REQUEST TO CONVERT FROM A MUTUAL INSTITUTION TO A STOCK INSTITUTION, FORM AC (APPLICATION FOR CONVERSION) AND EXHIBITS (FORM PS, PROXY STATEMENT, & FORM OC, OFFERING....)
ICR 199208-1550-001
OMB: 1550-0014
Federal Form Document
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 1550-0014 can be found here:
REQUEST TO CONVERT FROM A
MUTUAL INSTITUTION TO A STOCK INSTITUTION, FORM AC (APPLICATION FOR
CONVERSION) AND EXHIBITS (FORM PS, PROXY STATEMENT, & FORM OC,
OFFERING....)
12 CFR 563B STATES THAT NO MUTUAL
ASSOCIATION SHALL CONVERT TO A STOCK ASSOCIATION WITHOUT THE PRIOR
WRITTEN CONSENT OF THE OFFICE OF THRIFT SUPERVISION.
On behalf of this Federal agency, I certify that
the collection of information encompassed by this request complies
with 5 CFR 1320.9 and the related provisions of 5 CFR
1320.8(b)(3).
The following is a summary of the topics, regarding
the proposed collection of information, that the certification
covers:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a
benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control
number;
If you are unable to certify compliance with any of
these provisions, identify the item by leaving the box unchecked
and explain the reason in the Supporting Statement.