-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, KQNcsFjOCl7zpgJpmXOIi55Pcu9qBaY6PXXj0bTsS1j0/Ed6MunBftJehl2frKCN EoGvrXF0NFxb6hxDZn7h/Q== 0001144204-09-011358.txt : 20090227 0001144204-09-011358.hdr.sgml : 20090227 20090227161906 ACCESSION NUMBER: 0001144204-09-011358 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20090225 FILED AS OF DATE: 20090227 DATE AS OF CHANGE: 20090227 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: BRADLEY DAVID M CENTRAL INDEX KEY: 0001195965 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-27672 FILM NUMBER: 09643208 BUSINESS ADDRESS: STREET 1: C/O NORTH CENTRAL BANCSHARES INC STREET 2: 825 CENTRAL AVE. PO BOX 1237 CITY: FORT DODGE STATE: IA ZIP: 50501 BUSINESS PHONE: 5155767531 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 1 v141532_ex.xml X0303 4 2009-02-25 0 0001005188 NORTH CENTRAL BANCSHARES INC FFFD 0001195965 BRADLEY DAVID M C/O NORTH CENTRAL BANCSHARES, INC. 825 CENTRAL AVE. FORT DODGE IA 50501 1 1 0 0 Chairman, President & CEO Common Stock, par value $0.01 per share 12693 D Common Stock, par value $0.01 per share 203 I Spouse and minor child Common Stock, par value $0.01 per share 2009-02-25 4 I 0 948.0393 11.557 A 8004.7746 I 401(k) Trust Common Stock, par value $0.01 per share 20892 I ESOP Includes 400 shares of restricted stock which will vest on April 25, 2009 and 4,146 shares held in a self-directed IRA. The Reporting Person inadvertently understated the number of shares held in the self-directed IRA in a prior report, but did not understate the total number of shares directly owned. Reflects total shares allocable to the reporting person of the shares of stock held by The Principal Trust Company, as trustee of the North Central Bancshares, Inc. Stock Fund of the First Federal Savings Bank of Iowa 401(k) Plan. Pursuant to Rule 16a-3 (f)(1)(i)(B) under the Securities and Exchange Act of 1934, as amended. /s/ David M. Bradley 2009-02-27 -----END PRIVACY-ENHANCED MESSAGE-----