Notice Of Withdrawal From Registration As A Transfer Age

FORM TA-W

OMB No.: 1557-0124

Expiration Date: June 30, 2027

NOTICE OF WITHDRAWAL FROM REGISTRATION AS A TRANSFER AGENT

DISCLOSURE OF ESTIMATED REPORTING BURDEN

Public reporting for this collection of information is estimated to average .5 hours per deregistration including searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to The Bank Advisory group, Office of the Comptroller of the Currency, Washington, DC 20219; and to the Office of Management and Budget, ATTN: Paperwork Reduction Project, Washington, DC 20503.

Name of Registrant
Location (City and State)
Registered Transfer Agent Number

1. Furnish registrant’s reasons for ceasing the performance of transfer agent functions or for otherwise requesting withdrawal of its registration.

2. Furnish the date on which the bank last transferred any securities for which registration would be required.

3. Furnish the name(s) and location(s) of the organization or person, which will retain possession of the books and records which the bank maintained for its registered transfer agent functions.

4. Furnish the name(s) and location(s) of any successor transfer agent(s).

5. Describe any legal actions or proceedings, or potential claims against the bank, in connection with the performance of its registered transfer agent functions.

6. Describe any unsatisfied judgements or liens against the bank arising out of performance of its registered transfer agent functions.

Execution: I certify that the information contained herein is true and correct to the best of my knowledge and belief.
NAME AND TITLE OF OFFICIAL RESPONSIBLE FOR REQUEST
SIGNATURE OF OFFICIAL RESPONSIBLE FOR REQUEST	DATE

NOTE:	Submit an electronic copy of the completed form by secure email to: RTAFiling@occ.treas.gov Or return the completed form (original only) to: Comptroller of the Currency Asset Management Division 400 7th Street SW Washington, DC 20219
A copy should also be kept for the bank’s files.