f6200-55i

FDIC OMB No. 3064-0022; Expiration Date: 06/30/2024
FRB OMB No. 7100-0100; Expiration Date: 07/31/2022
OCC OMB No. 1557-0184; Expiration Date: 09/30/2022

Federal Deposit Insurance Corporation

INSTRUCTIONS FOR FORM MSD-5
UNIFORM TERMINATION NOTICE FOR MUNICIPAL SECURITIES PRINCIPAL OR
MUNICIPAL SECURITIES REPRESENTATIVE ASSOCIATED WITH A BANK
MUNICIPAL SECURITIES DEALER
GENERAL INSTRUCTIONS:
1. As used in these instructions and Form MSD-5, the term bank municipal securities dealer means a municipal securities dealer
that is a bank or a department or division of a bank.
2. Form MSD-5 is intended for use by bank municipal securities dealers in reporting the termination of a municipal securities
principal’s or municipal securities representative’s association with such dealer.
3. Bank municipal securities dealers are required to file Form MSD-5 with the appropriate regulatory agency as set forth below:
(a) A bank municipal securities dealer that is a state member bank of the Federal Reserve System, a department or division of
any such bank, a bank holding company (including a subsidiary bank of the bank holding company if the subsidiary is not
otherwise instructed to file this form with the Federal Deposit Insurance Corporation or the Comptroller of the Currency in
subparagraphs (b) or ( c) of this paragraph or with the Securities and Exchange Commission, and a division, department or
subsidiary of that subsidiary), a savings and loan holding company, or a State branch or agency of a foreign bank is required
to file with the Board of Governors of the Federal Reserve System.
(b) A bank municipal securities dealer that is a bank insured by the Federal Deposit Insurance Corporation (other than a Federal
Reserve System member bank) or a department or division of any such bank is required to file with the Federal Deposit
Insurance Corporation.
(c) A bank municipal securities dealer that is a national bank or bank operating under the Code of Law for the District of Columbia
or a department or division of any such bank is required to file with the Comptroller of the Currency.
4. Copies of Form MSD-5 may be obtained from any one of the regulatory agencies listed in instruction 3.
5. Bank municipal securities dealers that file with the Federal Deposit Insurance Corporation may either mail an original and one
copy of Form MSD-5 and any attachments within thirty days after termination of the association with the individual named in item
1 or, alternatively, submit an electronic copy of the form (available at www.fdic.gov) and attachments, in Portable Document
Format (“PDF”) to the secure email address MSD-GSD-Registration@FDIC.gov within thirty days after termination of association
with the individual named in item 1. Bank municipal securities dealers that file with the Comptroller of the Currency must submit
an electronic copy of the form and attachments to the OCC’s BankNet website at www.banknet.gov within thirty days after
termination of the association with the individual named in item 1. A bank municipal securities dealer filing Form MSD-5 shall
retain an exact copy in its records for at least three years after the applicant’s employment or other association with such dealer
has terminated.
6. A bank municipal securities dealer required to file with the Board of Governors of the Federal Reserve System must submit an
electronic copy of the form and attachments to the secure email address GSD-Registration@FRB.gov. Report the form and
attachments in Portable Document Format (“PDF”). Form MSD-5 must be submitted within thirty days after termination of the
association with the individual named in item 1. A bank municipal securities dealer filing Form MSD-5 shall retain an exact copy
in its records for at least three years after the applicant’s employment or other association with such dealer has terminated.
7. If more space is needed to complete an answer, an appropriate designation shall be entered in the answer space provided, and
one or more attachment sheets shall be used to complete the response. All attachments shall be submitted in the same format as
the items to which response is made and should be typed on white 8-1/2 x 11 in. paper. The answers to more than one question
may appear on an attachment sheet if the questions are clearly identified. Attachments should be paginated and the name of
both the person terminated and the bank municipal securities dealer should appear on every attachment sheet.
8. Form MSD-5 and any attachments may be duplicated by any method which produces legible copies of type size identical to that
of the Form MSD-5 on white 8-1/2 x11 in. paper.
9. Form MSD-5 shall be manually signed on page 1 (bottom) by a municipal securities principal of the employing bank municipal
securities dealer.
10. All items on Form MSD-5 must be completed. The date on which Form MSD-5 is received by the appropriate regulatory agency
shall be the date of filing. A Form MSD-5 that is not prepared and executed in accordance with the applicable requirements may
be returned as unacceptable. Acceptance for filing shall not constitute any finding that a Form MSD-5 has been completed in
accordance with those requirements or that any information reported on the form is true, current, complete, or not misleading.

FDIC 6200/55i (6-21)

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FDIC OMB No. 3064-0022; Expiration Date: 06/30/2024
FRB OMB No. 7100-0100; Expiration Date: 07/31/2022
OCC OMB No. 1557-0184; Expiration Date: 09/30/2022

11. Section 17(c)(1) of the Securities Exchange Act of 1934 requires every bank municipal securities dealer that files any application,
notice, report, or document with its appropriate regulatory agency to file a copy of that application, notice, report, or document
with the Securities and Exchange Commission (SEC). The SEC and the appropriate regulatory agencies listed in instruction 3
have developed procedures under which the latter will transmit a copy of any application, notice, report, or document filed with
them by a bank municipal securities dealer to the SEC. Accordingly, when this form is filed with the appropriate regulatory
agency, it will be deemed to have been filed with the SEC.
12. If this form is being filed in lieu of Form G-FIN-5, check all applicable types of qualifications requested in item 2.

FDIC 6200/55i (6-21)

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