Section 3.21.880. Custodian affidavit when securities are on deposit with the depository trust company or like entity; Form B.

A custodian required to produce an affidavit under 3 AAC 21.865(a)(11) when securities are on deposit with The Depository Trust Company or a similar entity must use the following form, substituting the judicial district for the county if the affidavit is executed in this state:  
FORM B  
CUSTODIAN AFFIDAVIT  
    [For use by a custodian where securities entrusted to its care are on deposit with The Depository Trust Company or other like holding entity.] 
 STATE OF ______________        ) 
        ) 
 COUNTY OF _____________        ) 
________________________
________________________
    (name of officer), 
________________________
    (title of officer)        (name of custodian) 
 a corporation organized under and pursuant to the laws of the ______________ 
                                                                      (state) 
________________________
          (address) 
 (hereinafter "corporation"): 
That my duties involve supervision of activities as custodian and records relating thereto; 
 That the corporation is custodian for certain securities of ______________ 
________________________
 (insurer)           (address) 
 (hereinafter "insurer") pursuant to an agreement between the corporation and the insurer; 
________________________
     (holding entity name) 
 attached hereto is a true and complete statement of the securities of the insurer of which the corporation was custodian as of the close of 
 business on ______________, which were so deposited 
     (date) 
 on that date; 
________________________
     (holding entity name) 
 in the agreement between the corporation as custodian and the insurer; and 
That, to the best of my knowledge and belief, unless otherwise shown on the schedule, the securities were the property of the insurer and were free of all liens, claims, or encumbrances whatsoever. 
________________________
________________________
           [other authorized corporation officer] 
    Subscribed and sworn to before me this __________ day of __________________, 20______. 
________________________
________________________

Authorities

21.06.090;21.21.410

Notes

Reference

3 AAC 21.865

Authority

AS 21.06.090 AS 21.21.410

History

Eff. 8/31/2008, Register 187