CUSTODIAN AFFIDAVIT
____________, being duly sworn deposes and says that he/she is ____________ of ____________, a banking corporation organized under and pursuant to the laws of the ____________ with the principal place of business at. ____________ (hereinafter called the "bank");
That his/her duties involve supervision of activities of the bank as custodian and records relating thereto;
That the bank is custodian for certain securities of ____________, having a place of business at ____________ (hereinafter called the "insurer") pursuant to an agreement between the bank and the insurer;
That the schedules attached hereto are true and complete statements of securities that, as of the close of business on ____________ were:
(check all that apply)
___
___
___
That the custodian has the responsibility for the safekeeping of such securities whether in the possession of the bank, credited to a book-entry account with a Federal Reserve Bank under the Federal Reserve book-entry system or deposited with a clearing corporation, as that responsibility is specifically set forth in the agreement between the bank as custodian and the insurer; and
That, to the best of his/her knowledge and belief, unless otherwise shown on the schedule, said securities were the property of said insurer and were free of all liens, claims or encumbrances whatsoever.
31 Pa. Code § 148a.3
This section cited in 31 Pa. Code § 148a.1 (relating to definitions); and 31 Pa. Code § 148a.2 (relating to permissible methods of holding securities).