Federal Deposit Insurance Corporation

3501 Fairfax Drive, Arlington, VA 22226-3500 Division of Finance

December 7, 2023

Banker Name, Title

Bank Name

Address Line 1

Address Line 2

City, State, ZIP

Subject: Order of Termination and the Final Deposit Insurance Invoice payment(s) due for 

 Bank Name, FDIC Certificate Number XXXXX

Banker Name:

The Federal Deposit Insurance Corporation (FDIC) issued the 8(p) Order of Termination, Docket 

No. FDIC-23-XXXXp, for Bank Name (“Bank”) on September 12, 2023. The Order states the 

Bank’s insured status will be terminated on December 31, 2023. Accordingly, the Bank must 

pay deposit insurance assessments through the termination date. As of the date of this letter, the 

Bank owes assessments for the third quarter of 2023 and fourth quarter of 2023. The process and 

options for paying these final assessment premiums are detailed below.

1. The FDIC will collect the Bank’s next payment via ACH on December 29, 2023

(payment for the third quarter of 2023), which will be based on the Bank’s September 30, 

2023 Report of Condition and Income (“Call Report”).

The FDIC will collect the Bank’s remaining payments for the fourth quarter of 2023 via 

ACH on March 29, 2024, which will be based on the Bank’s December 31, 2023 Call 

Report.

2. For its convenience, the Bank can elect to make a lump sum assessment payment for its 

final two quarters. In this situation, the Bank’s invoice for the third quarter of 2023 (due 

on December 29, 2023) will also include a charge for the fourth quarter of 2023. The 

final quarterly amounts would be calculated using the Bank’s September 30, 2023 Call 

Report financial data and the FDIC deposit insurance assessment rate. The Bank can 

elect to pay these assessments on or before the December 29, 2023 quarterly collection 

date.

For Call Reports that are not submitted through the automated Central Data Repository process, 

the Bank should manually complete and submit Call Report schedule RC-O, for the assessment 

base. Optionally, the Bank may complete RC, RC-E, RC-M, RC-N, RC-R, RI, and RI-B, if the 

Bank would like the assessment rate to be re-calculated. The Call Report Schedules should be 
emailed to: assessments@fdic.gov. The FDIC will create invoices using the data from the Call 

Report schedules you submit and the FDIC deposit insurance assessment rates for the applicable 

quarters will apply. 

If the Bank does not manually complete and submit the Call Report schedules, the last filed Call 

Report (June 30, 2023) will be used to produce future invoices. The FDIC deposit insurance 

assessment rate applied will be the same as the last invoice because the same financial data will 

be used to determine the risk rate.

Please reply with a letter containing the name, phone number, and email address for the 

person(s) responsible for handling the Bank’s final deposit insurance assessment payment(s) and 

maintaining its ACH account. Please indicate the option above by which you plan to finalize 

your assessment obligations. Your letter should be emailed to: assessments@fdic.gov. 

We trust that you appreciate the significance of paying your final deposit insurance assessment 

premiums. Should you have any questions, please contact Nick Badalaty of my staff by 

telephone at (571) 595-7861 or by email at nbadalaty@fdic.gov.

Sincerely,

Abi Shanmugam

Manager, Treasury Operations Section