BANK SECRECY ACT REPORTING

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FDIC Financial Institution Letters › BANK SECRECY ACT REPORTING

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Text

FRB:

FR 2230

OMB No. 7100-0212

FDIC:

6710/06

OMB No. 3064-0077

OCC:

8010-9,8010-1

OMB No. 1557-0180

OTS:

1601

OMB No. 1550-0003

Suspicious

Activity Report

July 2003

Previous editions will not be accepted after December 31, 2003

NCUA:

2362

OMB No. 3133-0094

TREASURY

TD F 90-22.47

OMB No. 1506-0001

ALWAYS COMPLETE ENTIRE REPORT

(see instructions)

1. Check box below only if correcting a prior report.

Corrects Prior Report (see instruction #3 under "How to Make a Report")

Part I

Reporting Financial Institution Information

2. Name of Financial Institution

EIN

Address of Financial Institution

5. Primary Federal Regulator

City

7. State

8. ZIP Code

—

Federal Reserve

FDIC

NCUA

OCC

OTS

Multiple Branches (include information in narrative, Part V)

Address of Branch Office(s) where activity occurred.

10. City

13. If institution closed, date closed

11. State

12. ZIP Code

—

YYYY

14. Account number(s) affected, if any

Closed?

Yes

Part II

Suspect Information

Suspect Information Unavailable

15. Last Name or Name of Entity

16. First Name

17. Middle

18. Address

19. SSN, EIN, or TIN

20. City

21. State

22. ZIP Code

23. Country

—

24. Phone Number - Residence (include area code)

25. Phone Number - Work (include area code)

( )

26. Occupation/Type of Business

27. Date of Birth

28. Admission/Confession?

YYYY

Yes b.

29. Forms of Identification for Suspect:

Driver's License/State ID

Passport

Alien Registration

Other ____________.

Number

Issuing Authority __________...

30. Relationship to Financial Institution:

Accountant

f Business

27. Date of Birth

28. Admission/Confession?

YYYY

Yes b.

29. Forms of Identification for Suspect:

Driver's License/State ID

Passport

Alien Registration

Other ____________.

Number

Issuing Authority __________...

30. Relationship to Financial Institution:

Accountant

Agent

Appraiser

Attorney

Borrower

Broker

Customer

Director

Employee

Officer

Shareholder

Other

31. Is the relationship an insider relationship? a.

Yes b.

32. Date of Suspension, Termination, Resignation

If Yes, specify:

Still employed at financial institution

Suspended

Terminated

Resigned

YYYY

Part III Suspicious Activity Information

33. Date or date range of suspicious activity

34. Total dollar amount involved in known or suspicious activity

From

YYYY

$ .00

35. Summary characterization of suspicious activity:

Bank Secrecy Act/Structuring/

Money Laundering

Bribery/Gratuity

Check Fraud

Check Kiting

Commercial Loan Fraud

Other

Computer Intrusion

Consumer Loan Fraud

Counterfeit Check

Counterfeit Credit/Debit Card

Counterfeit Instrument (other)

Credit Card Fraud

Debit Card Fraud

Defalcation/Embezzlement

False Statement

Misuse of Position or Self Dealing

Mortgage Loan Fraud

Mysterious Disappearance

Wire Transfer Fraud

Terrorist Financing

Identity Theft

(type of activity)

36. Amount of loss prior to recovery (if applicable)

37. Dollar amount of recovery (if applicable)

$ .00

Mortgage Loan Fraud

Mysterious Disappearance

Wire Transfer Fraud

Terrorist Financing

Identity Theft

(type of activity)

36. Amount of loss prior to recovery (if applicable)

37. Dollar amount of recovery (if applicable)

$ .00

38. Has the suspicious activity had a material

impact on, or otherwise affected, the

financial soundness of the institution?

39. Has the institution's bonding company been notified?

Yes

40. Has any law enforcement agency already been advised by telephone, written communication, or otherwise?

DEA

FBI

IRS

Postal Inspection

Secret Service

U.S. Customs

Other Federal

State

Local

Agency name (for g, h or i)

41. Name of person(s) contacted at Law Enforcement Agency

42. Phone Number (include area code)

( )

43. Name of person(s) contacted at Law Enforcement Agency

44. Phone Number (include area code)

( )

Part IV

Contact for Assistance

45. Last Name

46. First Name

47. Middle

48. Title/Occupation

49. Phone Number (include area code)

50. Date Prepared

( )

YYYY

51. Agency (if not filed by financial institution)

( )

43. Name of person(s) contacted at Law Enforcement Agency

44. Phone Number (include area code)

( )

Part IV

Contact for Assistance

45. Last Name

46. First Name

47. Middle

48. Title/Occupation

49. Phone Number (include area code)

50. Date Prepared

( )

YYYY

51. Agency (if not filed by financial institution)

Part V

Suspicious Activity Information Explanation/Description

Explanation/description of known or suspected violation of law or

suspicious activity.

This section of the report is critical. The care with which it is written may

make the difference in whether or not the described conduct and its possible

criminal nature are clearly understood. Provide below a chronological and

complete account of the possible violation of law, including what is unusual,

irregular or suspicious about the transaction, using the following checklist as

you prepare your account. If necessary, continue the narrative on a

duplicate of this page.

a. Describe supporting documentation and retain for 5 years.

b. Explain who benefited, financially or otherwise, from the transaction, how

much, and how.

c. Retain any confession, admission, or explanation of the transaction

provided by the suspect and indicate to whom and when it was given.

d. Retain any confession, admission, or explanation of the transaction

provided by any other person and indicate to whom and when it was given.

e. Retain any evidence of cover-up or evidence of an attempt to deceive

federal or state examiners or others.

f. Indicate where the possible violation took place (e.g., main office, branch,

other).

g. Indicate whether the possible violation is an isolated incident or relates to

other transactions.

h. Indicate whether there is any related litigation; if so, specify.

i. Recommend any further investigation that might assist law enforcement

authorities.

ceive

federal or state examiners or others.

f. Indicate where the possible violation took place (e.g., main office, branch,

other).

g. Indicate whether the possible violation is an isolated incident or relates to

other transactions.

h. Indicate whether there is any related litigation; if so, specify.

i. Recommend any further investigation that might assist law enforcement

authorities.

j. Indicate whether any information has been excluded from this report;

if so, why?

k. If you are correcting a previously filed report, describe the changes that

are being made.

For Bank Secrecy Act/Structuring/Money Laundering reports, include the

following additional information:

l. Indicate whether currency and/or monetary instruments were involved. If

so, provide the amount and/or description of the instrument (for example,

bank draft, letter of credit, domestic or international money order, stocks,

bonds, traveler's checks, wire transfers sent or received, cash, etc.).

m. Indicate any account number that may be involved or affected.

Tips on SAR Form preparation and filing are available in the SAR Activity Review at www.fincen.gov/pub_reports.html.

Paperwork Reduction Act Notice: The purpose of this form is to provide an effective and consistent means for financial institutions to notify appropriate law enforcement agencies

of known or suspected criminal conduct or suspicious activities that take place at or were perpetrated against financial institutions. This report is required by law, pursuant to

authority contained in the following statutes. Board of Governors of the Federal Reserve System: 12 U.S.C. 324, 334, 611a, 1844(b) and (c), 3105(c) (2) and 3106(a). Federal Deposit

Insurance Corporation: 12 U.S.C. 93a, 1818, 1881-84, 3401-22. Office of the Comptroller of the Currency: 12 U.S.C. 93a, 1818, 1881-84, 3401-22. Office of Thrift Supervision: 12

U.S.C. 1463 and 1464. National Credit Union Administration: 12 U.S.C. 1766(a), 1786(q)

f Governors of the Federal Reserve System: 12 U.S.C. 324, 334, 611a, 1844(b) and (c), 3105(c) (2) and 3106(a). Federal Deposit

Insurance Corporation: 12 U.S.C. 93a, 1818, 1881-84, 3401-22. Office of the Comptroller of the Currency: 12 U.S.C. 93a, 1818, 1881-84, 3401-22. Office of Thrift Supervision: 12

U.S.C. 1463 and 1464. National Credit Union Administration: 12 U.S.C. 1766(a), 1786(q). Financial Crimes Enforcement Network: 31 U.S.C. 5318(g). Information collected on this

report is confidential (5 U.S.C. 552(b)(7) and 552a(k)(2), and 31 U.S.C. 5318(g)). The Federal financial institutions' regulatory agencies and the U.S. Departments of Justice and

Treasury may use and share the information. Public reporting and recordkeeping burden for this information collection is estimated to average 30 minutes per response, and

includes time to gather and maintain data in the required report, review the instructions, and complete the information collection. Send comments regarding this burden estimate,

including suggestions for reducing the burden, to the Office of Management and Budget, Paperwork Reduction Project, Washington, DC 20503 and, depending on your primary

Federal regulatory agency, to Secretary, Board of Governors of the Federal Reserve System, Washington, DC 20551; or Assistant Executive Secretary, Federal Deposit Insurance

Corporation, Washington, DC 20429; or Legislative and Regulatory Analysis Division, Office of the Comptroller of the Currency, Washington, DC 20219; or Office of Thrift

Supervision, Enforcement Office, Washington, DC 20552; or National Credit Union Administration, 1775 Duke Street, Alexandria, VA 22314; or Office of the Director, Financial Crimes

Enforcement Network, Department of the Treasury, 2070 Chain Bridge Road, Vienna, VA 22182. The agencies may not conduct or sponsor, and an organization (or a person) is not

required to respond to, a collection of information unless it displays a currently valid OMB control number.

Credit Union Administration, 1775 Duke Street, Alexandria, VA 22314; or Office of the Director, Financial Crimes

Enforcement Network, Department of the Treasury, 2070 Chain Bridge Road, Vienna, VA 22182. The agencies may not conduct or sponsor, and an organization (or a person) is not

required to respond to, a collection of information unless it displays a currently valid OMB control number.

Suspicious Activity Report

Instructions

Safe Harbor Federal law (31 U.S.C. 5318(g)(3)) provides complete protection from civil liability for all reports of suspicious transactions made to

appropriate authorities, including supporting documentation, regardless of whether such reports are filed pursuant to this report’s instructions or are filed

on a voluntary basis. Specifically, the law provides that a financial institution, and its directors, officers, employees and agents, that make a disclosure of

any possible violation of law or regulation, including in connection with the preparation of suspicious activity reports, “shall not be liable to any person

under any law or regulation of the United States, any constitution, law, or regulation of any State or political subdivision of any State, or under any

contract or other legally enforceable agreement (including any arbitration agreement), for such disclosure or for any failure to provide notice of such

disclosure to the person who is the subject of such disclosure or any other person identified in the disclosure.”

Notification Prohibited Federal law (31 U.S.C. 5318(g)(2)) requires that a financial institution, and its directors, officers, employees and agents who,

voluntarily or by means of a suspicious activity report, report suspected or known criminal violations or suspicious activities may not notify any person

involved in the transaction that the transaction has been reported

d in the disclosure.”

Notification Prohibited Federal law (31 U.S.C. 5318(g)(2)) requires that a financial institution, and its directors, officers, employees and agents who,

voluntarily or by means of a suspicious activity report, report suspected or known criminal violations or suspicious activities may not notify any person

involved in the transaction that the transaction has been reported.

In situations involving violations requiring immediate attention, such as when a reportable violation is ongoing, the financial institution shall

immediately notify, by telephone, appropriate law enforcement and financial institution supervisory authorities in addition to filing a timely

suspicious activity report.

WHEN TO MAKE A REPORT:

All financial institutions operating in the United States, including insured banks, savings associations, savings association service corporations,

credit unions, bank holding companies, nonbank subsidiaries of bank holding companies, Edge and Agreement corporations, and U.S. branches

and agencies of foreign banks, are required to make this report following the discovery of:

Insider abuse involving any amount. Whenever the financial institution detects any known or suspected Federal criminal violation, or pattern

of criminal violations, committed or attempted against the financial institution or involving a transaction or transactions conducted through the

financial institution, where the financial institution believes that it was either an actual or potential victim of a criminal violation, or series of

criminal violations, or that the financial institution was used to facilitate a criminal transaction, and the financial institution has a substantial

basis for identifying one of its directors, officers, employees, agents or other institution-affiliated parties as having committed or aided in the

commission of a criminal act regardless of the amount involved in the violation.

or series of

criminal violations, or that the financial institution was used to facilitate a criminal transaction, and the financial institution has a substantial

basis for identifying one of its directors, officers, employees, agents or other institution-affiliated parties as having committed or aided in the

commission of a criminal act regardless of the amount involved in the violation.

Violations aggregating $5,000 or more where a suspect can be identified. Whenever the financial institution detects any

known or suspected Federal criminal violation, or pattern of criminal violations, committed or attempted against the financial institution or

involving a transaction or transactions conducted through the financial institution and involving or aggregating $5,000 or more in funds or other

assets, where the financial institution believes that it was either an actual or potential victim of a criminal violation, or series of criminal

violations, or that the financial institution was used to facilitate a criminal transaction, and the financial institution has a substantial basis for

identifying a possible suspect or group of suspects. If it is determined prior to filing this report that the identified suspect or group of suspects

has used an "alias," then information regarding the true identity of the suspect or group of suspects, as well as alias identifiers, such as drivers'

licenses or social security numbers, addresses and telephone numbers, must be reported.

Violations aggregating $25,000 or more regardless of a potential suspect

ned prior to filing this report that the identified suspect or group of suspects

has used an "alias," then information regarding the true identity of the suspect or group of suspects, as well as alias identifiers, such as drivers'

licenses or social security numbers, addresses and telephone numbers, must be reported.

Violations aggregating $25,000 or more regardless of a potential suspect. Whenever the financial institution detects any known or

suspected Federal criminal violation, or pattern of criminal violations, committed or attempted against the financial institution or involving a

transaction or transactions conducted through the financial institution and involving or aggregating $25,000 or more in funds or other assets,

where the financial institution believes that it was either an actual or potential victim of a criminal violation, or series of criminal violations, or

that the financial institution was used to facilitate a criminal transaction, even though there is no substantial basis for identifying a possible

suspect or group of suspects.

Transactions aggregating $5,000 or more that involve potential money laundering or violations of the Bank Secrecy Act. Any

transaction (which for purposes of this subsection means a deposit, withdrawal, transfer between accounts, exchange of currency, loan,

extension of credit, purchase or sale of any stock, bond, certificate of deposit, or other monetary instrument or investment security, or any other

payment, transfer, or delivery by, through, or to a financial institution, by whatever means effected) conducted or attempted by, at or through

the financial institution and involving or aggregating $5,000 or more in funds or other assets, if the financial institution knows, suspects, or has

reason to suspect that:

deposit, or other monetary instrument or investment security, or any other

payment, transfer, or delivery by, through, or to a financial institution, by whatever means effected) conducted or attempted by, at or through

the financial institution and involving or aggregating $5,000 or more in funds or other assets, if the financial institution knows, suspects, or has

reason to suspect that:

The transaction involves funds derived from illegal activities or is intended or conducted in order to hide or disguise funds or assets derived

from illegal activities (including, without limitation, the ownership, nature, source, location, or control of such funds or assets) as part of a

plan to violate or evade any law or regulation or to avoid any transaction reporting requirement under Federal law;

ii. The transaction is designed to evade any regulations promulgated under the Bank Secrecy Act; or

iii. The transaction has no business or apparent lawful purpose or is not the sort in which the particular customer would normally be expected to

engage, and the financial institution knows of no reasonable explanation for the transaction after examining the available facts, including

the background and possible purpose of the transaction.

The Bank Secrecy Act requires all financial institutions to file currency transaction reports (CTRs) in accordance with the Department of the Treasury's

implementing regulations (31 CFR Part 103). These regulations require a financial institution to file a CTR whenever a currency transaction exceeds

$10,000. If a currency transaction exceeds $10,000 and is suspicious, the institution must file both a CTR (reporting the currency transaction) and a

suspicious activity report (reporting the suspicious or criminal aspects of the transaction). If a currency transaction equals or is below $10,000 and is

suspicious, the institution should only file a suspicious activity report.

Computer Intrusion

If a currency transaction exceeds $10,000 and is suspicious, the institution must file both a CTR (reporting the currency transaction) and a

suspicious activity report (reporting the suspicious or criminal aspects of the transaction). If a currency transaction equals or is below $10,000 and is

suspicious, the institution should only file a suspicious activity report.

Computer Intrusion. For purposes of this report, "computer intrusion" is defined as gaining access to a computer system of a financial institution to:

a. Remove, steal, procure, or otherwise affect funds of the institution or the institution's customers;

b. Remove, steal, procure, or otherwise affect critical information of the institution including customer account information; or

c. Damage, disable, or otherwise affect critical systems of the institution.

For purposes of this reporting requirement, computer intrusion does not mean attempted intrusions of websites or other non-critical information

systems of the institution that provide no access to institution or customer financial or other critical information.

A financial institution is required to file a suspicious activity report no later than 30 calendar days after the date of initial detection of facts that may

constitute a basis for filing a suspicious activity report. If no suspect was identified on the date of detection of the incident requiring the filing, a

financial institution may delay filing a suspicious activity report for an additional 30 calendar days to identify a suspect. In no case shall reporting be

delayed more than 60 calendar days after the date of initial detection of a reportable transaction.

This suspicious activity report does not need to be filed for those robberies and burglaries that are reported to local authorities, or (except for savings

associations and service corporations) for lost, missing, counterfeit, or stolen securities that are reported pursuant to the requirements of 17 CFR

240.17f-1

lendar days after the date of initial detection of a reportable transaction.

This suspicious activity report does not need to be filed for those robberies and burglaries that are reported to local authorities, or (except for savings

associations and service corporations) for lost, missing, counterfeit, or stolen securities that are reported pursuant to the requirements of 17 CFR

240.17f-1.

HOW TO MAKE A REPORT:

Send each completed suspicious activity report to:

Detroit Computing Center, P.O. Box 33980, Detroit, MI 48232-0980

For items that do not apply or for which information is not available, leave blank.

If you are correcting a previously filed report, check the box at the top of the report (line 1). Complete the report in its entirety and include the corrected

information in the applicable boxes. Then describe the changes that are being made in Part V (Description of Suspicious Activity), line k.

Do not include any supporting documentation with the suspicious activity report. Identify and retain a copy of the suspicious activity report and

all original supporting documentation or business record equivalent for five (5) years from the date of the suspicious activity report. All supporting

documentation must be made available to appropriate authorities upon request.

If more space is needed to report additional suspects, attach copies of page 1 to provide the additional information. If more space is needed to report

additional branch addresses, include this information in the narrative, Part V.

Financial institutions are encouraged to provide copies of suspicious activity reports to state and local authorities, where appropriate.

This is a copy of a public record, reproduced as it was published. It is not legal advice, and it may not be the version a court would rely on. Check the official source before you cite it.