EXHIBIT A Shareholder Name* # of Shares Owned % Ownership

* If owned by a bank holding company, include a shareholder list for the parent.

EXHIBIT B Listing of loans originating at other banks and purchased by subject bank With or Without Recourse

Purchased From

Name of Borrower

Current Balance

EXHIBIT C Listing of loans originating at subject bank and sold to other banks With or Without Recourse

Sold To

Name of Borrower

Current Balance

EXHIBIT D Officers and Directors* Name and Address:

Title: Date Appointed: Year of Birth: Duties Performed at Subject Bank:

Time With Bank: Prior Banking Experience (title, duties, length of time):

Educational Background:

Principal Business Affiliation:

*

This exhibit needs to be completed only for new officers and directors employed since the previous Reserve Bank examination.

EXHIBIT E Officer's Statement of Bank and Bank Holding Company Stock Held as Collateral for Loans

(Name of Bank) As of
# of Shares

(City)

(State)

Name of Borrower/Stockholder

Stock

Cert. #

Original Amount

Current Balance

Rate

Note Date

Maturity

I

of the above named bank do hereby certify (Name of Officer) (Title) that, to the best of my knowledge and belief, the above is a true and correct statement of all of the bank and bank holding company stock held as collateral as of the above date.

(Signature)

EXHIBIT F Indebtedness to this Bank of Executive Officers of Other Banks

Name and Title

Name and Location of Other Bank

Direct/ Indirect* Amount

Interest Rate

Terms (Origination & maturity dates, payment provisions, security & purpose)

* Also reveal similar information on indirect indebtedness indicating nature of indebtedness (endorser, guarantor, etc., on loan to ...).

EXHIBIT G Loans to any borrowers secured by stocks, bonds, or other obligations of a related interest of a bank official. Refer to Section 215.2 of Regulation O for definition of "related interest"

Person Interested

Collateral

Amount

Interest Rate

Terms (Origination & maturity dates, payment provisions, security & purpose)

EXHIBIT H Indebtedness to this bank of a related interest (business interest) of an executive officer, principal shareholder or director. Refer to Section 215.2 of Regulation O for definition of "related interest"

Person interested, name of related interest and relationship to interest

Direct/Indirect* Amount

Interest Rate

Terms (Origination & maturity dates, payment provisions, security & purpose)

* Also reveal similar information on indirect indebtedness indicating nature of indebtedness (endorser, guarantor, etc., on loan to ...).

EXHIBIT I Extensions of credit to executive officers and directors of any subsidiaries of the bank holding company
Direct/Indirect* Amount Terms (Origination & maturity dates, payment provisions, security & purpose)

Borrower, position held and name of subsidiary

Interest Rate

* Also reveal similar information on indirect indebtedness indicating nature of indebtedness (endorser, guarantor, etc., on loan to ...).

EXHIBIT J Indebtedness to this bank of the bank holding company and any subsidiary of the bank or bank holding company

Borrower

Direct/Indirect* Amount

Interest Rate

Terms (Origination & maturity dates, payment provisions, security & purpose)

* Also reveal similar information on indirect indebtedness indicating nature of indebtedness (endorser, guarantor, etc., on loan to ...).

EXHIBIT K Indebtedness to this bank of a company, a majority of whose directors also constitute a majority of the directors of the bank or bank holding company

Borrower

Direct/Indirect* Amount

Interest Rate

Terms (Origination & maturity dates, payment provisions, security & purpose)

* Also reveal similar information on indirect indebtedness indicating nature of indebtedness (endorser, guarantor, etc., on loan to ...).

EXHIBIT L Indebtedness to this bank of executive officers, principal shareholders and directors of this bank and bank holding company. Refer to Section 215.2 of Regulation O for definitions of executive officers and principal shareholders.
Direct/Indirect* Amount Terms (Origination & maturity dates, payment provisions, security & purpose)

Name and Position or Title

Interest Rate

* Also reveal similar information on indirect indebtedness indicating nature of indebtedness (endorser, guarantor, etc., on loan to ...).

EXHIBIT M
Year Elected to Board Bonus, Fees, Etc. $(000)

Director's Name and Place of Residence

Year of Birth

Shares Owned

Net Worth $(000)

Occupation or Principal Business Affiliate

EXHIBIT N
Year Joined Bank Year Began in Present Position

Executive Officer's Name & Title

Area of Responsibility

Year of Birth

Salary/Bonus $(000)

EXHIBIT O

Contingent Liabilities and Other Memorandum Accounts LETTERS OF CREDIT Commercial - issued or confirmed Other (describe) STANDBY LETTERS OF CREDIT - bid or performance COMMITMENTS To grant or purchase loans Undisbursed loan funds To purchase securities To sell loans or securities To purchase real estate To extend credit in the form of lease arrangements LETTERS OF INDEMNITY, GUARANTEES FUTURES AND FORWARD CONTRACTS Commitments to purchase Commitments to sell STANDBY CONTRACTS AND SIMILAR ARRANGEMENTS Commitments to purchase Commitments to sell ENDORSEMENTS, RECOURSE AND REPURCHASE AGREEMENTS Acceptances of other banks sold with endorsement Loans, securities, and other assets sold under repurchase agreements Loans, securities, and other assets sold with recourse Agreements to maintain markets (loans, securities, C.D.'s, etc.) Participations in this bank's acceptances conveyed to others Participations in other bank's acceptances acquired by this bank PENDING LITIGATION Judgments against the bank where settlement has been delayed by reason of the suit being taken on appeal to a higher court Other pending litigation and claims which may result in liabilities to the bank $ $ $ $ $ $ $ $ Totals

EXHIBIT O (CONTINUED)

OTHER Agreements to honor sight drafts covering the shipment of automobiles, machinery, etc., to dealers Potential liabilities which, should unfavorable developments occur with respect to the contracts, conditions or agreements involved, may result in liabilities entailing a use of bank funds without the receipt of equivalent benefit TOTAL $

$

I

of

do hereby

(Name of Officer) (Title) (Name of Bank) certify that the above is a true and correct statement of the contingent liabilities of the bank as of the close of business as the best of my knowledge and belief.

(Signature)

EXHIBIT P List of Public Funds Under the appropriate heading, list the title of the account as it appears on bank records and the balance as of the date of this examination. Indicate time deposits in the space following the balance as follows: Demand (DDA), Savings (S), Time Certificate of Deposit (CD), Time Open Account (TO). Show rate of interest paid on all time deposits and the deposit contract time period (e.g. 90 days, 180 days, 1 year, etc.) STATES, COUNTIES, CITIES, SCHOOL DISTRICTS, ETC. Account Title Balance Interest Rate

U.S. GOVERNMENT (TREASURY TAX AND LOAN, POST OFFICE, SERIES E BOND SALES, ETC.) Account Title Balance Interest Rate