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OC10-Appx3_OAL

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2 views1 page

OC10-Appx3_OAL

Uploaded by

vetothegoat
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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OC-10 OFFICIAL AUTHORIZATION LIST 1

Page __ of __
Date: ______
Does this Authorization List supersede all previous Authorization Lists?
(If neither is selected, the previously provided Authorization List will also remain in effect and the individuals on such lists will Yes No
remain authorized as indicated)
Name of Borrower Routing (ABA) No.

Please use the table below to list the name and information of the individuals authorized by the Borrower to request advances from and/or pledge collateral to the
Federal Reserve Banks. Please check the appropriate boxes to indicate the action(s) each individual is authorized to perform. Individuals may be authorized to
perform more than one action.
The Borrower is responsible for ensuring that this Authorization List remains current at all times. An updated list should be provided to reflect any changes to
employment, staffing, contact information, or the action(s) that each individual is authorized to perform. The Federal Reserve Banks are not liable for any losses
incurred by the Borrower in connection with the Borrower’s failure to keep this Authorization List current.
Request Pledge
Name Title Telephone No. E-mail Address Signature
Advances Collateral

Authorized Officer Certifying Official


(Must be identified by title in Borrower’s OC-10 Authorizing Resolutions) I hereby certify that I am the Secretary, Assistant Secretary or officer of similar or higher rank of the
Borrower, and each individual executing this Authorization List is in fact an Authorized Officer of the
By: Borrower.
Name:
By:
Title:
Name:
(If a second signatory is required in Borrower’s OC-10 Authorizing Resolutions)
Title:
Second Authorized Officer
(Must be identified by title in Borrower’s OC-10 Authorizing Resolutions)

By:
Name:
Title:

1
You may add additional authorized individuals by completing this page multiple times and submitting it with your request. Please indicate the total number of
pages, including the first/signed page, appropriately at the top left-hand corner of this document.

Appendix 3
to Operating Circular No. 10

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