Contact Person

Contact Person Designation

Date

Director for District Licensing

Comptroller of the Currency

Address

City, State, ZIP Code

Re: Application Description, CAIS Control Number

Dear Director:

At the first meeting of the organizing directors of (name of proposed bank, in organization), we chose (name of individual and title) to receive all future correspondence from the Comptroller of the Currency. You can reach him/her at:

Address

City, State, ZIP Code

Telephone Number

Fax Number

E-mail Address

Sincerely,

─Signature─

Name and Title