ATM

c. Vital Records Center

k. Drive Thru

d. Backup Generator

l. Member Services

e. Future Office
f. Hot Site
g. Planned Evacuation Site
h. Other

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Report Date: ______________
Federal Charter/Certificate Number:___________

Credit Union Name:___________________

Payment System Service Provider (PSSP) Information
1. Select the credit union's Primary Settlement Agent (i.e., Member share draft clearing, ACH transactions, etc. -- See Instructions)
a. Federal Reserve Bank

b. CUSO

c. Corporate Credit Union

d. Federal Credit Union

e. Bank

f. Other Credit Union

g. Not Applicable
2. Select the name of the main payment system service provider.
a. If other was selected, please specify
3. Identify the payment service(s) provided by the main payment system service provider. (check all that apply)
a. Share Draft Processing and Settlement

b. Credit Card Processing and Settlement

c. Wire Transfers

d. ATM and Debit Processing and Settlement

e. Electronic Funds Transfer and Direct Deposit

f. Other (Please Specify)

4. Select the name(s) of additional payment system service providers.
a. If other was selected, please specify
5. Have you changed or do you plan to change payment system service providers within the next 12 months?
a. Yes

b. No

6. Select the name of the new provider :
a. If other was selected, please specify
7. Identify payment service(s) affected by this change. (check all that apply)
a. Share Draft Processing and Settlement

b. Credit Card Processing and Settlement

c. Wire Transfers

d. ATM and Debit Processing and Settlement

e. Electronic Funds Transfer and Direct Deposit

f. Other (Please Specify)

8. Systems used to process electronic payments (check all that apply)
a. Fedline Solutions

b. Corporate Credit Union

c. Correspondent Bank

d. CUSO

e. Clearing House Interbank Payments System (CHIPS)

f. EPN

g. Other (Please Specify)

9. If the credit union performs ACH transfers, are they domestic, international, or both? (check all that apply):
a. Domestic

b. International

10. If the credit union is an Originating Depository Financial Institution, what types of ACH transactions are originated by the credit union? (check all that
apply):
a. PPD - Prearranged Payment and Deposit Entry

b. WEB - Internet Initiated/Mobile Entry

c. TEL - Telephone Initiated Entry

d. IAT - International ACH Transactions

e. Other Consumer Entry Codes

f. Other Business Entry Codes

11. If the credit union performs wire transfers, are they domestic, international, or both? (check all that apply):
a. Domestic

b. International

12. Which method(s) can a member use to initiate electronic payments (e.g. wire transfer, ACH, etc.) from the credit union (check all that apply):
a. Email

b. Fax

c. Online Banking

d. Telephone

e. In Person

f. Other (Please Specify)

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Report Date: ______________
Federal Charter/Certificate Number:___________

Credit Union Name:___________________
Information Technology (IT)
1. Does the credit union have a website?

a. Yes

b. No

a. Internal

b. External

a. Informational Website

b. Mobile Application

a. Website Address :

2. Where is the website hosted ?
3. Provide the name of the external website vendor :
4. Select the service(s) offered :

c. Online Banking

5. If a credit union has online or mobile banking, how many members use it?
6. Which wireless networks, if any, does the credit union operate:
a. Public or Guest Network

b. Private or Restricted Network

7. Data Processing System used to maintain credit union records:
a. Manual System

b. Vendor Supplied In-House System

c. Vendor Online Service Bureau

d. CU Developed In-house System

8. Name of the primary share/loan data processing vendor:
9. If the credit union has undergone or plans to undergo a Core Data Processing Conversion, please provide the following:
a. Date of Conversion:
b. Core Processor Converting/Converted to:

10. Select the service(s) the credit union offers electronically:
a. External or Third-Party Account Aggregation

b. Bill Payment

c. Person-to-Person

d. Electronic Signature Auth./Cert.

e. E-Statements

f. External Transfers/Payments - ACH

g. Loan Payments

h. Member Application

i. Point-of-sale Processing

j. Mobile Payments

k. Loan Application

l. New Share Account

m. Remote Deposit Capture

n. Other (Please Specify)

11. Cloud Services (check all that apply):
a. Infrastructure as a Service

12. Email Services (check one only):
a. On-premises

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b. Platform as a Service

c. Software as a Service

b. Cloud

c. Hybrid

NCUA Profile Form 4501A
Effective December 31, 2023
Previous Editions Are Obsolete

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Report Date: ______________
Federal Charter/Certificate Number:___________

Credit Union Name:___________________
Regulatory Information
1. Please provide the date of the most recent annual meeting held by the credit union:

2. Please provide the effective date of the most recent supervisory committee or financial statement audit:
3. Please select the last type of audit performed for the credit union's records:
a. Financial statement audit performed by state licensed persons
b. Supervisory Committee audit performed by state licensed persons
c. Supervisory Committee audit performed by other external auditors
d. Supervisory Committee audit performed by the supervisory committee or designated staff
4. Provide the name of the Audit Firm or Auditor (see instructions)
5. Please provide the effective date of the most recent Supervisory Committee verification of member's accounts :
6. Who completed the verification of member's accounts:

a. Supervisory Committee

b. Third Party

7. Provide your Supervisory Committee contact information for public/official correspondence
Mailing Address:

Email:

Mailing City:

State:

Zip Code:

8. Provide the effective date of the most recent Bank Secrecy Act Independent Test:
9. Indicate the Fidelity Bond Provider Name :
10. Indicate the amount of Fidelity Coverage for any Single Loss (RR 713.5):
11. Please provide Section 701.4 certification date (Federal Credit Unions Only):
Certification Date
12. Please provide Section 701.4 certifier's name (Federal Credit Unions Only):
Certified By
13. Please provide Section 701.4 certifier's job title (Federal Credit Unions Only):
Job Title
14. Does your credit union meet any of the following criteria? (Yes/No)
- Credit union with 100 or more employees; or
- Credit union with 50 or more employees and:
1) Has a contract of at least $50,000 with the Federal government; or
2) Serves as a depository of U.S. government funds of any amount; or
3) Serves as a paying agent for U.S. Savings Bonds.
a. If yes, what is the last date you filed an EEO-1 Survey Report with the U.S. Equal Employment Opportunity Commission (MM/DD/YYYY)?
b. If yes, do you have a diversity policy and/or program in your credit union? (Yes/No)
15. Home Mortgage Disclosure Act - Loan Application Register criteria
a. Is your credit union located in a Metropolitan Statistical Area (MSA)? (Yes/No)

b. Yes

c. No

the preceding calendar year? (Yes/No)
g. Did your credit union originate closed-end mortgages in each of the two preceding
calendar years OR originate open-end lines of credit in each of the two preceding

e. Yes

f.

No

calendar years in excess of the HMDA Loan-Volume Threshold? (Yes/No)
j. If you answered yes to all three questions, please provide your HMDA LAR filing date.

h. Yes

i.

No

Did your credit union originate at least one home purchase loan or refinance a home
d.
purchase loan secured by a first lien on a one-to-four unit dwelling during

16. List any trade names the credit union uses for signage or advertising.

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Report Date: ______________
Federal Charter/Certificate Number:___________

Credit Union Name:___________________

Catastrophic Act / Business Continuity Information
1. In the event of a disaster, will the credit union communicate with members through a website ?
a. Yes

b. No

2. Please check the resources or services you have available and would be willing to share with other credit unions during the time of an emergency if you did
not need them. (Check all that apply)
a. Cash Non-Member Share Drafts

b. Generator

c. IT Support

d. Mobile Branch

e. Office Space

f. Staff/Management Services

3. Please provide the date of the last catastrophic act / business continuity test completed by the
credit union:
4. Indicate the method(s) used for the last catastrophic act / business continuity test completed by the credit union.
a. Orientation/Walk Through

b. Tabletop/Mini-Drill

c. Functional Testing

d. Full-Scale Testing

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Report Date: ______________
Federal Charter/Certificate Number:___________

Credit Union Name:___________________

Credit Union Programs and Member Services
1. Credit Union Programs (Check all that apply)
a. Approved Mortgage Seller

b. Brokered Certificates of Deposit

c. Brokered Deposits (all deposits acquired through a third party)

d. Investment Pilot Program (FCU Only)

e. Deposits and Shares Meeting 703.10(a)

f. Mortgage Processing

Payday Alternative Loans (PALs I & II - FCU Only)
g. PALs I (FCU Only)

h. PALs II (FCU Only)

2. Member Service and Product Offerings (Check all that apply)
Financial Literacy Education
a. Financial Counseling

b. Financial Education

c. Financial Literacy Workshops

d. First Time Homebuyer Program

e. Credit Management and Repair

f. Online Financial Literacy

Consumer Initiated Remittance Transfers
a. International Remittances

c. Proprietary remittance transfer services operated by the CU

b. Low-cost Wire Transfers

d. Proprietary remittance transfer services operated by another person

Other Member Services and Products
a. No Cost Share Drafts

b. No Cost Bill Payer

d. Share Certificates with low minimum balance requirement
f. Credit Builder

c. No Cost Tax Preparation Services
e. Student Scholarship

g. Bilingual Services

Youth Savings Accounts/Programs
a. Offer Custodial Accounts

b. Offer Non-Custodial Accounts

In-School Branches (If checked, specify number of branches)
a. Elementary School

b. Middle School

3. Does the credit union offer an ATM Network that is surcharge free?

c. High School
a. Yes

b. No

a. Yes

b. No

4. Provide the name of the surcharge free ATM Network
5. Does the credit union participate in Shared Service Centers/Networks?
6. Provide the name of the Shared Service Center/Network
7. Payday Alternative Loans (PALs I and II loans) program (FCUs Only) - Place a "" in the associated box for all the credit union offers
(Check all that apply)
a. Credit Bureau Reporting

b. Financial Education

c. Forced Savings Component

d. Payroll Deduction

8. Does the credit union use financial technology companies to provide member services?

a. Yes

b. No

9. If yes, select the services offered:
a. Auto Lending

b. Mortgage Lending

c. Secured personal loans

d. Unsecured personal loans

e. Lead generation for new members

f. Lead generation for share accounts

g. Acquire participation loans

h. Person-to-person payments

i. Investment security exchange services

j. Communication
10. Does the credit union offer cryptocurrency services to members ?

a. Yes

b. No

11. If yes, select the services offered:
a. Exchange services

b. Non-custodial wallets

c. Custodial wallets

d. Loans secured by digital assets

e. Depository for stablecoin reserves

f. Mobile application

12. Does the credit union use blockchain or distributed ledger technology to offer services to members or to record and store data?
a. Yes

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b. No

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Report Date: ______________
Federal Charter/Certificate Number:___________

Credit Union Name:___________________

Credit Union Grant Information
This page must be completed if the credit union receives grant funds.
Grant Information - Please provide information on any grants you have received since the last time you reported.

Grantor Type and Grantor

Date Awarded

Amount
Awarded

Grant Type*

Government (State, Local, Federal)
Community Development Financial Institution
Department of Education
Department of Health and Human Services
Federal Home Loan Bank
Housing and Urban Development
Internal Revenue Service
NCUA Technical Assistance Program
Small Business Administration
US Department of Agriculture
Other (Please Specify):
Other (Please Specify):
Trade Associations
National Credit Union Foundation
National Federation of Community Development Credit Unions
State League Foundation
Other (Please Specify):
Credit Unions and Banks
Specify Name:
Specify Name:
Foundations (local and national)
Specify Name:
Specify Name:
*Grant Types:

a. Capital - unrestricted donation to equity
b. Subsidy for Risk or ALLL

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c. Program Grant
d. Pass Through

NCUA Profile Form 4501A
Effective December 31, 2023
Previous Editions Are Obsolete

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Report Date: ______________
Federal Charter/Certificate Number:___________

Credit Union Name:___________________
Merger Partner Registry

This page is optional for credit unions and not required to be completed. If this page is completed, the mandatory fields are identified with an asterisk (*).
This information will not be released to the public.
1. Is your credit union interested in expanding its Field Of Membership through a consolidation of another credit union?
a. Yes

b. No

If Yes, Please proceed to the remaining questions.
2. Please provide the name and phone number of the person at the credit union who can be contacted regarding any potential consolidations.
*First Name :

*Last Name :

*Phone :

*Extension :

*Job Title :
3. Please identify the geographic areas in which the credit union would be interested. (Select only ONE Box)
Anywhere in the United States
Anywhere within Selected States (Please specify states)

Specific Counties/Cities within a Selected State (Specify the state(s) on lines above)
State

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County/Counties

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Effective December 31, 2023
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City/Cities

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