Bank Deposit Insurance Assessment Rate Tracker Form
Bank Deposit Insurance Assessment Rate Tracker Form
Institution name
*
Institution type
*
Commercial bank
Savings institution
Credit union
Other institution type
Jurisdiction
*
Reporting period
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Rate effective date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Assessment base amount (enter amount in the applicable currency)
*
Assessment rate components
*
Rows
Component name
Rate value (%)
Base rate
Applicable adjustment or surcharge
Total assessment rate (%)
*
Source or reference for the rate
*
Notes
Submit
Should be Empty: