Discount Window and Payment System Risk Contact Information for San Francisco
12th District (San Francisco) Forms
Please note: These forms are specifically for the Federal Reserve Bank of San Francisco. Information and forms for your Federal Reserve Bank may be available on your district's Contacts & Resources page.
- Appendix A - Instructions & Template [MS Word; 35K]
- Application for Borrower-In-Custody (BIC) –[MS Word; 79K] - Application for new Borrower-In-Custody relationship with the 12th District.
- Audit Certification [MS Word; 50K] - An Audit Certification must be completed annually to confirm that the institution has reviewed the BIC guidelines for compliance.
- Collateral Schedule Confirmation [MS Word; 24K] - In the Collateral Schedule Confirmation, the FI’s executive management attests that controls are in place to give reasonable assurances about the accuracy of the data submitted.
- Collateral Transmittal & Custody Receipt for Pledge of Credit Card Receivables (Form CCR-1) [MS Word; 73K]
- Collateral Transmittal & Custody Receipt for Pledge of Loans (Form BIC 1) [MS Word; 43K] – Monthly transmittal form for collateral pledged under the BIC program to the 12th District.
- Contingency Contact Information [MS Word; 40K]
- Electronic Collateral Reports [MS Word; 50K] – Request form for Electronic Subscription of Collateral Reports.
- FBO Collateral Transmittal & Custody Receipt for Pledge of Loans (Form BIC-1, FBO) [MS Word; 172K] - Monthly transmittal form for FBO's pledging collateral under the BIC program to the 12th District.
- FR 2046 – Form for completion by participants of the Seasonal Credit Program.
- Imaging Questionnaire [MS Word; 45K] – Collateral in image or electronic form must have a imaging questionnaire on file.
- Irrevocable Power of Attorney [MS Word; 36K] – Irrevocable POA form for the 12th District.
- Official OC-10 Authorization List [MS Word; 40K] – The 12th district's Authorization List for pledging collateral and borrowing.
- Pledge Listing Template [MS Excel; 13K] – Recommended template for listing of loans pledged, to be submitted monthly with the Collateral Transmittal & Custody Receipt (BIC 1) for the 12th District. Use of this template will allow for loan specific valuation of collateral.
- Seasonal Credit Program Application [MS Word; 60K] – Calculation of Deposits and Loans Worksheet – Application for the Seasonal Credit program with the 12th District.
- Third Party Custodian Certification [MS Word; 60K] -- Annual Certification for completion by Third Party Custodians that administer Certificates of Title.
Please contact us for additional information.