12th District (San Francisco) Forms

Please note: These forms are specifically for the Federal Reserve Bank of San Francisco. Information and forms for your Federal Reserve Bank may be available on your district's Contacts & Resources page.

• Appendix A - Instructions & Template 

• Application for Borrower-In-Custody (BIC)  - Application for new Borrower-In-Custody relationship with the 12th District.

• Audit Certification - An Audit Certification must be completed annually to confirm that the institution has reviewed the BIC guidelines for compliance.

• Collateral Schedule - Template for listing of loans pledged.  This must be submitted monthly with the Collateral Transmittal & Custody Receipt (BIC1) for the 12th District.  Use of this template will allow for loan specific valuation of collateral.

• Collateral Schedule Confirmation - In the Collateral Schedule Confirmation, the FI’s executive management attests that controls are in place to give reasonable assurances about the accuracy of the data submitted. 

• Collateral Transmittal & Custody Receipt for Pledge of Credit Card Receivables (Form CCR-1) 

• Collateral Transmittal & Custody Receipt for Pledge of Credit Card Receivables (Form CCR-2 only for In-scope Institutions)

• Collateral Transmittal & Custody Receipt for Pledge of Loans (Form BIC 1)  – Monthly transmittal form for collateral pledged under the BIC program to the 12th District.

• Contingency Contact Information 

• Electronic Collateral Questionnaire and Attestation - Questionnaire and Attestation for Loans with Payment Documents in electronic format and stored electronically. If applicable, this should be submitted alongside the BIC Application and Audit Certification documents.

• Electronic Collateral Reports  – Request form for Electronic Subscription of Collateral Reports.

• FBO Collateral Transmittal & Custody Receipt for Pledge of Loans (Form BIC-1, FBO)  - Monthly transmittal form for FBO's pledging collateral under the BIC program to the 12th District.

• FR 2046 – Form for completion by participants of the Seasonal Credit Program.

• Official OC-10 Authorization List  – The 12th district's Authorization List for pledging collateral and borrowing.

• Seasonal Credit Program Application  – Calculation of Deposits and Loans Worksheet – Application for the Seasonal Credit program with the 12th District.

• Third Party Custodian Certification  -- Annual Certification for completion by Third Party Custodians that administer Certificates of Title.

Please contact us for additional information.