The form of report to the Commissioner of Banking referred to in Section 34-3-350 shall be as follows: To the Commissioner of Banking: The report of the recent examination of this bank has been received, was submitted to the directors at a board meeting held __________ and was duly considered and a record of the action taken made upon the minutes. ( Chief Executive) Name and location of bank. We, the undersigned directors of __________ bank, have reviewed the report of the Commissioner of Banking under date of __________.