The form of report to the State Board of Bank Control referred to in Section 34-3-350 shall be as follows:

To the State Board of Bank Control:

The report of the recent examination of this bank has been received, was submitted to the directors at a board meeting held __________ and was duly considered and a record of the action taken made upon the minutes.

_______________________

(President or Cashier)

___________________________________

Name and location of bank.

We, the undersigned directors of __________ bank, have reviewed the report of the State Board of Bank Control under date of __________.