Appendix B to Part 1522—Attestation for an Annual Recertification Under Section 4(c) of the GENIUS Act

Appendix B to Part 1522—Attestation for an Annual Recertification Under Section 4(c) of the GENIUS Act

[States may include a brief introduction here]

Reference table of changes:

[List each change to the State-level regulatory regime or any known significant changes in circumstances in its own row and attach relevant documentation and additional narrative descriptions]

Primary contacts: [Names, titles, email addresses, and phone numbers of at least two authorized officials of the State payment stablecoin regulator]

Certification: The undersigned hereby certifies and attests that:

1. The information contained in and attached to this attestation form is true and correct to the best of the undersigned's knowledge;

2. [The State payment stablecoin regulator] believes that the State-level regulatory regime for [State]:

a. ____ has not materially changed and there have been no known significant changes in circumstances; or

b. ____ has materially changed or there have been significant changes in circumstances.

3. [State payment stablecoin regulator] confirms the continuing accuracy of the initial certification submitted on ____; and

4. The undersigned has the authority to submit this attestation and make representations on behalf of [State payment stablecoin regulator].