INFORMATION TO BE PROVIDED IN SUPPORT OF THE APPLICATION OF A STATE
CHARTERED CREDIT UNION FOR INSURANCE OF ACCOUNTS

***Existing credit unions must complete the entire application. All
other applicants do not have to complete questions 8, 11, 12, 13, 15,
and 16.***

      **Credit Union**

**1. Show below the location of the credit union\'s books and records.**

> **(Street Address)**      
>
> **(City) (State) (Zip)**      
>
> **(Telephone)**      

**2. Show the date (month, day, year) in which the credit union was
chartered.**

     

**3. Attach a copy of the credit union\'s field of membership as shown
in the charter, articles of incorporation and/or bylaws, as amended to
date. Please identify it as the first schedule in the consecutive number
sequence as discussed in the instructions. Schedule No.**      

**4. Potential membership (total number of persons who could be served
including present members).**      

**5. Identify charter type (e.g., single common bond, multiple common
bond, community).**      

**a. Attach a copy of the current official bylaws under which the**

**credit union operated. Schedule No.**      

**7. Is the credit union under any administrative restraints by the
State Supervisory Authority? Yes** **No** **(Complete a.)**

**a. Explain fully on an attached schedule. Schedule No.**      

**8. Attach a copy of the latest State supervisory authority
examination. Copies of any correspondence from the accountant\'s report
if made in lieu of a State supervisory authority examination. Copies of
any correspondence from the State supervisory authority which
accompanied the examination report should also be included.**

**9. Attach copies of the Balance Sheet and Statement of Income and
Expense (or Financial and Statistical Report) for the month preceding
the date of this application and for the same month of the preceding
year.**

**Schedule Nos.**      

**10. Reserves**

> **Show below the requirements of the State law and/or your bylaws for
> transfer of earnings to reserves (either monthly or at the end of each
> accounting period).**
>
>      

**11. Delinquent Loans and Charged-off Loans**

**a. Attach a copy of the delinquent loan list as of the month-end
preceding the date of this application. See instructions pertaining to
Item No. 11a. Schedule No.**      

> **b. List below the requested information on delinquent loans for the
> latest four calendar quarters preceding the date of the application
> (March 31, June 30, September 30 and December 31). Also show total
> share and loan balances for all members for the same period.**

+-----------+-------------+----------+----------+----------+----------+
| **(a)**   | **(b)**     | **Date** | **Date** | **Date** | **Date** |
|           |             |          |          |          |          |
| **\*Other | **D         |          |          |          |          |
| Del       | elinquent** |          |          |          |          |
| inquent** |             |          |          |          |          |
|           | **C         |          |          |          |          |
| **Cat     | ategories** |          |          |          |          |
| egories** |             |          |          |          |          |
+-----------+-------------+----------+----------+----------+----------+
|           | **2 to less | **\$**   | **\$**   | **\$**   | **\$**   |
|           | than**      |          |          |          |          |
|           |             |          |          |          |          |
|           | **6 mos.**  |          |          |          |          |
+-----------+-------------+----------+----------+----------+----------+
|           | **6 to less | **\$**   | **\$**   | **\$**   | **\$**   |
|           | than**      |          |          |          |          |
|           |             |          |          |          |          |
|           | **12 mos.** |          |          |          |          |
+-----------+-------------+----------+----------+----------+----------+
|           | **12 mos.   | **\$**   | **\$**   | **\$**   | **\$**   |
|           | and over**  |          |          |          |          |
+-----------+-------------+----------+----------+----------+----------+
|           | **Totals**  | **\$**   | **\$**   | **\$**   | **\$**   |
|           |             |          |          |          |          |
+-----------+-------------+----------+----------+----------+----------+
|           | **Share     | **\$**   | **\$**   | **\$**   | **\$**   |
|           | Balances**  |          |          |          |          |
+-----------+-------------+----------+----------+----------+----------+
|           | **Loan      | **\$**   | **\$**   | **\$**   | **\$**   |
|           | Balances**  |          |          |          |          |
+-----------+-------------+----------+----------+----------+----------+

**\*See instructions pertaining to Item No. 11 b.**

> **c. List below the requested information on loans charged off during
> the last three years and the current year. List total of all reserves
> both revocable and irrevocable for the same period as (balance at
> year-end and or current period).**

+-----------+--------+--------+--------+----------------+------------+
|           | **     | **     | **     | **Current Yr.  | **\*Totals |
|           | Year** | Year** | Year** | To Date**      | Since      |
|           |        |        |        |                | Orga       |
|           |        |        |        |                | nization** |
+-----------+--------+--------+--------+----------------+------------+
| **        |        |        |        |                |            |
| T****otal |        |        |        |                |            |
| Charged   |        |        |        |                |            |
| Off**     |        |        |        |                |            |
+-----------+--------+--------+--------+----------------+------------+
| **        |        |        |        |                |            |
| T****otal |        |        |        |                |            |
| Re        |        |        |        |                |            |
| covered** |        |        |        |                |            |
+-----------+--------+--------+--------+----------------+------------+
| **N****et |        |        |        |                |            |
| Charged   |        |        |        |                |            |
| Off**     |        |        |        |                |            |
+-----------+--------+--------+--------+----------------+------------+

> **\*If this information is available.**

**12. Does the credit union have any unrecorded or contingent
liabilities, (including pending law suits or civil actions)? Yes**
**No** **Complete a.**

> **a. List on an attached schedule the complete description of such
> liabilities, including amounts, status of the items, and a description
> of the circumstances creating the liabilities or contingent
> liabilities. Schedule No.**      

**13. Do any asset accounts other than loans to members, investments,
and real estate have actual values less than the book values shown on
the Balance Sheet?**

> **List on a separate schedule a description of such assets, showing at
> least the following information; account number, description of item,
> book value and actual value. Schedule No.**      

**14. List below or on an attached schedule, any investments or real
estate as discussed in the instructions pertaining to Item No. 14.
Schedule No.**      **. Attach a copy of the credit union\'s current
investment policies. Investments/Loans to Credit Union Service
Organization (CUSO) should be listed separately.**

**[Description of Item]{.underline} [Current Market Value]{.underline}
[Current Book Value]{.underline}**

  ------------------------------------ ----------------- -----------------
                                       **\$**            **\$**     

                                       **\$**            **\$**     

                                       **\$**            **\$**     
  ------------------------------------ ----------------- -----------------

**15. Individual Share and Loan Ledgers:**

> **a. Were the totals of the trial balance of the individual share and
> loan ledgers in agreement with the balances of the respective general
> ledger control accounts as of the month-end preceding the date of this
> application?**      
>
> **b. What are the differences as of the month and preceding the date
> of this application?**

+-----------------------------------------+-------------+-------------+
|                                         | **          | *           |
|                                         | [Shares]{.u | *[Loans]{.u |
|                                         | nderline}** | nderline}** |
+-----------------------------------------+-------------+-------------+
| **Balances in General Ledger**          | **\$**      | **\$**      |
+-----------------------------------------+-------------+-------------+
| **Totals of the trial balance of the**  | **\$**      | **\$**      |
|                                         |             |             |
| **individual ledgers**                  |             |             |
+-----------------------------------------+-------------+-------------+
| **Differences**                         | **\$**      | **\$**      |
+-----------------------------------------+-------------+-------------+

**16. Supervisory Committee:**

> **a. What is the effective date of the last complete comprehensive
> annual audit performed by the supervisory committee?**

**Effective Date**      

> **(1) If the effective date of the annual audit is not within the last
> 18 months what is the supervisory committee\'s target date for
> completion of a comprehensive audit? Date**      
>
> **b. Show the effective date of the supervisory committee\'s last
> controlled verification of all members\' accounts:**

**Effective Date**      

> **(1) If all members\' accounts have not been verified under
> controlled conditions during the last two years, what is the
> supervisory committee\'s target date for completion of the
> verification program?**
>
> **Date**      
>
> **c. If it is necessary to complete either 16a(1) or 16 b(1); please
> describe the directors\' plans for seeing that the target dates are
> met. (Discuss below or on an attached schedule.) Schedule No.**      

**17. List below the credit union\'s surety bond coverage.**

> **a. Name of carrier**      
>
> **b. Standard form number of the bond (i.e., 23, 576, 577, 578, 581,
> 562 CU-1, other)**      
>
> **c. Basic amount of coverage \$**     
>
> **d. Bond premium paid to (date)**      
>
> **e. What is the amount of coverage required by State law or your
> bylaws?**      
>
> **f. Riders to the bond (list below) (i.e., faithful performance,
> forgery, misplacement, etc.)**      

18. **Does the credit union render any services to or perform any
    functions on behalf of the members, non-members, organizations, or
    the public other than the usual savings and loan services for
    members?**      

**Attach a schedule describing each activity in full. Schedule No.**
     

**19. Does the board of directors or management know of any adverse
economic condition that is affecting or will affect the credit union's
present or future operation or that of the sponsor organization?**      

**Attach a schedule describing the condition and its possible effect on
the credit union\'s future. Schedule No.**      

**20. To the best of the credit union\'s knowledge and belief, has any
director, officer, committee member, or employee been convicted of any
criminal offense involving dishonesty or breach of trust?**      

> **a. Attach a statement describing the circumstances. Schedule No.**
>      

**21. Lending policies and practices:**

**a. Complete the following schedule showing the present policies and
practices on loans to members.**

**b. Complete the following schedule of largest loans with the attached
instructions pertaining to Item No. 21.**

**LENDING POLICIES AND PRACTICES**

+----------------------------+------------+------------+---------------+
|                            | *          | **Maximum  | **Required    |
|                            | *Maximum** | Period**   | Amount of**   |
|                            |            |            |               |
|                            | **Loan     | **of       | **Down        |
|                            | Amount**   | R          | Payment       |
|                            |            | epayment** | (Equity)**    |
+----------------------------+------------+------------+---------------+
| > **1. Credit Union        |            |            |               |
| > Policies and Practices** |            |            |               |
| >                          |            |            |               |
| > **a. Unsecured Loan      |            |            |               |
| > Limits**                 |            |            |               |
+----------------------------+------------+------------+---------------+
| **b. Secured Loan Limits** |            |            |               |
|                            |            |            |               |
| **(1) New Auto             |            |            |               |
| Collateral**               |            |            |               |
+----------------------------+------------+------------+---------------+
| **(2) Used Auto            |            |            |               |
| Collateral**               |            |            |               |
+----------------------------+------------+------------+---------------+
| **(3) Real Estate**        |            |            |               |
|                            |            |            |               |
| **(a) First Mortgage**     |            |            |               |
+----------------------------+------------+------------+---------------+
| **(b) Second Mortgage**    |            |            |               |
+----------------------------+------------+------------+---------------+
| **(4) Comakers**           |            |            |               |
+----------------------------+------------+------------+---------------+
| **(5) Others (describe)**  |            |            |               |
|                            |            |            |               |
| **     **                  |            |            |               |
+----------------------------+------------+------------+---------------+
| **c. Loans to              |            |            |               |
| Organizations**            |            |            |               |
+----------------------------+------------+------------+---------------+
| > **d. Loans to Directors, |            |            |               |
| > Officers, or Committee   |            |            |               |
| > Members**                |            |            |               |
+----------------------------+------------+------------+---------------+
| **2. State Credit Union    |            |            |               |
| Law; Bylaws**              |            |            |               |
|                            |            |            |               |
| **a. Unsecured Loan        |            |            |               |
| Limits**                   |            |            |               |
+----------------------------+------------+------------+---------------+
| **b. Secured Loan Limits** |            |            |               |
+----------------------------+------------+------------+---------------+
| > **c. Loans to Directors, |            |            |               |
| > Officers, or Committee   |            |            |               |
| > Members**                |            |            |               |
+----------------------------+------------+------------+---------------+

**List on an attached page, any additional policies, including the
interest rates applied to members\' loans and the method of assessing
and accounting for interest income, i.e.: add-on, discount or unpaid
balance.**

**SCHEDULE OF LARGEST LOANS**

Complete this form as discussed in the instructions pertaining to Item
21b.

+-------+-------+------------+-------+---------+---------+---+----------+
| # Ac  | **U   | **R        | **S   |         | **Appr  | * |          |
| count | npaid | epayment** | tatus |         | aised** | * |          |
|       | L     |            | of    |         |         | D |          |
| **    | oan** | **Period** | R     |         | **Colla | e |          |
| No.** |       |            | epaym |         | teral** | s |          |
|       | ####  | **(No.     | ent** |         |         | c |          |
|       |  Bal. | Months)**  |       |         | **Valu  | r |          |
|       |       |            |       |         | e**[^1] | i |          |
|       |       |            |       |         |         | p |          |
|       |       |            |       |         |         | t |          |
|       |       |            |       |         |         | i |          |
|       |       |            |       |         |         | o |          |
|       |       |            |       |         |         | n |          |
|       |       |            |       |         |         | o |          |
|       |       |            |       |         |         | f |          |
|       |       |            |       |         |         | * |          |
|       |       |            |       |         |         | * |          |
|       |       |            |       |         |         |   |          |
|       |       |            |       |         |         | * |          |
|       |       |            |       |         |         | * |          |
|       |       |            |       |         |         | C |          |
|       |       |            |       |         |         | o |          |
|       |       |            |       |         |         | l |          |
|       |       |            |       |         |         | l |          |
|       |       |            |       |         |         | a |          |
|       |       |            |       |         |         | t |          |
|       |       |            |       |         |         | e |          |
|       |       |            |       |         |         | r |          |
|       |       |            |       |         |         | a |          |
|       |       |            |       |         |         | l |          |
|       |       |            |       |         |         | * |          |
|       |       |            |       |         |         | * |          |
+-------+-------+------------+-------+---------+---------+---+----------+
|       |       |            | # Cu  | **Delin |         |   |          |
|       |       |            | rrent | quent** |         |   |          |
|       |       |            |       |         |         |   |          |
|       |       |            |       | **(No.  |         |   |          |
|       |       |            |       | Mo      |         |   |          |
|       |       |            |       | nths)** |         |   |          |
+-------+-------+------------+-------+---------+---------+---+----------+
|       |       |            |       |         |         |   |          |
|       |       |            |       |         |         |   |          |
|       |       |            |       |         |         |   |          |
|       |       |            |       |         |         |   |          |
|       |       |            |       |         |         |   |          |
+-------+-------+------------+-------+---------+---------+---+----------+
|       |       |            |       |         |         |   |          |
+-------+-------+------------+-------+---------+---------+---+----------+
|       |       |            |       |         |         |   |          |
+-------+-------+------------+-------+---------+---------+---+----------+
|       |       |            |       |         |         |   |          |
+-------+-------+------------+-------+---------+---------+---+----------+
|       |       |            |       |         |         |   |          |
+-------+-------+------------+-------+---------+---------+---+----------+
|       |       |            |       |         |         |   |          |
+-------+-------+------------+-------+---------+---------+---+----------+
|       |       |            |       |         |         |   |          |
+-------+-------+------------+-------+---------+---------+---+----------+
|       |       |            |       |         |         |   |          |
+-------+-------+------------+-------+---------+---------+---+----------+
|       |       |            |       |         |         |   |          |
+-------+-------+------------+-------+---------+---------+---+----------+
|       |       |            |       |         |         |   |          |
+-------+-------+------------+-------+---------+---------+---+----------+
|       |       |            |       |         |         |   |          |
+-------+-------+------------+-------+---------+---------+---+----------+
|       |       |            |       |         |         |   |          |
+-------+-------+------------+-------+---------+---------+---+----------+
|       |       |            |       |         |         |   |          |
+-------+-------+------------+-------+---------+---------+---+----------+
|       |       |            |       |         |         |   |          |
+-------+-------+------------+-------+---------+---------+---+----------+
|       |       |            |       |         |         |   |          |
+-------+-------+------------+-------+---------+---------+---+----------+
|       |       |            |       |         |         |   |          |
+-------+-------+------------+-------+---------+---------+---+----------+
|       |       |            |       |         |         |   |          |
+-------+-------+------------+-------+---------+---------+---+----------+
|       |       |            |       |         |         |   |          |
+-------+-------+------------+-------+---------+---------+---+----------+
|       |       |            |       |         |         |   |          |
+-------+-------+------------+-------+---------+---------+---+----------+
|       |       |            |       |         |         |   |          |
+-------+-------+------------+-------+---------+---------+---+----------+
|       |       |            |       |         |         |   |          |
+-------+-------+------------+-------+---------+---------+---+----------+
|       |       |            |       |         |         |   |          |
+-------+-------+------------+-------+---------+---------+---+----------+
|       |       |            |       |         |         |   |          |
+-------+-------+------------+-------+---------+---------+---+----------+
|       |       |            |       |         |         |   |          |
+-------+-------+------------+-------+---------+---------+---+----------+
|       |       |            |       |         |         |   |          |
+-------+-------+------------+-------+---------+---------+---+----------+

> **\*If there is more than one type of collateral assign value to each
> type.**

**CREDIT UNION SERVICE ORGANIZATION**

**(CUSO)**

**1. Name of CUSO**      

**2. Date of CUSO\'S Organization**      

> **(Date of obtaining charter from State)**

**3. Type of organization (check one):**

> **a. General Partnership** **c. Joint Ownership**
>
> **b. Limited Partnership** **d. Corporation**

**4. Owners of CUSO (list name, charter number if FCU, and percentage of
ownership, if possible).**

> **a. Name**      
>
> **Charter Number (If FCU)**      
>
> **%**      
>
> **b. Name**      
>
> **Charter Number (If FCU)**      
>
> **%**      
>
> **(Continue on reverse side if additional space is required)**

**5. Capitalization (list investors and amount of investment in CUSO).**

> **a. Name**      
>
> **Charter Number (If FCU)**      
>
> **Amount**      
>
> **b. Name**      
>
> **Charter Number (If FCU)**      
>
> **Amount**      
>
> **(Continue on reverse side if additional space is required)**

**6. List all known services which are being offered by CUSO (be as
specific as possible).**      

**7. Comments (include all other pertinent information, if applicable,
not previously discussed).**      

**8. Attach the latest Financial and Statistical Report of CUSO, if
available.**

**FORM 9600 INSTRUCTIONS**

**APPLICATION OF A STATE CHARTERED CREDIT UNION**

**FOR INSURANCE OF ACCOUNTS**

**The application and all supporting documents should be prepared,
photocopied, and submitted in accordance with the procedures outlined in
the letter that transmitted these instructions. Additional schedules may
be included if deemed appropriate.**

**Existing credit unions must complete the entire application. All other
applicants do not have to complete questions 8, 11, 12, 13, 15, and
16.**

**Existing credit unions must submit current policies and financial
statements as noted in the application. All other applicants must submit
proposed policies and pro forma financial statements for the first and
second year of operation.**

**When an item specifies that a schedule should be prepared and
attached, please assign a schedule number in consecutive order, starting
with number one. Please show the schedule number at the top right-hand
corner of the schedule.**

**Some of the items are self-explanatory and require no special
instructions. Other items, however, need special explanations,
definitions, and instructions for completion. These are listed below,
identified by the same item numbers as appear in Exhibit A.**

**Item No. 10: Reserves: The term \"reserves\" means that account, or
accounts, which represents segregated portions of earnings as provided
by the law, bylaws, and/or the credit union\'s management for the
absorption of losses relating to loans to members.**

**Item No. 11a: The delinquent loan list requested should include, for
each delinquent loan, the account number of the borrower, date of loan,
original amount of loan, unpaid balance, date of last payment of
principle, excluding transfers from pledged shares, collateral, and
comments regarding the collectibility of each loan in the categories 6
months to less than 12 months and 12 months and over. Payments of
interest only should be so identified.**

**Item No. 11b: The schedule provided for the delinquent loan
information is set up in delinquency categories of 2 months to less than
6 months, 6 to less than 12 months, and 12 months and over. Credit
unions that compute delinquency using categories other than shown in
column (b) may use these other categories and show them in column (a).
Credit unions using column (a) need not show the delinquencies in the
column (b) categories. It is not necessary to report on loans which are
delinquent less than 2 months.**

**Adverse Trends: If items 8, 9, or 11 indicate adverse trends such as
significant decreases in shares, loans or reserves, increases in loan
delinquency or loan charge-offs, or unresolved serious exceptions shown
in the State examination report, the credit union may attach an
explanation and identify it as \"Explanation of Adverse Trends or
Unresolved Examination Exceptions\" and assign it a schedule number.**

**Item No. 14: This item need be completed only if the credit union owns
any of the following:**

**A. Investments in U.S. Government securities guaranteed as to
principle and interest or Federal Agency securities, the market value of
which is now less than the book value.**

**B. Real estate other than that used entirely for the credit union\'s
own office(s).**

**C. Other investments of any type except:**

**1. Loans to other credit unions.**

> **2. Certificates of, or accounts in, federally insured financial
> institutions.**
>
> **3. Deposits or accounts in corporate credit unions.**

**If corporate bonds are listed, please show maturity date, rate of
interest on bonds and current yield rate.**

**If stocks are listed, please show number of shares and bid price.**

**Please identify the source of the market valuation information and the
date of such information.**

**Item No. 21b: In selecting the largest loans for this Exhibit, list
the largest outstanding unpaid loan balance and proceed in descending
order by dollar amount until the number specified below has been shown.
The number of such loans to be listed will be determined as follows:**

+----------------------------+------------+---------------------------+
| **If your credit**         |            | **You should list the**   |
|                            |            |                           |
| **union has the**          |            | **following no. of**      |
|                            |            |                           |
| **following no. of**       |            | **the largest unpaid**    |
|                            |            |                           |
| **outstanding loans**      |            | **balances**              |
+----------------------------+------------+---------------------------+
| **Under 100**              |            | **5**                     |
|                            |            |                           |
| **100 to 199**             |            | **10**                    |
|                            |            |                           |
| **200 to 299**             |            | **15**                    |
|                            |            |                           |
| **300 to 399**             |            | **20**                    |
|                            |            |                           |
| **400 or more**            |            | **25**                    |
+----------------------------+------------+---------------------------+

**If any of the above loans are delinquent, please show the number of
months delinquent in the appropriate \"Status of Re-payment\" column.**

**Complete the Credit Union Service Organization (CUSO) schedule for
each investment/loan to a CUSO.**

### TERMINATION OF INSURANCE

**Should the credit union, after obtaining insurance of member accounts,
desire to terminate its insured status, this could be accomplished by
complying with the provisions of Section 206(a), (c) and (d) of Title II
of the Federal Credit Union Act. This action would require approval by a
vote of the majority of the members, and ninety days written notice of
the proposed termination date to NCUA. Member accounts would continue to
be insured for one year following termination of insurance and the
insurance premium would be paid during that period. After termination of
insurance, the credit union shall give prompt and reasonable notice to
all members whose accounts are insured that it has ceased to be an
insured credit union.**

**Sections 206(a)(2) and 206(d)(2) and (3) of the Act provide that an
insured credit union may also terminate its insurance by converting from
its status as an insured credit union under the Act to insurance from a
corporation authorized and duly licensed to insure member accounts. In
this event, approval is required by a majority of all the directors and
by affirmative vote of a majority of the members voting, provided that
at least 20 percent of the members have voted on the proposition. Under
this provision for termination, insurance of member accounts would cease
as of the date of termination.**

**APPLICATION AND AGREEMENTS FOR INSURANCE OF ACCOUNTS**

**STATE CHARTERED CREDIT UNION**

**TO: The National Credit Union Administration Board Date      **

**The       Credit Union,**

**Insurance Certificate Number       (if applicable)**

**(mailing address)      **

**(city)(state) (zip code)      **

**applies for insurance of its accounts as provided in Title II of the
Federal Credit Union Act, and in consideration of the granting of
insurance, hereby agrees:**

**1. To permit and pay the cost of such examinations as the NCUA Board
deems necessary for the protection of the interests of the National
Credit Union Share Insurance Fund.**

**2. To permit the Board to have access to all records and information
concerning the affairs of the credit union, including any information or
report related to an examination made by or for any other regulating
authority, and to furnish such records, information, and reports upon
request of the NCUA Board.**

**3. To possess such fidelity coverage and such coverage against
burglary, robbery, and other losses as is required by Parts 713 and 741
of NCUA\'s regulations.**

**4. To meet, at a minimum, the statutory reserve and full and fair
disclosure requirements imposed on Federal Credit Unions by Part 702 of
NCUA\'s regulations, and to maintain such special reserves as the NCUA
Board may be regulation or on a case-by-case basis determine are
necessary to protect the interests of members. Any waivers of the
statutory reserve or full and fair disclosure requirements or any direct
charges to the statutory reserve other than loss loans must have the
prior written approval of the NCUA Board. In addition, corporate credit
unions shall be subject to the reserve requirements specified in Part
704 of NCUA\'s regulations.**

**5. Not to issue or have outstanding any account or security the form
of which has not been approved by the NCUA Board, except accounts
authorized by state law for state credit unions.**

**6. To maintain the deposit and pay the insurance premium charges
imposed as a condition of insurance pursuant to Title II (Share
Insurance) of the Federal Credit Union Act.**

**7. To comply with the requirement of Title II (Share Insurance) of the
Federal Credit Union Act and of regulations prescribed by the NCUA Board
pursuant thereto.**

**8. For any investments other than loans to members and obligations or
securities expressly authorized in Title I of the Federal Credit Union
Act, as amended to establish now and maintain at the end of each
accounting period and prior to payment of any dividend, an Investment
Valuation Reserve Account in an amount at least equal to the net excess
of book value over current market value of the investments. If the
market value cannot be determined, an amount equal to the full book
value will be established. When, as of the end of any dividend period,
the amount in the Investment Valuation Reserve exceeds the difference
between book value and market value, the board of directors may
authorize the transfer of the excess to Undivided Earnings.**

**9. When a state-chartered credit union is permitted by state law to
accept nonmember shares or deposits from sources other than other credit
unions and public units, such nonmember accounts shall be identified as
nonmember shares or deposits on any statement or report required by the
NCUA Board for insurance purposes. Immediately after a state-chartered
credit union receives notice from NCUA that its member accounts are
federally insured, the credit union will advise any present nonmember
share and deposit holders by letter that their accounts are not insured
by the National Credit Union Share Insurance Fund. Also, future
nonmember share and deposit fund holders will be so advised by letter as
they open accounts.**

**10. In the event a state-chartered credit union chooses to terminate
its status as a federally-insured credit union, then it shall meet the
requirements imposed by Sections 206(a)(1) and 206(c) of the Federal
Credit Union Act and Part 741.208 of NCUA\'s regulations.**

**11. In the event a state-chartered credit union chooses to convert
from federal insurance to some other insurance from a corporation
authorized and duly licensed to insure member accounts, then it shall
meet the requirements imposed by Sections 206(a)(2), 206(c), 206(d)(2),
and 206(d)(3) of the Federal Credit Union Act and any other applicable
federal law.**

**In support of this application we submit the following schedules:**

**Schedule No. and Title**

**     **

# CERTIFICATIONS AND RESOLUTIONS

**We, the undersigned, certify that we are the duly elected and
qualified presiding officer and recording officer of the credit union
and that at a properly called and regular or special meeting of its
board of directors, at which a quorum was present, the following
resolutions were passed and recorded in its minutes:**

> **We, the undersigned, certify to the correctness of the information
> submitted.**
>
> **Be it resolved that this credit union apply to the National Credit
> Union Administration Board for insurance of its accounts as provided
> in Title II of the Federal Credit Union Act.**
>
> **Be it resolved that the presiding officer and recording officer be
> authorized and directed to execute the Application and Agreement for
> Insurance of Accounts as prescribed by the NCUA Board and any other
> papers and documents required in connection therewith and to pay all
> expenses and do all such other things necessary or proper to secure
> and continue in force such insurance.**
>
> **We further certify that to the best of our knowledge and belief no
> existing or proposed officer, committee member, or employee of this
> credit union has been convicted of any criminal offense involving
> dishonesty or breach of trust, except as noted in attachments to this
> application. We further agree to notify the Board if any existing,
> proposed or future officer, committee member or employee is indicted
> for such an offense.**

**(Signature) Chairperson, Board of Directors**

**     **

**(Print or type Chairperson's Name)**

**(Signature) Secretary, Board of Directors**

**     **

**(Print or type Secretary\'s Name)**

[^1]: ^^