0000927797-05-000014.txt : 20120705
0000927797-05-000014.hdr.sgml : 20120704
20050131153810
ACCESSION NUMBER: 0000927797-05-000014
CONFORMED SUBMISSION TYPE: SC 13G/A
PUBLIC DOCUMENT COUNT: 1
FILED AS OF DATE: 20050131
DATE AS OF CHANGE: 20050131
SUBJECT COMPANY:
COMPANY DATA:
COMPANY CONFORMED NAME: NORTH CENTRAL BANCSHARES INC
CENTRAL INDEX KEY: 0001005188
STANDARD INDUSTRIAL CLASSIFICATION: SAVINGS INSTITUTION, FEDERALLY CHARTERED [6035]
IRS NUMBER: 421449849
STATE OF INCORPORATION: IA
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: SC 13G/A
SEC ACT: 1934 Act
SEC FILE NUMBER: 005-48441
FILM NUMBER: 05561693
BUSINESS ADDRESS:
STREET 1: 825 CENTRAL AVE
STREET 2: C/O FIRST FED SAVINGS BANK OF FT DODGE
CITY: FORT DODGE
STATE: IA
ZIP: 50501
BUSINESS PHONE: 5155767531
MAIL ADDRESS:
STREET 1: 825 CENTRAL AVENUE
CITY: FORT DODGE
STATE: IA
ZIP: 50501
FILED BY:
COMPANY DATA:
COMPANY CONFORMED NAME: NORTH CENTRAL BANCSHARES INC
CENTRAL INDEX KEY: 0001005188
STANDARD INDUSTRIAL CLASSIFICATION: SAVINGS INSTITUTION, FEDERALLY CHARTERED [6035]
IRS NUMBER: 421449849
STATE OF INCORPORATION: IA
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: SC 13G/A
BUSINESS ADDRESS:
STREET 1: 825 CENTRAL AVE
STREET 2: C/O FIRST FED SAVINGS BANK OF FT DODGE
CITY: FORT DODGE
STATE: IA
ZIP: 50501
BUSINESS PHONE: 5155767531
MAIL ADDRESS:
STREET 1: 825 CENTRAL AVENUE
CITY: FORT DODGE
STATE: IA
ZIP: 50501
SC 13G/A
1
ncb13g-amend4_013105.txt
SCHEDULE 13G AMENDMENT 4 - 01-31-05
UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, DC 20549
SCHEDULE 13G
Under the Securities Exchange Act of 1934
(Amendment No. 4) *
North Central Bancshares, Inc.
--------------------------------------------------------------------------------
(Name of Issuer)
Common Stock, $.01 par value per share
--------------------------------------------------------------------------------
(Title of Class of Securities)
658418-10-8
--------------------------------------------------------------------------------
(CUSIP Number)
--------------------------------------------------------------------------------
(Date of Event Which Requires Filing of this Statement)
Check the appropriate box to designate the rule pursuant to which this Schedule
is filed:
[X] Rule 13d-1(b)
[ ] Rule 13d-1(c)
[ ] Rule 13d-1(d)
* The remainder of this cover page shall be filled out for a reporting person's
initial filing on this form with respect to the subject class of securities, and
for any subsequent amendment containing information which would alter the
disclosures provided in a prior cover page.
The information required in the remainder of this cover page shall not be deemed
to be "filed" for the purpose of Section 18 of the Securities Exchange Act of
1934 ("Act") or otherwise subject to the liabilities of that section of the Act
but shall be subject to all other provisions of the Act (however, see the
Notes).
CUSIP NO. 658418-10-8 Page 2 of 6 Pages
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1. Names of Reporting Persons.
I.R.S. Identification Nos. of above persons (entities only)
First Federal Savings Bank of Iowa - Employee Stock Ownership Plan
------------------------------------------------------------------
--------------------------------------------------------------------------------
2. Check the Appropriate Box if a Member of a Group (See Instructions)
(a)
--------------------------------------------------------
(b)
--------------------------------------------------------
--------------------------------------------------------------------------------
3. SEC Use Only
-------------------------------------------------------------
--------------------------------------------------------------------------------
4. Citizenship or Place of Organization
Employee Benefit Plan of Federally-chartered Savings Bank
---------------------------------------------------------
--------------------------------------------------------------------------------
5. Sole Voting Power 0
Number of --------------------------------
Shares -------------------------------------------------------
Beneficially
Owned by 6. Shared Voting Power 8,118
------------------------------
Each -------------------------------------------------------
Reporting
Person With 7. Sole Dispositive Power 0
---------------------------
-------------------------------------------------------
8. Shared Dispositive Power 167,609
-------------------------
--------------------------------------------------------------------------------
9. Aggregate Amount Beneficially Owned by Each Reporting Person 167,609
-------------
--------------------------------------------------------------------------------
10. Check if the Aggregate Amount in Row (9) Excludes Certain Shares (See
Instructions): [ ]
--------------------------------------------------------------------------------
11. Percent of Class Represented by Amount in Row (9) 10.95% of 1,530,530
-------------------------
shares of common stock outstanding as of December 31, 2004.
--------------------------------------------------------------------------
--------------------------------------------------------------------------------
12. Type of Reporting Person (See Instructions) EP
------------------------------
--------------------------------------------------------------------------------
CUSIP NO. 658418-10-8 Page 3 of 6 Pages
--------------------------------------------------------------------------------
Item 1(a). Name of Issuer:
North Central Bancshares, Inc., an Iowa corporation
Item 1(b). Address of Issuer's Principal Executive Offices:
825 Central Avenue, Fort Dodge, Iowa 50501
Item 2(a). Name of Person Filing:
First Federal Savings Bank of Iowa
Employee Stock Ownership Plan and Trust
Trustee: First Bankers Trust Company, N.A.
Item 2(b). Address of Principal Business Office or, if None, Residence:
2321 Koch's Lane
Quincy, IL 62305
Item 2(c). Citizenship or Place of Organization:
Employee Benefit Plan of a Federal Savings Bank
Item 2(d). Title of Class of Securities:
Common Stock, $.01 par value per share
Item 2(e). CUSIP Number:
658418-10-8
Item 3. If This Statement is Filed Pursuant to ss.ss.240.13d-1(b), or
240.13d-2(b) or (c), Check Whether the Person Filing is a:
The person filing is an:
(f) Employee benefit plan which is subject to the provisions of
the Employee Retirement Income Security Act of 1974
Item 4. Ownership.
(a) Amount beneficially owned: 167,609 shares
-------
(b) Percent of class: 10.95 %
-----
(c) Number of shares as to which the person has:
(i) sole voting power to vote or direct the vote: 0 shares
---
CUSIP NO. 658418-10-8 Page 4 of 6 Pages
--------------------------------------------------------------------------------
(ii) shared power to vote or to direct the vote: 8,118 shares
-------
(iii) sole power to dispose or to direct the disposition of:
0 shares
---
(iv) shared power to dispose or to direct the disposition of:
167,609 shares
---------
The reporting person is a tax qualified employee stock ownership
plan under the Employee Retirement Income Security Act of 1974, as
amended ("ERISA"), with individual accounts for the accrued
benefits of participating employees and their beneficiaries. The
reporting person is administered by an ESOP Committee ("ESOP
Committee") and its assets are held in trust by a trustee ("Plan
Trustee"). The number of shares listed as beneficially owned
represents the entire number of shares of Common Stock held by
First Bankers Trust Company, N.A., as Plan Trustee, as of December
31, 2004. As of December 31, 2004, 159,491 of such shares of
Common Stock had been allocated to individual accounts established
for participating employees and their beneficiaries, and 8,118 of
such shares were held, unallocated, for allocation in future
years. In general, participating employees and their beneficiaries
have the power and authority to direct the voting of shares of
Common Stock allocated to their individual accounts. Such
allocated shares are, therefore, not included as shares over which
the reporting person has sole or shared voting power. The
reporting person, through Plan Trustee, has shared voting power
over unallocated Common Stock. Any unallocated Common Stock is
generally required to be voted by the Plan Trustee in the same
proportion as Common Stock which has been allocated to
Participants is directed to be voted. The reporting person,
through the Plan Trustee (who is instructed by the ESOP Committee)
shares dispositive power over all unallocated Common Stock held by
the reporting person. The reporting person, acting through the
Plan Trustee (who is instructed by the ESOP Committee) shares
dispositive power over allocated Common Stock with participating
employees and their beneficiaries, who have the right to determine
whether Common Stock allocated to their respective accounts will
be tendered in response to a tender offer but otherwise have no
dispositive power. Any unallocated Common Stock is generally
required to be tendered by the Plan Trustee in the same proportion
as Common Stock which has been allocated to Participants is
directed to be tendered. In limited circumstances, ERISA may
confer upon the Plan Trustee the power and duty to control the
voting and tendering of Common Stock allocated to the accounts of
participating employees and beneficiaries who fail to exercise
their voting and/or tender rights. The reporting person disclaims
voting power with respect to such allocated Common Stock.
Item 5. Ownership of Five Percent or Less of a Class.
Not applicable.
Item 6. Ownership of More than Five Percent on Behalf of Another Person.
Dividends declared on Common Stock held by the Plan which have
been allocated to the account of a Participant are allocated to
the account of such Participant. Such dividends may be held and
invested in the same manner as funds generally held or invested by
the Plan which are not invested in Common Stock or distributed to
Participants in accordance with and at such time as provided in
the Plan Document. Participants may receive, or direct the receipt
of, proceeds of the sale of Common Stock held by the Plan and
allocated to their accounts to the extent they have become vested
in such Common Stock and at such times as provided in the Plan
document. No participant has the right to receive or the power to
direct the receipt of dividends on, or the proceeds of the sale
of, more than 5% of the Common Stock issued and outstanding as of
the date hereof.
CUSIP NO. 658418-10-8 Page 5 of 6 Pages
--------------------------------------------------------------------------------
Item 7. Identification and Classification of the Subsidiary which
Acquired the Security being Reported on by the Parent Holding
Company.
Not applicable.
Item 8. Identification and Classification of Members of the Group.
The Reporting Person is an employee benefit plan subject to the
provisions of the Employee Retirement Income Security Act of 1974.
Item 9. Notice of Dissolution of Group.
Not applicable.
Item 10. Certification.
By signing below I certify that, to the best of my knowledge and
belief, the securities referred to above were not acquired and are
not held for the purpose of or with the effect of changing or
influencing the control of the issuer of the securities and were
not acquired and are not held in connection with or as a
participant in any transaction having that purpose or effect.
CUSIP NO. 658418-10-8 Page 6 of 6 Pages
--------------------------------------------------------------------------------
Signature:
After reasonable inquiry and to the best of my knowledge and belief, I
certify that the information set forth in this statement is true, complete and
correct.
Date: January 31, 2005
----------------
NORTH CENTRAL BANCSHARES, INC. EMPLOYEE STOCK OWNERSHIP PLAN
First Bankers Trust Company, N.A., as Trustee of the North Central Bancshares,
Inc. Employee Stock Ownership Plan
By: /s/ Linda Shultz
----------------
Name/Title: Linda Shultz, Trust Officer
---------------------------
ESOP Committee of North Central Bancshares, Inc. Employee Stock Ownership Plan
By: /s/ Melvin R. Schroeder
-----------------------
Name/Title: Melvin R. Schroeder, Chairman
-----------------------------
By: /s/ Robert H. Singer, Jr.
------------------------
Name/Title: Robert H. Singer, Jr., Member
-----------------------------
By: /s/ Randall L. Minear
---------------------
Name/Title: Randall L. Minear, Member
-------------------------