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SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 10-K/A
Amendment No. 1
[X] ANNUAL REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT
OF 1934
For the Fiscal Year Ended December 31, 1996
[_] TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE
ACT OF 1934
For the transition period from ___________ to ___________
0-27672
(Commission File Number)
NORTH CENTRAL BANCSHARES, INC.
(Exact Name of Registrant as Specified in its Charter)
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Iowa 421449849
(State or Other Jurisdiction of Incorporation or Organization) (I.R.S. Employer Identification Number)
c/oFirst Federal Savings Bank of Fort Dodge
825 Central Avenue, Fort Dodge, Iowa 50501
(Address of Principal Executive Offices) (Zip Code)
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(515) 576-7531
(Registrant's Telephone Number including area code)
Securities Registered Pursuant to Section 12(b) of the Act:
None
Securities Registered Pursuant to Section 12(g) of the Act:
Common Stock, par value $.01 per share
(Title of Class)
Indicate by check mark whether the Registrant (1) has filed all reports
required to be filed by Section 13 or 15(d) of the Securities Exchange Act of
1934 during the preceding twelve months (or for such shorter period that the
Registrant was required to file reports) and (2) has been subject to such
requirements for the past 90 days.
YES X NO___
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Indicate by check mark if disclosure of delinquent filers pursuant to Item 405
of Regulation S-K is not contained herein, and will not be contained, to the
best of Registrant's knowledge, in definitive proxy or information statements
incorporated by reference in Part III of this Form 10-K or any amendments to
this Form 10-K. [X]
As of March 20, 1997, there were issued and outstanding 3,429,455 shares of
the Registrant's Common Stock. The aggregate value of the voting stock held by
non-affiliates of the Registrant, computed by reference to the average bid and
asked prices of the Common Stock as of February 28, 1997 $48,693,235.
DOCUMENTS INCORPORATED BY REFERENCE
1. Portions of the Proxy Statement for the Registrant's 1997 Annual Meeting of
Shareholders are incorporated by reference into Items 10, 11, 12 and 13 of
Part III hereof.
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PART IV
ITEM 14. EXHIBITS, FINANCIAL STATEMENT SCHEDULES AND REPORTS ON FORM 8-K
(a) 1. Financial Statements
The following are filed as part of this annual report on Form 10-K:
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- Independent Auditor's Report
- Consolidated Statements of Financial Condition at December 31, 1996 and 1995
- Consolidated Statements of Income for each of the years in the three year period ended December 31,
1996
- Consolidated Statements of Shareholders' Equity for each of the years in the three year period ended
December 31, 1996
- Consolidated Statements of Cash Flows for each of the years in the three year period ended December
31, 1996
- Notes to the Consolidated Financial Statements
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2. Financial Statement Schedules
Financial Statement Schedules have been omitted because they are not
applicable or the required information is shown in the Consolidated
Financial Statements or Notes thereto.
(b) Reports on Form 8-K filed during the last quarter of 1996:
A Form 8-K was filed on December 20, 1996, to report, pursuant to item
5, the retirement of Paul C. Eide, director and Chairman of the Board
of the Holding Company and the Bank as of December 31, 1996, the
election of Robert H. Singer, Jr. elected as a director of the Holding
Company and the Bank to fill the vacancy created by Mr. Eide's
retirement, and the election of David M. Bradley as Chairman of the
Board of the Holding Company and the Bank, effective as of January 1,
1997.
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(c) Exhibits Required by Item 601 of Securities and Exchange Commission
Regulation S-K:
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Exhibit No. Description Page No.
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3.1 Articles of Incorporation of North Central Bancshares, Inc. *
3.2 Bylaws of North Central Bancshares, Inc. *
4.1 Federal Stock Charter of First Federal Savings Bank of Fort Dodge *
4.2 Bylaws of First Federal Savings Bank of Fort Dodge *
4.3 Specimen Stock Certificate of North Central Bancshares, Inc. *
10.1 Employee Stock Ownership Plan of First Federal Savings Bank of Fort *
Dodge and ESOP Trust Agreement
10.2 ESOP Loan Documents, dated September 3, 1996
10.3 Employee Retention Agreements between First Federal Savings Bank of Fort **
Dodge and certain executive officers
10.4 Employment Agreement between First Federal Savings Bank of Fort Dodge *
and David M. Bradley, effective as of August 31, 1994
10.5 Form of Employment Agreement between First Federal Savings Bank of Fort *
Dodge and David M. Bradley
10.6 Form of Employment Agreement between North Central Bancshares, Inc. and *
David M. Bradley
10.7 Salary Continuation Plan Agreement between First Federal Savings Bank of *
Fort Dodge and Paul C. Eide
10.8 Lease Agreement of First Federal Savings Bank of Fort Dodge for Ames *
branch
10.9 North Central Bancshares, Inc. 1996 Stock Option Plan ***
10.10 Asset Purchase Agreement between First Iowa Title Services, Inc. and *
Webster County Title Company, Inc.*
10.11 Asset Purchase Agreement between First Iowa Title Services, Inc. and *
Calhoun County Abstract Company, Inc.*
11.1 Statement regarding computation of per share earnings
21.1 Subsidiaries of the Registrant **
27.1 Financial Data Schedule
99.1 Proxy Statement for Annual Meeting of Shareholders of North Central
Bancshares, Inc. filed with the Securities and Exchange Commission is
incorporated herein by reference.
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* Incorporated herein by reference to Registration Statement No. 33-80493 on
Form S-1 of North Central Bancshares, Inc. filed with the Securities and
Exchange Commission, (the "Commission") on December 18, 1995, as amended.
** Incorporated herein by reference to the Exhibits to the Annual Report on
Form 10-K filed by North Central Bancshares, Inc. for fiscal year 1995,
filed with the Commission on March 29, 1996.
*** Incorporated herein by reference to the Amended Schedule 14A of North
Central Bancshares, Inc. filed with the Commission on August 19, 1996.
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SIGNATURES
Pursuant to the requirements of the Securities Exchange Act of 1934, the
registrant has duly caused this report to be signed on its behalf by the
undersigned thereunto duly authorized.
North Central Bancshares, Inc.
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(Registrant)
By: /s/ John L. Pierschbacher
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John L. Pierschbacher
Treasurer (principal accounting and financial officer)
April 10, 1997
