A Demand for Payment and Proof of Claim form that may be used if a non-commercial paper FDIC-guaranteed debt issuance defaults is provided on the FDIC's website at:

www.fdic.gov/regulations/resources/TLGP/claims.html.

This form contemplates that an authorized representative will be the claimant; an individual debtholder may also use this form or request an alternate form from the FDIC. The form is self-explanatory and sets forth the specific information that must be provided by the claimant. An electronic version of the completed and signed demand and proof of claim form may be transmitted to the Federal Deposit Insurance Corporation by e-mail at TLGPDebtClaims@fdic.gov to expedite review of the claim and processing of payment. The complete executed copy of the proof of claim form and accompanying assignment must, however, be mailed or hand-delivered to the FDIC at the address listed on the claim form before payment is made.

The Proof of Claim must satisfy certain evidentiary requirements as specified in the TLGP Final Rule, 12 C.F.R. Part 370. If demand is made by an authorized representative, the proof of claim must contain certain information evidencing the authorized representative's financial and organizational capacity to act as representative, its exclusive authority to act on behalf of each and every debtholder, and its fiduciary duty to such debtholders. All claimants must include evidence of payment default and proof of ownership, and must be accompanied by an assignment of the debtholder's rights, title and interest in the debt to FDIC. In addition, claimants must provide a copy of the governing document of the FDIC-guaranteed debt instrument and an executed and completed form of assignment of the debtholder's interest in the FDIC-guaranteed debt that includes the right of the FDIC to receive any and all distributions on the debt from the proceeds of the receivership or bankruptcy estate, if any. An authorized representative must submit evidence of financial and organizational capacity, respectively, as well as evidence that the governing documents provide for exclusive authority to act on behalf of each and every debtholder.

The FDIC anticipates that review and the decision to approve or disapprove the claim will be completed within a timeframe to make payment to an authorized representative within five (5) business days after initial receipt of the claim. Failure of the claimant to submit all required information along with the proof of claim or to deliver to the FDIC an executed copy of the demand and proof of claim form, accompanied by an executed assignment, may cause delay in processing payment.