0001140361-12-004985.txt : 20120202
0001140361-12-004985.hdr.sgml : 20120202
20120202143523
ACCESSION NUMBER: 0001140361-12-004985
CONFORMED SUBMISSION TYPE: 4/A
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20100916
FILED AS OF DATE: 20120202
DATE AS OF CHANGE: 20120202
ISSUER:
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
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
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: SINGER ROBERT H JR
CENTRAL INDEX KEY: 0001195969
FILING VALUES:
FORM TYPE: 4/A
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-27672
FILM NUMBER: 12565556
MAIL ADDRESS:
STREET 1: C/O NORTH CENTRAL BANCSHARES INC
STREET 2: 825 CENTRAL AVE PO BOX 1237
CITY: FORT DODGE
STATE: IA
ZIP: 50501
4/A
1
doc1.xml
FORM 4/A
X0304
4/A
2010-09-16
2010-09-20
0
0001005188
NORTH CENTRAL BANCSHARES INC
FFFD
0001195969
SINGER ROBERT H JR
C/O NORTH CENTRAL BANCSHARES INC
825 CENTRAL AVENUE
FORT DODGE
IA
50501
1
0
0
0
Common Stock, par value $0.01 per share
2010-09-16
4
P
0
500
13.00
A
9583
D
This Form 4/A is being filed to correct the transaction amount, which was incorrectly reported as 600 in the original Form 4 that was filed on 9/20/2010.
The figure in Column 5 of Table I is corrected in this Form 4/A to reflect an updated total beneficial ownership amount based on the corrected transaction amount described in footnote (1). The adjustment to the total beneficial ownership amount also affects the cumulative total beneficial ownership amount reported in one Form 4 that was filed by the reporting person after his original Form 4 referenced in footnote (1) was filed. The amount reported in this Column 5 of Table I reflects the total beneficial ownership amount of the reporting person as of the date of the filing of this amendment and includes 725 shares of restricted stock which will vest on April 22, 2012.
/s/ Robert H. Singer, Jr.
2012-02-02