FFIEC 041

Draft Reporting Form for Call Report Revisions

Proposed to Take Effect March 31, 2018 This draft reporting form reflects the burden-reducing revisions to the FFIEC 041

Call Report proposed to take effect March 31, 2018, as described in the federal banking agencies initial Paperwork Reduction Act Federal Register notice

to be published on June 27, 2017. The Federal Register notice for these proposed Call Report revisions will be available on the

FFIECs web page for the FFIEC 041 Call Report. These proposed Call Report revisions are annotated in red font in the draft reporting form.

Note: This draft reporting form also includes proposed revisions to the FFIEC 041 Call Report in response to changes in the accounting for equity

securities that take effect March 31, 2018, for certain institutions and at later dates for other institutions. These proposed equity securities revisions are

included in the June 2017 Federal Register notice noted above. These proposed Call Report revisions are annotated in blue font in the draft reporting form.

Draft as of June 26, 2017 DRAF

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https://www.ffiec.gov/forms041.htm

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Board of Governors of the Federal Reserve System OMB Number 7100-0036 Federal Deposit Insurance Corporation OMB Number 3064-0052 Office of the Comptroller of the Currency OMB Number 1557-0081

Approval expires March 31, 2020 Page 1 of 85

Federal Financial Institutions Examination Council

Consolidated Reports of Condition and Income for a Bank with Domestic Offices OnlyFFIEC 041

Report at the close of business March 31, 2017

This report is required by law: 12 U.S.C. 324 (State memberbanks); 12 U.S.C. 1817 (State nonmember banks); 12 U.S.C. 161(National banks); and 12 U.S.C. 1464 (Savings associations).

(20170331)(RCON 9999)

This report form is to be filed by banks with domestic offices onlyexcept those banks that file the FFIEC 051. Banks with foreignoffices (as defined in the instructions) must file FFIEC 031.

Unless the context indicates otherwise, the term "bank" in thisreport form refers to both banks and savings associations.

NOTE: Each banks board of directors and senior management areresponsible for establishing and maintaining an effective system ofinternal control, including controls over the Reports of Condition andIncome. The Reports of Condition and Income are to be prepared inaccordance with federal regulatory authority instructions. The Reportsof Condition and Income must be signed by the Chief FinancialOfficer (CFO) of the reporting bank (or by the individual performing anequivalent function) and attested to by not less than two directors(trustees) for state nonmember banks and three directors for statemember banks, national banks, and savings associations.

I, the undersigned CFO (or equivalent) of the named bank, attestthat the Reports of Condition and Income (including the supporting

Signature of Chief Financial Officer (or Equivalent)

Date of Signature

Director (Trustee)

Director (Trustee)

Director (Trustee)

We, the undersigned directors (trustees), attest to the correctnessof the Reports of Condition and Income (including the supportingschedules) for this report date and declare that the Reports ofCondition and Income have been examined by us and to the bestof our knowledge and belief have been prepared in conformancewith the instructions issued by the appropriate Federal regulatoryauthority and are true and correct.

Submission of ReportsEach bank must file its Reports of Condition and Income (CallReport) data by either:(a) Using computer software to prepare its Call Report and then

submitting the report data directly to the FFIECs Central Data Repository (CDR), an Internet-based system for data collec-tion (https://cdr.ffiec.gov/cdr/), or

(b) Completing its Call Report in paper form and arranging with a software vendor or another party to convert the data into theelectronic format that can be processed by the CDR. Thesoftware vendor or other party then must electronically submitthe banks data file to the CDR.

For technical assistance with submissions to the CDR, pleasecontact the CDR Help Desk by telephone at (888) CDR-3111, byfax at (703) 774-3946, or by e-mail at CDR.Help@ffiec.gov.

To fulfill the signature and attestation requirement for the Reportsof Condition and Income for this report date, attach your bankscompleted signature page (or a photocopy or a computer gener-ated version of this page) to the hard-copy record of the data filesubmitted to the CDR that your bank must place in its files.

Legal Title of Bank (RSSD 9017)

City (RSSD 9130)

State Abbreviation (RSSD 9200) Zip Code (RSSD 9220)FDIC Certificate Number

(RSSD 9050)

03/2017

The estimated average burden associated with this information collection is 74.9 hours per respondent and is expected to vary by institution, depending on individual circumstances. Burdenestimates include the time for reviewing instructions, gathering and maintaining data in the required form, and completing the information collection, but exclude the time for compiling andmaintaining business records in the normal course of a respondents activities. A Federal agency may not conduct or sponsor, and an organization (or a person) is not required to respond toa collection of information, unless it displays a currently valid OMB control number. Comments concerning the accuracy of this burden estimate and suggestions for reducing this burdenshould be directed to the Office of Information and Regulatory Affairs, Office of Management and Budget, Washington, DC 20503, and to one of the following: Secretary, Board of Governorsof the Federal Reserve System, 20th and C Streets, NW, Washington, DC 20551; Legislative and Regulatory Analysis Division, Office of the Comptroller of the Currency, Washington, DC20219; Assistant Executive Secretary, Federal Deposit Insurance Corporation, Washington, DC 20429.

schedules) for this report date have been prepared in confor-mance with the instructions issued by the appropriate Federalregulatory authority and are true and correct to the best of myknowledge and belief.

Legal Entity Identifier (LEI)

(Report only if your institution already has an LEI.) (RCON 9224)

The appearance of your banks hard-copy record of the submitteddata file need not match exactly the appearance of the FFIECssample report forms, but should show at least the caption of eachCall Report item and the reported amount.DRAF

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mailto:CDR.Help@ffiec.govhttps://cdr.ffiec.gov/cdrCady.CoddingText BoxThis report form is to be filed by banks with domestic offices only and with total consolidated assets of less than $100 billion, except those banks that file the FFIEC 051. Banks with foreign offices (as defined in the instructions) and banks with domestic offices only with total consolidated assets of $100 billion or more must file the FFIEC 031.

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Cady.CoddingText Box20180331

Cady.CoddingText Box2018

FFIEC 041 Page 2 of 85

Consolidated Reports of Condition and Income for a Bankwith Domestic Offices Only

Table of Contents

Signature Page ............................................................ 1

Contact Information ................................................. 3, 4

Report of IncomeSchedule RIIncome Statement .................... RI-1, 2, 3, 4

Schedule RI-AChanges in Bank Equity Capital..........RI-5

Schedule RI-BCharge-offs and Recoveries on Loans and Leases and Changes in Allowance for Loan and Lease Losses.............................RI-5, 6, 7

Schedule RI-EExplanations...............................RI-9, 10

Report of Condition

Schedule RCBalance Sheet ............................. RC-1, 2

Schedule RC-ACash and Balances Due from Depository Institutions (to be completed only by selected banks) ..............RC-3

Schedule RC-BSecurities ....................RC-3, 4, 5, 6, 7, 8

Schedule RC-CLoans and Lease FinancingReceivables:Part I. Loans and Leases ...............RC-9, 10, 11, 12, 13Part II. Loans to Small Businesses and

Small Farms .............................................RC-14, 15

Schedule RC-DTrading Assets and Liabilities (to be completed only by selected banks)....................................................RC-16, 17, 18

Schedule RI-CDisaggregated Data on the Allowance for Loan and Lease Losses (to be completed only by selected banks) ............... RI-8

Schedule RC-GOther Liabilities............................. RC-22

Schedule RC-KQuarterly Averages ......................RC-23

Schedule RC-LDerivatives and Off-Balance-Sheet Items.......................RC-24, 25, 26, 27

Schedule RC-MMemoranda............RC-28, 29, 30, 31, 32Schedule RC-NPast Due and Nonaccrual Loans, Leases, and Other Assets ....... RC-33, 34, 35, 36, 37, 38

Schedule RC-OOther Data for Deposit Insurance and FICO Assessments .......... RC-39, 40, 41, 42, 43, 44

Schedule RC-P14 Family Residential Mortgage Banking Activities (to be completed only by selected banks).......................................RC-45

Schedule RC-QAssets and Liabilities Measured at Fair Value on a Recurring Basis (to be completed only by selected banks) ............ RC-46, 47, 48

Schedule RC-RRegulatory Capital:

Schedule RC-SServicing, Securitization, and Asset Sale Activities ..........................RC-63, 64, 65

Schedule RC-TFiduciary and Related Services............................................ RC-66, 67, 68, 69

Schedule RC-VVariable I