External Subscriber Credential and Access Control Request Form

Legal Agreement

We, the Institution (“Participant”), designate the following authorized Subscriber to transact business with the Federal Reserve Banks using FedLine^® Web-based services and business applications. Please issue a credential (a certificate, and/or a user ID and password, and/or a FedLine Security Token and pass phrase) to this Subscriber and grant him/her access to the Applications and/or Access Levels designated in this form. The Subscriber will comply with all terms and conditions specified in Operating Circular No. 5 (“OC 5”) and the Certification Practice Statement (“CPS”)(in the case of Subscribers holding certificates/FedLine Security Token and pass phrase), as well as all applicable security procedures, as they are all amended from time to time. OC 5 and the CPS are both located at http://frbservices.org/OperatingCirculars/index.html