The following is an illustration of Department Form 25 and of the instructions for Department Form 25:
Form 25 (3/11/98)
California Department of
Business OversightUniform California Application/Notice
In shaded area, neither application or notice required for federal purposes.
(Check one or more appropriate boxes)
Report for Exempted Transaction? (Yes/No) __________
APPLICANT INFORMATION:
___________________________
Name:
Address: ____________________ City __________ State __________ Zip Code __________
___________________________
Correspondent's Name:
Address: ____________________ City __________ State __________ Zip Code __________
LOCATION:
___________________________
Official Name of Branch:
___________________________
Proposed Address:
City ____________________ County __________ State __________ Zip Code __________
___________________________
Address of Office to be Discontinued:
City ____________________ County __________ State __________ Zip Code __________
Proposed Date ____________________
APPLICATION DETAILS:
For Applications Involving Branch Offices Only (Information for federal purposes):
Officer's Signature: | ___________________________ | Date: ___________________________ |
Name: ___________________________ | Title: ___________________________ |
Uniform Application California and Interstate
Application Instructions
A version of this "Uniform Application" was developed by the State/Federal Working Group for the purpose of reducing regulatory burden, by elimination of the need for banks to file multiple different application forms for common applications. By providing the information in this application/notice, applicant will meet the requirements of the California Department of Business Oversight. It is expected that a version of this application form will be adopted by the FDIC, FRB and all other State Banking Departments in the future. In the minority of cases where additional information is required, you will receive a separate request for additional information to supplement the application. You may also use the top part of this form for filing a "Notice" where no formal application is required.
File one copy of this application with the California Department of Business Oversight in the regional office where you are located. If application involves an interstate activity, there is no need to file a separate application with any state except your home state.
Banks with a CAMELS rating of 1 or 2 are exempt from the application process, and need only file the top part of the form as a notice or report.
Check the appropriate box for establishment, relocation, or discontinuance. Also check whether the application concerns a "branch office"; "place of business" other than a branch office such as a "loan production office" (LPO) or representative office; or an automated service location such as a stand alone automated teller machine, or cash dispensing machine. The activity conducted at the location will determine whether the office is considered a "branch" under state or federal statutes. Note if the Form is being used to file a report of an exempted transaction.
A. | Name and Address: | Bank's full name and headquarters office address. |
B. | Correspondent: | Provide the name and address of the individual the bank wants to handle any inquiries or requests concerning this application. |
C. | Popular Name: | Please indicate the popular or official name of the office or proposed office such as "Main Street Office" or "Produce Mart Office." |
D. | Proposed Location: | Provide the complete street address of the location where the bank wishes to establish or relocate a new physical facility. |
E. | Address of Office to be Discontinued: | If the application involves the discontinuance, or relocation of an existing facility, provide the address of the location where the business will be discontinued. |
For additional information on the application process, you may wish to contact the Assistant Deputy Commissioner assigned to your bank.
This part of the Form applies only in cases where the applicant is required to file an application or notice of discontinuance. However, this part of the Form does not apply in cases where the applicant proposes to relocate or discontinue an automated teller machine branch office. In any event, the applicant should provide all information required by appliciable statutes. The information provided by the applicant in response to this part of the Form should be set forth on continuation pages attached to the Form.
The following three questions apply only to applications involving the establishment of new branches to comply with specific federal requirements. These questions need not be answered for applications filed only with the California Department of Business Oversight.
Cal. Code Regs. Tit. 10, § 95.25
2. Editorial correction of FORM 25 (Register 98, No. 23).
3. Change without regulatory effect amending section and NOTE filed 8-21-2019 pursuant to section 100, title 1, California Code of Regulations (Register 2019, No. 34).
Note: Authority cited: Section 326, Financial Code. Reference: Sections 321, 1076, 1078 and 1081, Financial Code.
2. Editorial correction of Form 25 (Register 98, No. 23).
3. Change without regulatory effect amending section and Note filed 8-21-2019 pursuant to section 100, title 1, California Code of Regulations (Register 2019, No. 34).