Line 

#

Previous Quarter End (for 

comparative purposes only)

Last Day of 1st Month 

in Qtr

Last Day of 2nd Month 

in Qtr

Last Day of 3rd Month 

in Qtr

Line 

#

1 1

2 2

3 3

4 4

5

0 0 0 0

5

6 6

7 7

8 8

9 9

9a

9b

9c

9d

9e

9f

10 10

Institution Name:

Certificate Number:

Quarter End Date:

a. LESS: Unrealized net gain (loss) related to changes in the fair value of liabilities that are 

due to changes in own credit risk (if a gain, report as a positive value; if a loss, report as a 

negative value)

b. LESS: Net unrealized loss on available-for-sale preferred stock classified as an equity 

security under GAAP and available-for-sale equity exposures (report loss as a positive value)

c. LESS: Accumulated net gains (losses) on cash flow hedges (if a gain, report as a positive 

value; if a loss, report as a negative value)

d. LESS: Amounts recorded in AOCI attributed to defined benefit postretirement plans 

resulting from the initial and subsequent application of the relevant GAAP standards that 

pertain to such plans (if a gain, report as a positive value; if a loss, report as a negative value)

e. LESS: Net unrealized gains (losses) on held-to-maturity securities that are included in 

AOCI (if a gain, report as a positive value; if a loss, report as a negative value)

f. To be completed only by institutions that entered “0” for No in item 3.a: LESS: 

Accumulated net gain (loss) on cash flow hedges included in AOCI, net of applicable income 

taxes, that relates to the hedging of items that are not recognized at fair value on the balance 

sheet (if a gain, report as a positive value; if a loss, report as a negative value)

Other deductions from (additions to) common equity tier 1 capital before threshold-based 

deductions:

Total Tangible Equity - Monthly Average Reporting Summary (***)

(***) Do not complete if Average Tangible Equity was reported as Quarter-End amount

Common stock plus related surplus, net of treasury stock and unearned employee stock 

ownership plan (ESOP) shares

Retained Earnings

Accumulated other comprehensive income (AOCI)

a. AOCI opt-out election (enter "1" for Yes; enter "0" for No)

Common equity tier 1 minority interest includable in common equity tier 1 capital

Common equity tier 1 capital before adjustments and deductions (sum of items 1 through 4)

Common Equity Tier 1 Capital: Adjustments and Deductions

Common Equity Tier 1 Capital

LESS: Goodwill net of associated deferred tax liabilities (DTLs)

LESS: Intangible assets (other than goodwill and mortgage servicing assets (MSAs)), net of 

associated DTLs

LESS: Deferred tax assets (DTAs) that arise from net operating loss and tax credit 

carryforwards, net of any related valuation allowances and net of DTLs

AOCI-related adjustments (items 9.a through 9.e are effective January 1, 2015) (if entered 

“1” for Yes in item 3.a, complete only items 9.a through 9.e; if entered “0” for No in item 

3.a, complete only item 9.f):

 Title of Tangible Equity Categories (from Schedule RC-R Regulatory Capital)

a. LESS: Net unrealized gains (losses) on available-for-sale securities (if a gain, report as a 

positive value; if a loss, report as a negative value)
Line 

#

Previous Quarter End (for 

comparative purposes only)

Last Day of 1st Month 

in Qtr

Last Day of 2nd Month 

in Qtr

Last Day of 3rd Month 

in Qtr

Line 

#

Institution Name:

Certificate Number:

Quarter End Date:

Total Tangible Equity - Monthly Average Reporting Summary (***)

(***) Do not complete if Average Tangible Equity was reported as Quarter-End amount

Common Equity Tier 1 Capital

 Title of Tangible Equity Categories (from Schedule RC-R Regulatory Capital)

10a

10b

11 11

12 0 0 0 0 12

13 0 13

14 0 14

15 0 15

16 0 16

17 17

18 0 0 0 0 18

19 0 0 0 0 19

20 0 0 20

21 21

22 22

23 0 0 0 0 23

24 24

25 0 0 0 0 25

26 0 0 0 0 26

0

0

Tier 1 capital (sum of items 19 and 25)

As reported on Schedule RC-O / Line 5

Difference

Additional tier 1 capital instruments plus related surplus

Non-qualifying capital instruments subject to phase out from additional tier 1 capital

Tier 1 minority interest not included in common equity tier 1 capital

Additional tier 1 capital before deductions (sum of items 20, 21, and 22)

LESS: Additional tier 1 capital deductions

Additional tier 1 capital (greater of item 23 minus item 24, or zero)

LESS: DTAs arising from temporary differences that could not be realized through net 

operating loss carrybacks, net of related valuation allowances and net of DTLs, that exceed 

the 10 percent common equity tier 1 capital deduction threshold

LESS: Amount of significant investments in the capital of unconsolidated financial 

institutions in the form of common stock, net of associated DTLs; MSAs, net of associated 

DTLs; and DTAs arising from temporary differences that could not be realized through net 

operating loss carrybacks, net of related valuation allowances and net of DTLs; that exceeds 

the 15 percent common equity tier 1 capital deduction threshold

LESS: Deductions applied to common equity tier 1 capital due to insufficient amounts of 

additional tier 1 capital and tier 2 capital to cover deductions

Total adjustments and deductions for common equity tier 1 capital (sum of items 13 through 

17)

Common equity tier 1 capital (item 12 minus item 18)

Additional Tier 1 Capital

a. LESS: Unrealized net gain (loss) related to changes in the fair value of liabilities that are 

due to changes in own credit risk (if a gain, report as a positive value; if a loss, report as a 

negative value)

b. LESS: All other deductions from (additions to) common equity tier 1 capital before 

threshold-based deductions

LESS: Non-significant investments in the capital of unconsolidated financial institutions in 

the form of common stock that exceed the 10 percent threshold for non-significant 

investments

Subtotal (item 5 minus items 6 through 11)

LESS: Significant investments in the capital of unconsolidated financial institutions in the 

form of common stock, net of associated DTLs, that exceed the 10 percent common equity 

tier 1 capital deduction threshold

LESS: MSAs, net of associated DTLs, that exceed the 10 percent common equity tier 1 

capital deduction threshold

Average Tangible Equity (Average of Tier 1 capital for the 3 months in the quarter)