FFIEC 004 Report on Indebtedness of Executive Officers and Principal Shareholders and Their Related Interests to Correspondent Banks
Form FFIEC 004 collects information from "each executive officer and each principal shareholder of an insured bank who was indebted, or whose related interests were indebted, during the calendar year for which the information is being submitted to a correspondent bank of their bank. Each officer or shareholder must file information on the maximum amount of his or her indebtedness to each correspondent bank as well as separate information on the indebtedness of each of the related interests of the officer or shareholder to each correspondent bank. State member banks must furnish a list of their correspondent banks to their executive officers and principal shareholders, keep records of the information submitted by the officers and shareholders, and provide to the public upon request a list of names of officers and shareholders to whom a correspondent bank of the member bank had an extension of credit in excess of the specified minimum level.
Form and Instructions:
The current and historical versions of this form and their instructions are maintained on the Federal Financial Institutions Examination Council's (FFIEC) website in PDF format.