Notice of Change in Activities or Operations

Notice of Change in Activities or Operations

Type of Notice (Check the appropriate box)

This is to notify the OCC of the following change affecting the identified federal branch or agency:

 Corporate Title

 Mailing Address of: Foreign bank Federal branch or agency

 Home State Designation

 Conversion to State-licensed Operation

Complete the information as applicable to the particular change checked.

Foreign Bank Identifying Information

For Changes in Corporate Title

Foreign Bank Previous Name ____________________________________________ (exact corporate title of bank)

Foreign Bank New Name ________________________________________________ (exact corporate title of bank following title change)

Effective Date ______________________

For Changes in the Mailing Address of the Foreign Bank

Previous Address (Headquarters office of foreign bank)

City State Country ____________________

New Address (Headquarters office of foreign bank)

City State Country ____________________

Effective Date ______________________

Federal Branch or Agency Identifying Information

License No. ___________________________________________________

Name ________________________________________________________

(exact corporate title of United States office)

For Changes in the Mailing Address of the Federal Branch or Agency

Current Mailing Address

City County State ZIP Code

New Mailing Address

City County State ZIP Code

Effective Date _________________________

For Changes in Home State Designation

Current Home State _______________________________

New Home State _______________________________

Effective Date ________________________________

A copy of the notice or application to the Federal Reserve Board (FRB) or determination of the FRB for a change in home state designation should be attached.

For Conversion to a State License

Reasons for converting:

Planned Effective Date

A certified copy of the resolution adopted by senior management of the foreign bank and a copy of the state application should be attached.

Upon approval to convert, we certify that the license certificate, trust permit (if applicable), and reports of examination and any related correspondence will be returned to the OCC (or in the case of the reports of examination and related correspondence, these have been destroyed). We understand that the CED will not be released until all OCC official documents are returned or destroyed.

Executed this day of , .

Signature of Authorized Officer

Typed Name

Title