BSA-AML Examiner School Case Study eBook

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Currency Transaction Report

Step 3. Person(s) Involved Information

Step 2. Transaction Location(s) Information

Step 4. Amount and Type of Transaction(s)

Step 1. Filing Institution Contact Information

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Part III Transaction Location 1

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Would you like to insert all applicable filing institution information into Part III?

Yes

Depository institution

*38 Type of financial institution

Other (specify)

* 29 Primary federal regulator

Federal Reserve

39 If 38a - Casino/Card Club is checked, indicate type (check only one) State licensed casino Tribal authorized casino

Card club

Other

* 30 Legal name of financial institution

TS&J BANK

31 Alternate name, e.g. trade name, DBA

Unknown

* 32 EIN

470006789

* 33 Address

555 MAIN STREET

OMAHA

* 34 City

* 35 State

NE

68509

*36 ZIP Code

US

*37 Country

Research, Statistics, Supervision and Discount (RSSD) number

40 Financial institution ID type

5999

ID number

13,836

*41 Cash in amount for transaction location

*42 Cash out amount for transaction location

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This form has been signed and cannot be altered.