(a) Provide a table showing, with respect to each proposed director of the subject institution:

1. (1) Name.
2. (2) Business address.
3. (3) Home address.
4. (4) Age.
5. (5) Business or occupation.
6. (6) Amount of shares of the subject institution for which the proposed director and his consociates intend to subscribe.

(b) With respect to each proposed director of the subject institution, provide:

1. (1) Personal financial statement in the form of Department Form 2, containing the information called for therein, dated as of a date within 90 days before the filing of the application, and signed by the proposed director.
2. (2) Confidential resume in the form of Department Form 3, containing the information called for therein, dated as of a date within 90 days before the filing of the application, and signed by the proposed director.

3. (3) Statement dated as of a date within 90 days before the filing of the application and signed by the proposed director, stating:

   1. (A) Amount of shares of the subject institution for which the proposed director intends to subscribe, the source of funds with which he intends to pay for such subscription, and, if any of such funds are to be borrowed, the amount to be borrowed and the source of funds with which he intends to repay such amount.
   2. (B) Whether or not, to the knowledge or information and belief of the proposed director, any consociate of the proposed director intends to subscribe for shares of the subject institution and, if so, the name, business address, home address, and business or occupation of the consociate, the amount of shares of the subject institution for which the consociate intends to subscribe, the source of funds with which he intends to pay for such subscription, and, if any of such funds are to be borrowed, the amount to be borrowed and the source of funds with which he intends to repay such amount.
   3. (C) Commercial banking, trust, other financial, and other business experience of the proposed director, including, with respect to each position held, title, description of duties, name and address of employer, period of employment, and reason for leaving.
   4. (D) Whether or not the proposed director has had in the past or has presently any relationship with any bank as director, officer, employee, adviser, five percent equity security owner, or in any other capacity (other than solely as a customer), and, if so, the name of the bank and a description of the relationship, and, in the case of any present relationship, whether the proposed director intends to continue, change, or terminate such relationship if and when the subject institution commences business.
   5. (E) Ways in which the proposed director intends to serve the subject institution, including generating business and otherwise promoting the well-being of the subject institution, and qualifications of the proposed director to implement such intentions, including, as applicable, civic, professional, social, and other organizational memberships and participation in local community affairs.
   6. (F) Amount of time which the proposed director intends to devote to the affairs of the subject institution during each of the first three years of business of the subject institution.