FDIC Regulation 370 | 91�� Bank

We need your help with FDIC Regulation 370

91�� Bank is��required to collect information��under��certain��regulations of the Federal Deposit Insurance Corporation.

Please submit the form below to ensure our data is accurate in compliance with FDIC Regulation 370.

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More Information on FDIC Regulation 370

We, and other large banks, are required to collect additional information��under��certain��regulations of the Federal Deposit Insurance Corporation, which apply��to all U.S. banking institutions with 2 million or more deposit accounts��(12 CFR Part 370).��

Large banks are required to collect and retain information that is important in determining the amount of insurance coverage for accounts held by governmental customers.�� We must obtain the following 2 pieces of additional information that are linked to your government account(s).

Title or position of the “Official Custodian” - Officer, employee, or agent of the��public unit��who has��plenary authority over funds��of��the��public unit.��
Specific��name of the government subdivision��- This should be the name of political��subdivision, or principal department.

You may obtain your complete list of account numbers from your Statement of Accounts and electronic platforms.

For more information or for assistance with questions, please reach out to your Relationship Manager or call us at 1-800-724-2240 (Monday-Friday 8am-6pm).

Please fill out and complete the form below by first entering your Company Name, and your last four digits, Official Custodian, and Political Subdivision of each account you have with 91�� Bank.��

Company Name*

Email Address*

1. Account Number (Enter Last Four Digits)*

1. Title or Position of the “Official Custodian"* (Do Not Include the First or Last Name)

1. Political Subdivision *

2. Account Number (Enter Last Four Digits)

2. Title or Position of the “Official Custodian" (Do Not Include the First or Last Name)

2. Political Subdivision

3. Account Number (Enter Last Four Digits)

3. Title or Position of the “Official Custodian" (Do Not Include the First or Last Name)

3. Political Subdivision

4. Account Number (Enter Last Four Digits)

4. Title or Position of the “Official Custodian" (Do Not Include the First or Last Name)

4. Political Subdivision

5. Account Number (Enter Last Four Digits)

5. Title or Position of the “Official Custodian" (Do Not Include the First or Last Name)

5. Political Subdivision

6. Account Number (Enter Last Four Digits)

6. Title or Position of the “Official Custodian" (Do Not Include the First or Last Name)

6. Political Subdivision

7. Account Number (Enter Last Four Digits)

7. Title or Position of the “Official Custodian" (Do Not Include the First or Last Name)

7. Political Subdivision

8. Account Number (Enter Last Four Digits)

8. Title or Position of the “Official Custodian" (Do Not Include the First or Last Name)

8. Political Subdivision

9. Account Number (Enter Last Four Digits)

9. Title or Position of the “Official Custodian" (Do Not Include the First or Last Name)

9. Political Subdivision

10. Account Number (Enter Last Four Digits)

10. Title or Position of the “Official Custodian" (Do Not Include the First or Last Name)

10. Political Subdivision

11. Account Number (Enter Last Four Digits)

11. Title or Position of the “Official Custodian" (Do Not Include the First or Last Name)

11. Political Subdivision

12. Account Number (Enter Last Four Digits)

12. Title or Position of the “Official Custodian" (Do Not Include the First or Last Name)

12. Political Subdivision

13. Account Number (Enter Last Four Digits)

13. Title or Position of the “Official Custodian" (Do Not Include the First or Last Name)

13. Political Subdivision

14. Account Number (Enter Last Four Digits)

14. Title or Position of the “Official Custodian" (Do Not Include the First or Last Name)

14. Political Subdivision

15. Account Number (Enter Last Four Digits)

15. Title or Position of the “Official Custodian" (Do Not Include the First or Last Name)

15. Political Subdivision

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We need your help with FDIC Regulation 370

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