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OTS Form 1313Rev. March 2007
Thrift Financial Report
2007
Office of Thrift Supervision
1700 G Street, N.W.Washington, DC 20552
OMB No. 1550-0023
OFFICE OF THRIFT SUPERVISIONTHRIFT FINANCIAL REPORT
PAPERWORK REDUCTION ACT STATEMENTThe Office of Thrift Supervision will use this information to supervise thesavings associations and to develop regulatory policy.Collection of the information is mandatory [12 CFR Part 563.180].The estimated average burden associated with this collection of informationper response is 35.4 hours for quarterly schedules and 2.6 hours forschedules only required annually (total of 144.2 hours annually). If a validOMB Control Number does not appear on this form, you are not required tocomplete this form. Send comments regarding this burden estimate or anyother aspect of this collection of information, including suggestions forreducing this burden to Information Collection Comments, Chief Counsel’sOffice, Office of Thrift Supervision, 1700 G Street, NW, Washington, DC20552, and to the Office of Management and Budget, Paperwork ReductionProject (1550-0023), Washington, DC 20503. All comments shouldreference OMB Control Number 1550-0023.
OTS Form 1313Rev. March 2007
OTS Form 1313
- 1 -
Revised March 2007
Association ________________________ Docket Number _____________________
Office of Thrift Supervision2007 Thrift Financial ReportOfficers’ and Directors’Certification
For the Thrift Financial Report as of ________________________, 2007The Thrift Financial Report is required by OTS regulation 12 CFR 563.180 to be filed by all savingsassociations as defined in 12 CFR 561.43. OTS regulation 12 CFR 563.180(b) requires that no false ormisleading statements or omission shall knowingly be made in financial reports filed with OTS. Thiscertification is required under 12 U.S.C. 1817(a) (3).The Statements of Condition and Operations (including all supporting schedules) must be signed by anauthorized officer of the reporting savings association. The Statements of Condition and Operations areto be prepared in accordance with Office of Thrift Supervision instructionsThis certification form must be retained in the file of the reporting savings association and be availablefor inspection by OTS.I, _________________________________, of the
(Name and Title of Officer Authorized to Sign Report)
named savings association do hereby declare thatthese Statements of Condition and Operations(including the supporting schedules) have beenprepared in conformance with the instructionsissued by the Office of Thrift Supervision and aretrue to the best of my knowledge and belief. ________________________________________
Signature of Officer Authorized to Sign Report
________________________________________
Date of Signature
We, the undersigned directors, attest to thecorrectness of this Statement of Condition (includingthe supporting schedules) and declare that it has beenexamined by us and to the best of our knowledge andbelief has been prepared in conformance with theinstructions issued by the Office of Thrift Supervisionand is true and correct. _________________________________________
Director
_________________________________________
Director
_________________________________________
Director
of 00
US Federal Reserve: 78199
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