FEDERAL CREDIT UNION INVESTIGATION REPORT

**This form must be filled in completely and submitted with the other
completed forms listed in the instructions to this form.**

# A. INFORMATION FOR CHARTER AND BYLAWS

**1. Proposed name:**

      Federal Credit Union

#### 

#### Second choice:

#### 

####       Federal Credit Union

**2. Contact Person:**      

**Business Tel.:**      

Residence Tel.:      

**Address:**      

     

**3. The credit union will maintain its offices at:**

(City)      

**(State)**      

**(County)**      

**(Zip Code)**      

**3a. Proposed permanent mailing address of credit union:**

     

     

**4. Define proposed field of membership:**

     

**5. The board will have (an odd number, 5 to 15)**       **members; the
credit committee will have (an odd number, 3 to 7)**       **members;
the supervisory committee will have (3 to 5)**       **members. Each
official must complete a Report of Official and Agreement to Serve (NCUA
4012) which is to be submitted with this investigation report.**

# B. ECONOMIC ADVISABILITY OF ORGANIZING PROPOSED CREDIT UNION

**(Attach a separate sheet if space available is not adequate.)**

**GENERAL INFORMATION**

**1. Potential membership:**      

NOTE: Number of employees for occupational, active members for
associational (or families for religious groups), or population per most
recent census for community-type fields of membership.

**2. Potential interest (survey results).**

NOTE: Sample must consist of a minimum of 250 potential members. Copy of
survey form(s) utilized should be attached.

> **Number of people surveyed:**      
>
> **Number of people responding to survey:**      
>
> **Number of people pledging an initial deposit:**      
>
> **Total dollars pledged:** \$     

##### Number pledging systematic savings:      

> **Total dollars pledged (per month):** \$     

**3. Number of persons attending the charter-organization meeting:**
     

**4. Attach a business plan containing, at a minimum, the following
elements:**

> **• mission statement;**
>
> **• analysis of market conditions, including if applicable,
> geographic, demographic, employment, income, housing, and other
> economic data;**
>
> **• evidence of member support;**
>
> **• goals for shares, loans, and for number of members;**
>
> **• financial services needed/desired;**
>
> **• financial services to be provided to members of all segments
> within the field of membership;**
>
> **• how/when services are to be implemented;**
>
> **• organizational/management plan addressing qualification and
> planned training of officials/employees;**
>
> **• continuity plan for directors, committee members, and management
> staff;**

-   **operating facilities, to include office space/equipment and
    supplies, safeguarding of assets, insurance coverage, etc.;**

    **• type of record keeping and data processing system;**

    **• detailed semiannual pro forma financial statements (balance
    sheet, income and expense projections) for 1st and 2nd year,
    including assumptions - e.g., loan and dividend rates;**

    **• plans for operating independently;**

    **• written policies (shares, lending, investments, funds
    management, capital accumulation, dividends, collections, etc.);**

    **• source of funds to pay expenses during initial months of
    operation, including any subsidies, assistance, etc., and terms or
    conditions of such resources; and**

    **• evidence of sponsor commitment (or other source of support) if
    subsidies are critical to success of the federal credit union.
    Evidence may be in the form of letters, contracts, financial
    statements from the sponsor, and any other such document on which
    the proposed federal credit union can substantiate its
    projections.**

**5. What potential difficulties do you detect in the elected officials
carrying out their management responsibilities or in the FCU achieving
its stated objectives?**

     

**6. What provisions have been made to overcome potential
difficulties?**

     

**Dates of planned contacts by organizer to determine progress and to
assist the group:**

**First Contact Date:**      

**Second Contact Date:**      

**Third Contact Date:**      

####### SPECIFIC INFORMATION - OCCUPATIONAL (same company) CHARTER APPLICANTS

**1. How long has the sponsor company been in existence?**      

2\. What was the highest number of employees during the past three
years?      

Lowest number during the past three years?      

If a large variance, please explain.

     

**3. Are there any contemplated changes in the corporate structure of
the company?**      

**If yes, explain.**

     

**4. Have there been any significant changes in the corporate structure
in the past three years?**      

**If yes, please explain.**

     

**5. Are there any negotiations now in progress between management and
labor that could lead to work stoppages?**      

**If yes, please explain.**

     

**6. If the credit union cannot operate on the employer\'s property,
explain how the credit union will be able to transact business
effectively with the members.**

     

**7. If the employees to be served by the credit union work in more than
one location or city, identify each location with the corresponding
number of employees working at each.**

     

**8. Are there other employees of the company who are not being included
in the proposed field of membership?**      

If so, give the number and location of the other employees and explain
why they are not included in the proposed credit union's field of
membership.

     

**SPECIFIC INFORMATION - OCCUPATIONAL (trade, industry or profession)
CHARTER APPLICANTS**

**1. Explain how the credit union will be able to transact business
effectively with the members.**

     

**SPECIFIC INFORMATION - ASSOCIATIONAL CHARTER APPLICANTS**

**1. State the purpose and goals of the organization sponsoring this
charter.**

     

**2. List the types of activities and their frequency, which the
organization sponsors that provide contact among the members and from
which common loyalties, mutual benefits, and mutual interests are
developed.**

     

**3. In what year was the organization established?**      

**Is it incorporated?**      

**Where is the headquarters located?**      

**4. Give statistics as to trends in membership during the last five
years.**

     

**5. What is the frequency of membership meetings?**      

**Average attendance:**      

**Dues required:** \$     

**6. State the geographic territory where members reside.**      

**7. Submit a copy of the current bylaws of the association, the
constitution, articles of incorporation, or equivalent documentation and
recent financial statements, i.e. balance sheet, and income and expense
statement, with this application.**

8\. If the bylaws, constitution, articles of incorporation, or
equivalent documentation provide for more than one type of membership
and if all classes of membership are to be included in the credit
union\'s field of membership, provide justification for the inclusion of
other than \"regular\" members.

     

**SPECIFIC INFORMATION -- MULTIPLE COMMON BOND CHARTER APPLICANTS**

**1. Explain how the credit union will be able to transact business
effectively with the members.**

     

**SPECIFIC INFORMATION - COMMUNITY CHARTER APPLICANTS**

**1. Community charters must be based on a well-defined local community,
neighborhood, or rural district where individuals have common interests
and/or interact. Please refer to Chapter 2, Section V of the
*"Chartering and Field of Membership Manual"* when answering this
question.**

     

**2. Provide a map which clearly outlines the credit union\'s proposed
community boundaries and identify proposed service facilities.**

# C. CHARACTER AND FITNESS OF SUBSCRIBERS

**1. List of subscribers who have signed the Organization Certificate (7
not more than 10 persons). Names should be IDENTICAL to signature on the
Organization Certificate (NCUA 4008). Each subscriber listed below has
subscribed to at least one share in accordance with Section 103 of the
Federal Credit Union Act:**

Name:      

Address:      

     

Occupation:      

Years of Residence:      

Name:      

Address:      

     

Occupation:      

Years of Residence:      

Name:      

Address:      

     

Occupation:      

Years of Residence:      

Name:      

Address:      

     

Occupation:      

Years of Residence:      

Name:      

Address:      

     

Occupation:      

Years of Residence:      

Name:      

Address:      

     

Occupation:      

Years of Residence:      

Name:      

Address:      

     

Occupation:      

Years of Residence:      

Name:      

Address:      

     

Occupation:      

Years of Residence:      

Name:      

Address:      

     

Occupation:      

Years of Residence:      

Name:      

Address:      

     

Occupation:      

Years of Residence:      

**2. Are all of the subscribers within the field of membership?**      

Do they appear to be representative of the group described in the
definition of the field of membership?      

If not, explain.

     

**3. Does your investigation indicate that the subscribers are persons
of good character?**      

######### If not, explain. 

     

**4. From your investigation, is it your judgment that the directors and
committee members are persons of good character, and that they have the
ability and determination to operate a credit union satisfactorily?**
     

If not, explain.

     

**5. Does it appear that there are any factions within the group which
may render smooth and efficient credit union operations difficult?**
     

**If so, explain.**

     

**6. Is there any indication that the proposed credit union would be
used for selfish gain by any person or group of persons within the group
to be served?**

     

**7. Is an application for a State Charter now pending?**      

8\. Has the group ever had a credit union?      

**If so, when did it liquidate or merge?**      

**ANY ADDITIONAL COMMENTS OR INFORMATION THAT IS DEEMED PERTINENT OR
HELPFUL IN GIVING CONSIDERATION TO THIS APPLICATION SHOULD BE INCLUDED
AS AN ATTACHMENT.**

**The undersigned certifies that to the best of their knowledge and
belief the above information is true and correct.**

**I do (do not) recommend that a charter be granted to this group.**

**Signature:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_,
Organizer**

**Organizer\'s Address:**      

>      

**Telephone No.:**      

**Date:**      

**FORM 4001 INSTRUCTIONS**

###### A. INFORMATION FOR CHARTER AND BYLAWS

> **The subscriber should select a name for the proposed credit union.
> It is the responsibility of the federal credit union organizers to
> ensure that the proposed federal credit union name does not constitute
> an infringement on the name of any corporation in its trade area. The
> last three words in the name must be \"Federal Credit Union.\" Since
> the name selected should not duplicate exactly the name of an existing
> credit union, Item 1 provides space for a second choice.**

**The territory of operations of a Federal Credit Union is described in
the field of membership, item 4. The principal office of the credit
union will usually be maintained at a location described in the field of
membership.**

**The proposed field of membership should be defined so clearly that it
leaves no room for any doubt as to whom the credit union is to serve or
the area which it is to operate. Corporations and other organizations
referred to in the definition of the field of membership should be
designated by the exact names rather than by some local or popular
contraction of these names. The field of membership for each type of
common bond and samples are discussed in detail in Chapter 2 of the
\"*Chartering and Field of Membership Manual*.\"**

**With the guidance of the organizer, the subscribers to the
Organization Certificate decide on the number of directors and credit
committee members. The board and credit committee must be composed of an
odd number of members. The supervisory committee is appointed by the
board of directors.**

###### B. ECONOMIC ADVISABILITY OF ORGANIZING PROPOSED CREDIT UNION

**This section of the report contains information on the required
business plan elements and other information needed to make a decision
on the economic advisability of chartering the proposed credit union.**

###### C. CHARACTER AND FITNESS OF SUBSCRIBERS

**The names and addresses of the subscribers should be recorded legibly
and completely in item C. 1. of this report. It is from this information
that the National Credit Union Administration prepares Section 3 of the
charter. The names of the subscribers must be IDENTICAL to their
signatures on the Organization Certificate.**

**D. SUBMITTAL OF CHARTER APPLICATION**

**In addition to this Investigation Report, the following should be
submitted to the appropriate regional director of NCUA:**

**1. Organization Certificate, NCUA 4008 - one notarized original. At
least seven, *but no more than ten persons*, must sign the organization
certificate. The person administering the oath must not be one of the
subscribers. The oath on the organization certificate must be executed
and show the notary\'s seal and date the commission expires as required
by State law;**

**2. Report of Official and Agreement to Serve, NCUA 4012 -- one
original for each board member, credit committee member, and supervisory
committee member;**

3\. Business Plan - refer to Part B, question 4 of this form and Chapter
1 of the *Chartering and Field of Membership Manual* for a discussion of
the components of an acceptable business plan;

**4. Application and Agreements for Insurance of Accounts, NCUA 9500 -
one original; and**

5\. Certification of Resolutions, NCUA 9501 - one original.