Form SFN53086 "Application to Establish a Branch or Operating Subsidiary" - North Dakota

What Is Form SFN53086?

This is a legal form that was released by the North Dakota Department of Financial Institutions - a government authority operating within North Dakota. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on July 1, 2021;
  • The latest edition provided by the North Dakota Department of Financial Institutions;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form SFN53086 by clicking the link below or browse more documents and templates provided by the North Dakota Department of Financial Institutions.

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Download Form SFN53086 "Application to Establish a Branch or Operating Subsidiary" - North Dakota

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APPLICATION TO ESTABLISH A BRANCH
1200 Memorial Hwy
OR OPERATING SUBSIDIARY
Bismarck, ND 58504
NORTH DAKOTA DEPARTMENT OF FINANCIAL INSTITUTIONS
Telephone (701) 328-9933
BANKS AND TRUST COMPANIES DIVISION
Fax Number (701) 328-0290
SFN 53086 (Rev. 7-2021)
Branch
Operating Subsidiary
Name of Trust Company
Date
Address
City
State
Zip Code
PART I. GENERAL INFORMATION (if additional space is needed attach additional sheets)
1. Estimated number of potential customers that will use facility
2. Estimated number of current customers that will use facility
3. Principal office is
owned by trust company
in rented space
4. Proposed Branch or Subsidiary Office Address
Size (Square Footage)
5. Distance from Principal Office
6. Statement of contributing factors considered by management to be in support of the establishment of the proposed branch or subsidiary
7. Hours of Operation
8. Describe Security Measures
9. Name and Qualifications of Manager
10. Services to be Offered or Functions to be Performed
11. Describe method by which daily transactions will be transmitted to principal office
PART II. FINANCIAL IMPACT OF PROPOSED BRANCH OR SUBSIDIARY
It is incumbent that the applicant demonstrate to the State Banking Board that the proposed branch or subsidiary would not
have an overly detrimental effect on the consolidated operation of the applicant. In that regard, the applicant should provide
estimates of anticipated activity at the proposed branch or subsidiary as follows:
1.
OPERATING EXPENSE
Occupancy Expense:
Rent*/Depreciation** on Facility
$
$
$
Heat, Lights and Power
Telephone
Repairs and Maintenance
Taxes and Insurance
Other Occupancy Expense
Gross Occupancy Expense
Less, Rental Income (if any)
(
) (
) (
)
Net Occupancy Expense
0.00
0.00
0.00
* If leased
** If owned
APPLICATION TO ESTABLISH A BRANCH
1200 Memorial Hwy
OR OPERATING SUBSIDIARY
Bismarck, ND 58504
NORTH DAKOTA DEPARTMENT OF FINANCIAL INSTITUTIONS
Telephone (701) 328-9933
BANKS AND TRUST COMPANIES DIVISION
Fax Number (701) 328-0290
SFN 53086 (Rev. 7-2021)
Branch
Operating Subsidiary
Name of Trust Company
Date
Address
City
State
Zip Code
PART I. GENERAL INFORMATION (if additional space is needed attach additional sheets)
1. Estimated number of potential customers that will use facility
2. Estimated number of current customers that will use facility
3. Principal office is
owned by trust company
in rented space
4. Proposed Branch or Subsidiary Office Address
Size (Square Footage)
5. Distance from Principal Office
6. Statement of contributing factors considered by management to be in support of the establishment of the proposed branch or subsidiary
7. Hours of Operation
8. Describe Security Measures
9. Name and Qualifications of Manager
10. Services to be Offered or Functions to be Performed
11. Describe method by which daily transactions will be transmitted to principal office
PART II. FINANCIAL IMPACT OF PROPOSED BRANCH OR SUBSIDIARY
It is incumbent that the applicant demonstrate to the State Banking Board that the proposed branch or subsidiary would not
have an overly detrimental effect on the consolidated operation of the applicant. In that regard, the applicant should provide
estimates of anticipated activity at the proposed branch or subsidiary as follows:
1.
OPERATING EXPENSE
Occupancy Expense:
Rent*/Depreciation** on Facility
$
$
$
Heat, Lights and Power
Telephone
Repairs and Maintenance
Taxes and Insurance
Other Occupancy Expense
Gross Occupancy Expense
Less, Rental Income (if any)
(
) (
) (
)
Net Occupancy Expense
0.00
0.00
0.00
* If leased
** If owned
SFN 53086 (Rev. 7-2021) Page 2
YEAR 1
YEAR 2
YEAR 3
Other Operating Expense:
Salaries and Benefits
$
$
$
Furniture, Fixtures, and Equipment (rent*,
depreciation**, maintenance, etc.)
Legal
Postage
Data Processing
Miscellaneous
Total Other Operating Expense
0.00
0.00
0.00
TOTAL OPERATING EXPENSE
0.00
0.00
0.00
(Sum A and B)
* If leased
** If owned
AVERAGE DURING
2.
ANTICIPATED VOLUME OF:
YEAR 1
YEAR 2
YEAR 3
NUMBER
NUMBER
NUMBER
Trust Accounts (all types)
$
$
$
Staff (all types)
AVERAGE DURING
3.
ANTICIPATED REVENUES AND EXPENSES:
YEAR 1
YEAR 2
YEAR 3
Gross Income from all Sources
$
$
$
Less: Operating Expenses (from Section1)***
(
) (
) (
)
0.00
0.00
0.00
Net Operating Income
0.00
0.00
0.00
Less: Interest and Dividend Expense
(
) (
) (
)
Net Income (before reserve transfer)
0.00
0.00
0.00
4.
ANTICIPATED COST OF:
****
Facility (if owned)
$
****
Leasehold Improvements
$
Furniture, Fixtures and Equipment
$
***
Should include anticipated charge-offs, net of recoveries.
****
Should include such items as architect’s fees, site preparation, paving, landscaping, etc.
SFN 53086 (Rev. 7-2021) Page 3
5. Please attach a five-year projection of the trust company for the additional branch or subsidiary, consolidated with
the main trust company.
6. Names and location of trust service providers within the city limits of the proposed location.
NAME
LOCATION
7. If the branch or subsidiary is located out-of-state or outside the United States, please provide a legal opinion and a
"no objection letter" from the host state or host country authority as to the legality of opening a branch or
subsidiary in that state or country.
PART III. CERTIFICATION
We hereby certify and declare the information included in this application and all attachments hereto to be true and correct to
the best of our knowledge and belief. We agree to comply with the provisions of all laws and all rules promulgated by the
State Banking Board applicable to branch offices and operating subsidiaries.
Signed for the Board of Directors (Chairman)
Date
The following additional information is attached in support of this application:
a. Copy of board minutes supporting decision to establish a branch or subsidiary office.
b. Copy of proposed building plans and/or contractual agreements.
c. Copy of the trust company’s most recent financial statement.
d. Copies of Notice of Publication(s), if required.
e. Application fee is $500.00. Check to be made payable to the Department of Financial Institutions.
If space provided is insufficient, attach additional sheet(s)
RETURN TO:
State Banking Board
Department of Financial Institutions
2000 Schafer Street, Suite G
Bismarck, ND 58501-1204
This is to certify that the State Banking Board, at its meeting on
,
,
granted
denied this application for the establishment of a trust branch.
State Banking Board Secretary
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