"Branch Relocation Notification Form" - Idaho

This Idaho-specific printable "Branch Relocation Notification Form" is a part of the legal paperwork issued by the Idaho Department of Finance.

Download the up-to-date PDF by clicking the link below and mail it as per the guidelines provided by the department.

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FINANCIAL INSTITUTIONS BUREAU
Bureau Chief – Mary E. Hughes
800 Park Blvd, Suite 200, Boise, ID 83712
Mail To: P.O. Box 83720, Boise ID 83720-0031
Phone: (208) 332-8005 Fax: (208) 332-8098
http://finance.idaho.gov
PROTECTING THE INTEGRITY OF IDAHO FINANCIAL MARKETS SINCE 1905
_______________________________________________________________________________________________________________________________________
STATE CREDIT UNION
BRANCH RELOCATION NOTIFICATION
The Idaho Credit Union Act § 26-2108(p) provides that a credit union has the power to relocate its head office or
branches upon written notice to the director. This form lists the information that will be considered sufficient for the
Department to consider the relocation. If the proposed location is within the same city as the current head office or
branch, it will be considered relocation and this form will be accepted. If the proposed location is not within the same city,
the credit union should submit an application for a new branch pursuant to the Idaho Credit Union Act § 26-2143.
CREDIT UNION
Name of Credit Union:________________________________________________________________________________
Address of Credit Union:_______________________________________________________________________________
City:_______________________________ State: __________________ Zip Code:_____________________________
Name & Title of Contact Person:________________________________________________________________________
Address (if different from above):_______________________________________________________________________
City:_______________________________ State:___________________ Zip Code:_____________________________
Telephone Number:__________________________________________________________________________________
BRANCH OFFICE DATA
On a separate page please submit the following information as part of the notification of a branch office relocation:
 Reason for the request.
 Description of services to be provided at the relocated branch, if different from the current location.
 Current location and proposed new location of branch office, including street address.
 Distance and geographical direction from current location to proposed new location.
 Information to support the opinion there is a member need for the relocation.
 A physical description of the new quarters to be occupied by the branch.
 If the property is to be purchased, information as to the estimated cost.
 If the property is to be leased, information as to the terms of the proposed lease and the estimated improvement
costs, if any, to be incurred by the lessee.
 Indicate whether the proposed relocation involves or results in a transaction with a member of the Board of Directors
or senior management of the credit union.
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FINANCIAL INSTITUTIONS BUREAU
Bureau Chief – Mary E. Hughes
800 Park Blvd, Suite 200, Boise, ID 83712
Mail To: P.O. Box 83720, Boise ID 83720-0031
Phone: (208) 332-8005 Fax: (208) 332-8098
http://finance.idaho.gov
PROTECTING THE INTEGRITY OF IDAHO FINANCIAL MARKETS SINCE 1905
_______________________________________________________________________________________________________________________________________
STATE CREDIT UNION
BRANCH RELOCATION NOTIFICATION
The Idaho Credit Union Act § 26-2108(p) provides that a credit union has the power to relocate its head office or
branches upon written notice to the director. This form lists the information that will be considered sufficient for the
Department to consider the relocation. If the proposed location is within the same city as the current head office or
branch, it will be considered relocation and this form will be accepted. If the proposed location is not within the same city,
the credit union should submit an application for a new branch pursuant to the Idaho Credit Union Act § 26-2143.
CREDIT UNION
Name of Credit Union:________________________________________________________________________________
Address of Credit Union:_______________________________________________________________________________
City:_______________________________ State: __________________ Zip Code:_____________________________
Name & Title of Contact Person:________________________________________________________________________
Address (if different from above):_______________________________________________________________________
City:_______________________________ State:___________________ Zip Code:_____________________________
Telephone Number:__________________________________________________________________________________
BRANCH OFFICE DATA
On a separate page please submit the following information as part of the notification of a branch office relocation:
 Reason for the request.
 Description of services to be provided at the relocated branch, if different from the current location.
 Current location and proposed new location of branch office, including street address.
 Distance and geographical direction from current location to proposed new location.
 Information to support the opinion there is a member need for the relocation.
 A physical description of the new quarters to be occupied by the branch.
 If the property is to be purchased, information as to the estimated cost.
 If the property is to be leased, information as to the terms of the proposed lease and the estimated improvement
costs, if any, to be incurred by the lessee.
 Indicate whether the proposed relocation involves or results in a transaction with a member of the Board of Directors
or senior management of the credit union.
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 Description of vault, furniture, fixtures, and equipment for the proposed relocated branch, along with projection of
their cost. If complete building plans have not been formulated for the branch, limits should be set on the expected
investment in building, leasehold improvements, furniture, fixtures, and equipment.
 Proposed opening date of the relocated branch.
 Approximate annual cost of operating the relocated branch.
 Impact proposed relocated branch office will have on head office (indicate the credit union’s fixed asset investment).
 Plans for staffing the proposed relocated branch, if different from current location. Submit a resume of the proposed
branch manager and indicate the number and experience level of subordinate personnel.
 Most recent month-end financial statements (include income and expenses).
 If expenses related to the relocated branch will be greater than the current branch, an estimate of income and
expenses for the first three years at the proposed branch. (See attached sample 3 year pro forma statement.)
BOARD APPROVAL
The Idaho Credit Union Act § 26-2116(i) establishes a special duty of the Board of Directors to authorize the conveyance
of property. Please certify by checking below that the Board of Directors has approved any purchase or sale of real
property related to the proposed branch:
 The Board of Directors has authorized all purchases or sales of real property related to this proposed branch.
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__________________________________________________________________________________________________________
SAMPLE PRO FORMA STATEMENT
Year 1
Year 2
Year 3
Estimate
Estimate
Estimate
Income
Interest from Loans
$
-
$
-
$
-
Investment Income
$
-
$
-
$
-
Other Income
$
-
$
-
$
-
Total Income
$
-
$
-
$
-
Expenses
Salaries, Wages, and
Benefits
$
-
$
-
$
-
Travel and Conference
$
-
$
-
$
-
Office Occupancy
$
-
$
-
$
-
Office Operations
$
-
$
-
$
-
Education and Promotion
$
-
$
-
$
-
Loan Servicing
$
-
$
-
$
-
Other
$
-
$
-
$
-
Interest Expense
$
-
$
-
$
-
Total Expenses
$
-
$
-
$
-
Net Gain or Loss
$
-
$
-
$
-
Total Loans Outstanding
$
-
$
-
$
-
Total Shares
$
-
$
-
$
-
Total Assets
$
-
$
-
$
-
Total Members
#
#
#
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