State Examination System (SES) - Agency Interest Form
The following information and attached form are intended for State Regulatory Agencies Only to review and complete as part of their initial commitment to adopting the State Examination System.
Summary
Financial institutions will be invited to participate in SES by a state regulator that is using SES, likely before the next scheduled examination. Until a financial institution receives these notifications, no action needs to be taken.
Below are instructions and field requirements for each section of the attached form. It is best to collect the information below, and when you have all required information, open and complete the attached Agency Interest Form (PDF format).
Part 1: Contact Information
Please provide the following information for the individual at the Agency responsible for the adoption and implementation of SES (this is the person SRR State Relations will contact to initiate next steps)
- First Name
- Last Name
- Email Address
- Telephone Number
- Title
- State Agency Name
- Role in the Supervision Process (if any)
Part 2: Supervisory Activity1
Thinking in terms of the supervisory activity the agency plans to conduct using SES, please answer the following questions.
- Target Start Date for Supervisory Activity in SES
- Industry to be examined
- Is this a multi-state exam
- If yes, please list the other agencies participating
- If no, are there plans for agency to schedule multi-state exams?
Part 3: Complaints Information
If an agency is interested in using the Complaint functionality in SES (either in conjunction with or separate from the Supervisory Activity functions), they must complete the Complaints Information section.
- Target Start Date for Complaints Activity in SES
- Contact Name responsible for Agency implementation if different than that listed in Section 1
- Contact Phone
- Contact Email
- Industry the agency plans to issue a Complaint to using SES
Part 4: Agency/Staff Training
- Estimated Staff Training Size for Account Admin (minimum of 2/maximum of 5)
- Estimated Staff Training Size for Staff Director or User
- Estimate Staff Training Size for Examiner/Examiner in Charge (EIC)/Examiner Reviewer
Form Submission
- When ready, click on the attached Agency Interest Form (PDF format) form (fillable PDF)
- Download the form and complete all fields
- Once all information is entered, click the File dropdown at the top of the page, then the Save As option.
- Save the form with the name of your agency included in the file name
- Submit the form to the Regulatory User Group by attaching the form to an email and send to the Regulatory User Group. Visit our Secure Portal (requires agency login) for email and phone number.
- You will receive an email confirmation of your form submission within 1-2 business days
Questions and Follow Up
- If you have any questions on filling out the form, or after you have submitted it, please reach out to the Regulatory User Group using the email or phone number at our Secure Portal (requires agency login).
- Once your response is submitted, the SRR State Relations Team will schedule a follow up call to review the on boarding project and discuss/assign tasks agencies can perform prior to on-boarding.