Transferring Institution Letterhead

[Date] [Name and Address of appropriate FDIC Regional Director] SUBJECT: Certification of Total Assumption of Deposits This certification is being provided pursuant to 12 U.S.C. 1818(q) and 12 CFR 307.2. On [ state the date the deposit assumption took effect ], [ state the name of the depository institution assuming the deposit liabilities ] assumed all of the deposits of [ state the name and location of the transferring institution whose deposits were assumed ]. [If applicable, state the date and method by which the transferring institution's authority to engage in banking was or will be terminated.] Please contact the undersigned, at [ telephone number ], if additional information is needed. Sincerely, By: [Name and Title of Authorized Representative]