California Code of Regulations › Title 10 - Investment › Chapter 1 - Commissioner of Business Oversight, Division of Financial Institutions › Subchapter 95 - Forms › Section 95.25 - Uniform California Application/Notice Form

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
The following is an illustration of Department Form 25 and of
				  the instructions for Department Form 25:
Form 25 (3/11/98)
California Department of
Business Oversight
Uniform California
				  Application/Notice
Click
				  here to view image
In shaded area, neither application or notice required for
				  federal purposes.
(Check one or more appropriate boxes)
Report for Exempted Transaction? (Yes/No) __________
APPLICANT INFORMATION:
___________________________
Name:
Address: ____________________ City __________ State
				  __________ Zip Code __________
___________________________
Correspondent's Name:
Address: ____________________ City __________ State
				  __________ Zip Code __________
LOCATION:
___________________________
Official Name of Branch:
___________________________
Proposed Address:
City ____________________ County __________ State __________
				  Zip Code __________
___________________________
Address of Office to be Discontinued:
City ____________________ County __________ State __________
				  Zip Code __________
Proposed Date ____________________
APPLICATION DETAILS:
1. Please briefly describe the services to be
				provided from the location, or in the case of a discontinuance, services which
				will no longer be provided.
2. Are
				premises or equipment to be purchased or leased from an officer, director or
				ten (10) percent shareholder in connection with this application? If so,
				provide details.
3. Please provide
				a brief statement as to why the subject of this application will promote the
				public convenience and advantage, or not have a material adverse effect on the
				public convenience and advantage.
4. Is the establishment or relocation of the
				branch consistent with intrastate branching restrictions which may exist in the
				state where the branch is located?
5. If there is any requirement to provide
				prior notification to the bank's customers, or general public notification
				through newspa per publication, please provide the date and place of such
				notification. (Branch Discontinuance requires 90-days prior notice to
				appropriate federal agency)
For Applications Involving Branch Offices Only
				  (Information for federal purposes):
6. If the bank's last CRA rating was not at
				least satisfactory, please provide a detailed explanation of how the subject of
				this application will promote the bank's efforts to meet its CRA goals, and
				correct any current deficiencies.
7. If enacted, will the subject of this
				application result in the demolition or significant alternation of any
				structure which may have historic or cultural significance? For FDIC purposes,
				non-member banks must also provide a letter from the State Office of Historic
				Preservation.
8. Does the proposed
				branch comply with local zoning ordinances?
Officer's
						  Signature:
___________________________
Date:
						  ___________________________
Name: ___________________________
Title: ___________________________
Uniform Application California and
				  Interstate
Application Instructions
I.
GENERAL INFORMATION
A version of this "Uniform Application" was developed by the
				  State/Federal Working Group for the purpose of reducing regulatory burden, by
				  elimination of the need for banks to file multiple different application forms
				  for common applications. By providing the information in this
				  application/notice, applicant will meet the requirements of the California
				  Department of Business Oversight. It is expected that a version of this
				  application form will be adopted by the FDIC, FRB and all other State Banking
				  Departments in the future. In the minority of cases where additional
				  information is required, you will receive a separate request for additional
				  information to supplement the application. You may also use the top part of
				  this form for filing a "Notice" where no formal application is
				  required.
II.
FILING
				INSTRUCTIONS
File one copy of this application with the California
				  Department of Business Oversight in the regional office where you are located.
				  If application involves an interstate activity, there is no need to file a
				  separate application with any state except your home state.
Banks with a CAMELS rating of 1 or 2 are exempt from the
				  application process, and need only file the top part of the form as a notice or
				  report.
III.
TYPE OF
				APPLICATION
Check the appropriate box for establishment, relocation, or
				  discontinuance. Also check whether the application concerns a "branch office";
				  "place of business" other than a branch office such as a "loan production
				  office" (LPO) or representative office; or an automated service location such
				  as a stand alone automated teller machine, or cash dispensing machine. The
				  activity conducted at the location will determine whether the office is
				  considered a "branch" under state or federal statutes. Note if the Form is
				  being used to file a report of an exempted transaction.
IV.
APPLICANT INFORMATION
A.
Name and
						  Address:
Bank's full name and headquarters office address.
B.
Correspondent:
Provide
						  the name and address of the individual the bank wants to handle any inquiries
						  or requests concerning this application.
C.
Popular
						  Name:
Please indicate the popular or official name of the office
						  or proposed office such as "Main Street Office" or "Produce Mart Office."
D.
Proposed
						  Location:
Provide the complete street address of the location
						  where the bank wishes to establish or relocate a new physical facility.
E.
Address of Office to be
						  Discontinued:
If the application involves the discontinuance, or
						  relocation of an existing facility, provide the address of the location where
						  the business will be discontinued.
For additional information on the application process, you
				  may wish to contact the Assistant Deputy Commissioner assigned to your
				  bank.
V.
APPLICATION
				DETAILS
This part of the Form applies only in cases where the
				  applicant is required to file an application or notice of discontinuance.
				  However, this part of the Form does not apply in cases where the applicant
				  proposes to relocate or discontinue an automated teller machine branch office.
				  In any event, the applicant should provide all information required by
				  appliciable statutes. The information provided by the applicant in response to
				  this part of the Form should be set forth on continuation pages attached to the
				  Form.