Appendix B to Part 103--Recertification Regarding Correspondent Accounts for Foreign Banks
The undersigned financial institution, _______________________________________________
("Foreign Bank"), hereby certifies as follows:
1. Foreign Bank has executed a Certification dated __________, 20__ (the "Certification")
relating to one or more Correspondent Accounts maintained by one or more Covered Financial
Institutions for Foreign Bank. Terms defined in the Certification have the same meaning in this
Recertification.
2. The information contained in the Certification:
remains true and correct.
is revised by the information provided with this Recertification (attach a statement
describing the information that is no longer correct and stating the correct
information).
Foreign Bank understands that each Covered Financial Institution at which it maintains a
Correspondent Account may provide a copy of this Recertification to the Secretary of the
Treasury and the Attorney General of the United States. Foreign Bank further understands that
the statements contained in this Recertification may be transmitted to one or more departments or
agencies of the United States of America for the purpose of fulfilling such departments' and
agencies' governmental functions.
I, __________________________(name of signatory), certify that I have read and understand
this Recertification, that the statements made in this Recertification are complete and correct, and
that I am authorized to execute this Recertification on behalf of Foreign Bank.
_____________________________
[Name of Foreign Bank]
_____________________________
[Signature]
_____________________________
[Title]
Executed on this _______ day of __________, 200__.
Received and reviewed by:
Name: ________________________________
Title: ________________________________
For: ________________________________
[Name of Covered Financial Institution]
Date: ________________
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