Date of E-mail received from FinCEN:
Response Due Date to FinCEN:
FinCEN Tracking Nos:
_________________________________________________
The following areas have been searched:
CIS Database (past 12 months) includes DDA, SAV, COD, Loans/Lines of Credit:
NIL report* Positive Hit (list name & port of individual or entity below)
Funds Transfers (wires) to search back 6 months for originator/transmittor or beneficiary / recipient of a funds transfer.
NIL report* Positive Hit (copy of wire attached)
Cash sales of Monetary Instruments sold ($3,000 - $10,000) for past 6 months. Only sales to non-customers need be searched, as well as any sales to customers that were matched from the CIS search.
NIL report* Positive Hit (list name and /or port of individual or entity below)
Search Completed in all areas described above on:
If positive match identified, response to FinCEN via e-mail (copy of e-mail attached) on (date):
Validated by:
____________________________________ _____________________________
Signature Date
Attach copies of the FinCEN request and other source documents as proof of search performed and positive match identified (if applicable). Copies are filed in chronological date order and retained for 5 years.
* NIL Report (“No Information Located”) – Record Retention is 5 years.