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Home Source documents U.S. Department of the Treasury, Emergency Capital Investment Program: "Form of Interim Final Rule Certification: Archived Version"

U.S. Department of the Treasury, Emergency Capital Investment Program: "Form of Interim Final Rule Certification: Archived Version"

Summary

The form of ECIP Interim Final Rule Certification, marked 3-21-2023 Version 1, for a recipient of an Emergency Capital Investment Program investment from the U.S. Department of the Treasury. A Senior Executive Officer certifies that, from the Closing Date, the recipient has complied with 31 C.F.R. 35.22(a) through (d) on executive compensation, severance payments, excessive or luxury expenditures and related policies, and 31 C.F.R. 35.23(a) and (b) on capital distributions. It warns that a knowing and willful false or fraudulent statement may be punished by fine, imprisonment, or both, citing 18 U.S.C. 1001. The Paperwork Reduction Act notice estimates the burden at 10 minutes per response.

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Cite this document

“U.S. Department of the Treasury, Emergency Capital Investment Program: ‘Form of Interim Final Rule Certification: Archived Version.’” Original at home.treasury.gov. Archived at Pandemic Darlings, https://pandemicdarlings.com/source-documents/u-s-department-of-the-treasury-emergency-capital-investment-program-fo-e444cd7047/, SHA-256 df91650d89d199f389a8eeaed08e46b5aae90c6be8bd5c5604a267838bfb9e27.

Full text

3-21-2023 Version 1


                          Emergency Capital Investment Program

                                   Required Certifications



              FORM OF ECIP INTERIM FINAL RULE CERTIFICATION

                                ECIP CERTIFICATION OF
                                      [RECIPIENT]

In connection with that certain Letter Agreement, dated [              ], 20[ ] (the “Agreement”)
by and between [RECIPIENT] (the “Recipient”) and the United States Department of the Treasury
(the “Investor”), the undersigned does hereby certify on behalf of the Recipient as follows:

   1. I am a duly elected/appointed Senior Executive Officer of the Recipient.

   2. From the Closing Date through the date of this certification, the Recipient has complied
      with the requirements in:

           a. 31 C.F.R. 35.22(a), which addresses restrictions on executive compensation;

           b. 31 C.F.R. 35.22(b), which addresses restrictions on severance payments;

           c. 31 C.F.R. 35.22(c), which addresses restrictions on excessive or luxury
              expenditures;

           d. 31 C.F.R. 35.22(d), which addresses material changes in policies or procedures
              maintained for purposes of compliance with 31 C.F.R. 35.22(a)–(c);

           e. 31 C.F.R. 35.23(a), which addressees restrictions on capital distributions due to
              nonpayment on the Preferred Shares; and

           f. 31 C.F.R. 35.23(b), which addresses limitations on the amount of capital
              distributions.

   3. The undersigned and the Recipient understand that a knowing and willful false or
      fraudulent statement made in connection with this certification may be punished by fine,
      imprisonment, or both. (See, for example, 18 U.S.C. 1001).

The foregoing certifications are made and delivered as of [                      ] pursuant to
Section 4.1(d)(iii) of the Agreement.

Capitalized terms used and not otherwise defined herein shall have the meanings assigned to them
in the Agreement unless otherwise stated.

                                   [Signature page follows]
3-21-2023 Version 1


IN WITNESS WHEREOF, this Certificate has been duly executed and delivered as of the [           ]
day of [      ], 20[ ].




                                                    [RECIPIENT]


                                                    By:
                                                          Name:
                                                          Title: [Chief Executive Officer/
                                                                 Chief Financial Officer]


                                                    By:
                                                          Name:
                                                          Title: [Chief Executive Officer/
                                                                 Chief Financial Officer]


Paperwork Reduction Act Notice.

OMB Approval No.: 1505-0275
Expiration Date: June 30, 2026

The information collected will be used for the U.S. Government to process requests for support.
The estimated burden associated with this collection of information is 10 minutes per response.
Comments concerning the accuracy of this burden estimate and suggestions for reducing this
burden should be directed to the Office of Privacy, Transparency and Records, Department of the
Treasury, 1500 Pennsylvania Ave., N.W., Washington, D.C. 20220. DO NOT send the form to
this address. An agency may not conduct or sponsor, and a person is not required to respond to, a
collection of information unless it displays a valid control number assigned by OMB.

File and source

File
TREAS-FORM-OF-ECIP-INTERIM-FINAL-RULE-CERTIFICATION.pdf
Size
175,815 bytes
SHA-256
df91650d89d199f389a8eeaed08e46b5aae90c6be8bd5c5604a267838bfb9e27
Our copy
TREAS-FORM-OF-ECIP-INTERIM-FINAL-RULE-CERTIFICATION.pdf
Original
home.treasury.gov
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