Stock Dividend Under Section 52

Certificate of
Stock Dividend Under Section 52

(Name of Bank)

This is TO CERTIFY that, pursuant to resolution pf the Board of Directors adopted at a meeting held on the _________ day of _____________, ________ (certified copy attached) a stock dividend has been declared:

  1. The date upon which the dividend declared is to be paid is __________. _______;
  2. The amount of the dividend is $__________, represented by __________ shares of stock at $__________ par value per share;
  3. After giving effect to the payment of such dividend, the amount of common stock of the institution is $_____________, and the amount of surplus of the institution is $______________.

IN WITNESS WHEREOF, the institution has caused this certificate to be executed by two officers of the institution pursuant to section 52 of

The Banking Act of 1948, as amended this __________ day of ______________, _________.

President or Vice President: ______________________________________

Secretary: ________________________________________________________


State of New Jersey, County of ________________________________________:ss:

On this _________________ day of ___________________, ______________, before me personally appeared ________________________________________ and ____________________________________, and they acknowledged that they signed, sealed and delivered the foregoing instrument as the free and voluntary act and deed of said corporation, made by virtue of authority of its board of directors.

________________________________________ Notary Public

My commission expires ______________________, ____________

The capital stock position of the institution as a result of this transaction is as follows:

Status Prior To Amendment Changes (+) or (-) Due To Amendment Balance After Amendment
(1) Total Number of Shares Outstanding
(2) Total Authorized and Unissued Stock Held For Stock Option Plans
(3) Total Number of Shares Authorized But Unissued Under NJSA 17:9A-6.1 or 8.5
(4) Total Other Authorized and Unissued Stock
Total Number of Shares Authorized (1)+(2)+(3)+(4)
Total Dollar Amount of Common Capital Stock Outstanding (1) x Par Value $ $ $
Total Dollar Amount of Surplus $ $ $