Affidavit Re: Increase In Capital Stock Of A Bank
______________________________ and _____________________________,
being duly sworn according to law on their oaths, depose and say that they are, respectively, the
(President or Vice President)_________________________ and (Title of Other Officer)________________________ of the
_______________________________, of ___________________, New Jersey;
the proceeds of the sale of _______________ shares of stock at $________ per share, amounting to
$___________________, has been paid to the bank in cash; that the date of issuance of said stock will be __________________________,
and that, pursuant to the proposed amendment to the Certificate of Incorporation of the bank together
with appropriate resolutions, duly adopted by the Board of Directors thereof on the ____________ day
of ___________, ________, the proceeds above represented an increase in capital stock and an increase in surplus as detailed in the
Recapitulation of Capital Stock Schedule.
(Signature)____________________________________
![Seal of Institution](corpseal.gif)
(Signature)_____________________________________
State of New Jersey, County of ___________________________ :ss:
Subscribed and sworn to before me this ________________day
of _________________ _________.
_____________________________________________ Notary Public
My commission expires ______________________, ____________
Recapitulation of Capital Stock Schedule
Recapitulation of Common Stock
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Status Prior To Amendment |
Changes (+) or (-) Due To Amendment |
Balance After Amendment |
(1) Total Number of Shares Outstanding |
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(2) Total Authorized and Unissued Stock Held For Stock Option Plans |
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(3) Total Number of Shares Authorized But Unissued Under NJSA 17:9A-6.1 or 8.5 |
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(4) Total Other Authorized and Unissued Stock |
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Total Number of Shares Authorized (1)+(2)+(3)+(4) |
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Total Dollar Amount of Common Capital Stock Outstanding (1) x Par Value |
$![](../../../space.gif) |
$![](../../../space.gif) |
$![](../../../space.gif) |
Total Dollar Amount of Surplus |
$![](../../../space.gif) |
$![](../../../space.gif) |
$![](../../../space.gif) |
Recapitulation of Preferred Stock
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Status Prior To Amendment |
Changes (+) or (-) Due To Amendment |
Balance After Amendment |
(5) Total Number of Shares Preferred Stock Issued |
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(6) Total Number of Shares of Preferred Stock Unissued |
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Total Number of Shares of Preferred Stock Authorized (5)+(6) |
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Total Dollar Amount of Preferred Stock Outstanding |
$![](../../../space.gif) |
$![](../../../space.gif) |
$![](../../../space.gif) |
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