Form DBO-10 Application for Authority to Organize Bank - California

Form DBO-10 or the "Application For Authority To Organize Bank" is a form issued by the California Department of Business Oversight.

The form was last revised in May 1, 2017 and is available for digital filing. Download an up-to-date Form DBO-10 in PDF-format down below or look it up on the California Department of Business Oversight Forms website.

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STATE OF CALIFORNIA – DEPARTMENT OF BUSINESS OVERSIGHT
APPLICATION FOR AUTHORITY TO ORGANIZE BANK
DBO-10 (Rev. 5-17)
(Facing Page)
To: Commissioner of Business Oversight
Date:
The undersigned hereby apply for authority to organize and establish a corporation under the
laws of the State of California to engage in:
(Check one or more)
Commercial Banking Business
Trust Business
Industrial Bank
(Street address or vicinity)
(City)
(County)
under the name
with shareholder's equity of $
The documents attached hereto are hereby referred to and by this reference incorporated herein.
The person authorized to represent the applicants in connection with this application is:
Name:
Telephone:
Address:
APPLICANTS
Name and Business or Occupation
Address
Signature
(This is a facing page only. For instructions on completing and signing this application, refer to the
Regulations of the Commissioner of Business Oversight. Signature must be acknowledged.)
STATE OF CALIFORNIA – DEPARTMENT OF BUSINESS OVERSIGHT
APPLICATION FOR AUTHORITY TO ORGANIZE BANK
DBO-10 (Rev. 5-17)
(Facing Page)
To: Commissioner of Business Oversight
Date:
The undersigned hereby apply for authority to organize and establish a corporation under the
laws of the State of California to engage in:
(Check one or more)
Commercial Banking Business
Trust Business
Industrial Bank
(Street address or vicinity)
(City)
(County)
under the name
with shareholder's equity of $
The documents attached hereto are hereby referred to and by this reference incorporated herein.
The person authorized to represent the applicants in connection with this application is:
Name:
Telephone:
Address:
APPLICANTS
Name and Business or Occupation
Address
Signature
(This is a facing page only. For instructions on completing and signing this application, refer to the
Regulations of the Commissioner of Business Oversight. Signature must be acknowledged.)
STATE OF CALIFORNIA – DEPARTMENT OF BUSINESS OVERSIGHT
APPLICATION FOR AUTHORITY TO ORGANIZE BANK
DBO-10 (Rev. 5-17)
DBO’s Privacy Notice on Collection
DBO Collects and Uses Personal Information: The DBO collects the information requested on this
form as authorized by Chapter 1 of Title 10 of the California Code of Regulations. The DBO uses this
information to process applications for authority to organize and establish a corporation to engage in
the banking or trust business pursuant to Division 1.1 of the Financial Code. Use of the personal
Information DBO collects is subject to limitations contained in the Information Practices Act of 1977 and
other applicable state and federal laws.
Providing Personal Information Is Mandatory: When providing information or documents, please do
not include unrequested personal information such as a Social Security number, driver’s license
number, or financial information.
DBO May Disclose Your Personal Information: We may share your personal information with other
federal and state financial institution regulators, or any law enforcement agency. Your personal
information may also be disclosed:
 In response to a Public Records Act request, as allowed by the Information Practices Act.
 To another governmental agency as required by state or federal law.
 In response to a court order or administrative order, a subpoena or a search warrant.
Your Access to Your Personal Information: You may review the records maintained by DBO that
contain your personal information. To request access, contact: DBO Privacy Officer, 1515 K Street,
Sacramento, CA 95814, (866) 275-2677.

Download Form DBO-10 Application for Authority to Organize Bank - California

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