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OMB Number: 30640121 Expiration Date: 10/31/2018Federal Deposit Insurance CorporationAPPLICANT CERTIFICATION STATEMENT FRAUD OR FRAUDULENT STATEMENT NOTICE Falsification of an answer may result in
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The 212016 application certification statement is a form used to certify that all information provided in an application is accurate and truthful.
Anyone submitting an application that requires certification of the information provided.
You must read the form carefully and provide all requested information accurately. Then sign and date the certification statement.
The purpose is to ensure that all information provided in an application is true and accurate to the best of the applicant's knowledge.
All relevant information related to the application, including personal details, financial information, and any supporting documentation.
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