Dodd-Frank Annual Stress Test Reporting Template for Covered Institutions with Total Consolidated Assets Between 10 and 50 Billion - Results Submission Cover Sheet

Sep 2, 2026

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Dodd-Frank annual stress test results submission cover sheet template for covered institutions with total consolidated assets greater than $10 billion and less than $50 billion under 12 CFR part 46, subpart H. National banks and federal savings associations must complete the income statement and balance sheet templates for baseline, adverse, and severely adverse scenarios, keeping the workbook structure unchanged. Unlike call report reporting, report actual and projected income statement figures on a quarterly (in the quarter) basis. The form also captures institution identifiers, planning horizon years, submission and completion dates, and a contact person.

LanguageEnglish

CategoryForms

FormatPDF

Pages11

Reading Time4 min

AccessFree to download

Results Submission Cover Sheet

Filing eligibility and reporting requirements

Institution information and contact fields

Income statement impacts (baseline/adverse/severely adverse)

Balance sheet statement impacts

| Results Submission Cover Sheet | | --- | | Dodd‐Frank Annual Stress Test Reporting Template for Covered Institutions with Total Consolidated Assets Between $10 and $50 Billion | | This report form is to be filed by National Banks and Federal Savings Associations that meet a threshold of greater than $10 billion but less than $50 billion in total consolidated assets, as defined by 12 CFR part 46, subpart H. The Office of the Comptroller of the Currency may not conduct or sponsor, and an organization (or a person) is not required to respond to, a collection of information unless it displays a currently valid OMB control number. | | | | | | | | | | | | | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | | Institutions are expected to complete the Income Statement and Balance Sheet templates for each required scenario ‐ Baseline, Adverse, and Severely Adverse. | | | | | | | | | | | | | | | | | | | | | | | | | | Please note that unlike Call Report reporting, all actual and projected income statement figures should be reported on a quarterly basis (in the quarter) and not on a cumulative basis. | | | | | | | | | | | | | Please do not change the structure of this workbook. Any questions should be directed [to DFA165i2.reporting@occ.treas.gov](to DFA165i2.reporting@occ.treas.gov) . | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | Institution Name: | | XYZ | | | | | | | | | | | RSSD ID | | \#\#\#\#\# | | | | | | | | | | | OCC Charter ID: | | \#\#\#\#\# | | | | | | | | | | | Institution Type: | | | (National Bank or Federal Savings Assocation) | | | | | | | | | | Planning Horizon Year 1 (YYYY): | | 2015 | (Enter appropriate year) | | | | | | | | | | Planning Horizon Year 2 (YYYY): | | 2016 | (Enter appropriate year) | | | | | | | | | | Submission Date (MM/DD/YYYY): | | xx/xx/20xx | (Enter date) | | | | | | | | | | When Completed (MM/DD/YYYY): | | xx/xx/20xx | (Enter date) | | | | | | | | | | | | | | | | | | | | | | | Person whom questions about this report should be directed: | | | | | | | | | | | | | Name / Title | | | | | | | | | | | | | Area Code / Phone Number | | | | | | | | | | | | | Fax Number | | | | | | | | | | | | | E‐mail Address | | | | | | | | | | | | | | | | | | | | | | | | | Income Statement Impacts | Actual | Projected | Year 1: 2015 --Projected (in the quarter) | | | | | Year 2: 2016 --Projected (in the quarter) | | | | | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | | | As of 9/30 | As of 12/31 | Q1 | | Q2 | Q3 | Q4 | Q5 | Q6 | Q7 | Q8 | | Net Charge-Offs | | | | | | | | | | | | | 1 First lien mortgages | | | | | | | | | | | | | 2 Closed-end junior liens | | | | | | | | | | | | | 3 HELOCs | | | | | | | | | | | | | 4 C&I loans | | | | | | | | | | | | | 5 1-4 family construction loans | | | | | | | | | | | | | 6 Other construction loans | | | | | | | | | | | | | 7 Multifamily loans | | | | | | | | | | | | | 8 Non-farm, non-residential owner occupied loans | | | | | | | | | | | | | 9 Non-farm, non-residential other loans | | | | | | | | | | | | | Credit cards | | | | | | | | | | | | | Automobile loans | | | | | | | | | | | | | Other consumer | | | | | | | | | | | | | All other loans and leases | | | | | | | | | | | | | Total loan and lease net charge offs (sum of items 1 to 13) | 0 | 0 | 0 | 0 | | 0 | 0 | 0 | 0 | 0 | 0 | | | | | | | | | | | | | | | Net interest income | | | | | | | | | | | | | Non-interest income | | | | | | | | | | | | | Non-interest expense | | | | | | | | | | | | | Pre-provision net re

FAQs

Who must file this Dodd-Frank annual stress test results template?

National banks and federal savings associations with total consolidated assets greater than $10 billion but less than $50 billion must file it under 12 CFR part 46, subpart H.

What scenarios must be completed in the income statement and balance sheet templates?

Complete the templates for each required scenario: Baseline, Adverse, and Severely Adverse.

How should income statement figures be reported compared with call reports?

Report actual and projected income statement figures on a quarterly basis (in the quarter), not on a cumulative basis.

Sep 2, 2026

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