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FORM 3 OMB APPROVAL
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OMB Number 3235-0104
Express Sept. 30, 1998
Estimated average burden
hours per response...0.5
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934,
Section 17(a) of the Public Utility Holding Company Act of 1935 or
Section 30(f) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person*
Citizens Banking Corporation
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(Last) (First) (Middle)
328 S. Saginaw Street
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(Street)
Flint MI 48502
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(City) (State) (Zip)
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2. Date of Event Requiring Statement (Month/Day/Year)
4/18/99
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3. IRS Identification Number of Reporting Person, if an Entity (Voluntary)
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4. Issuer Name and Ticker or Trading Symbol
F&M Bancorporation, Inc. (FMBK)
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5. Relationship of Reporting Person to Issuer
(Check all applicable)
[_] Director [X] 10% Owner
[_] Officer (give title below) [_] Other (specify below)
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6. If Amendment, Date of Original (Month/Day/Year)
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7. Individual or Joint/Group Filing (Check Applicable Line)
[_] Form Filed by One Reporting Person
[_] Form Filed by More Than One Reporting Person
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TABLE I -- NON-DERIVATIVE SECURITIES BENEFICIALLY OWNED
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3. Ownership Form:
2. Amount of Securities Direct (D) or
1. Title of Security Beneficially Owned Indirect (I) 4. Nature of Indirect Beneficial Ownership
(Instr. 4) (Instr. 4) (Instr. 5) (Instr. 4)
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<S> <C> <C> <C>
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Reminder: Report on a separate line for each class of securities beneficially
owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction
5(b)(v).
(over)
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FORM 3 (CONTINUED)
TABLE II -- DERIVATIVE SECURITIES BENEFICIALLY OWNED
(E.G., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES)
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5. Owner-
3. Title and Amount of Securities ship
Underlying Derivative Security Form of
2. Date Exercisable (Instr. 4) Derivative
and Expiration Date --------------------------------- 4. Conver- Security:
(Month/Day/Year) Amount sion or Direct 6. Nature of
---------------------- or Exercise (D) or Indirect
Date Expira- Number Price of Indirect Beneficial
1. Title of Derivative Exer- tion of Derivative (I) Ownership
Security (Instr. 4) cisable Date Title Shares Security (Instr. 5) (Instr. 5)
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<S> <C> <C> <C> <C> <C> <C> <C>
Option (Right to Buy) (1) (2) Common Stock 3,097,908 $35.55 D
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</TABLE>
Explanation of Responses:
See attachment.
**Intentional misstatements or omissions of facts constitute Federal Criminal
Violations.
See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
/s/ Thomas W. Gallagher 4/27/99
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**Signature of Reporting Person Date
Thomas W. Gallagher
Senior Vice President,
General Counsel and Secretary
Note: File three copies of this Form, one of which must be manually signed.
If space provided is insufficient, see Instruction 6 for procedure.
Potential persons who are to respond to the collection of information contained
in this form are not required to respond unless the form displays a currently
valid OMB Number.
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SEC 1473(7-96)
(Print or Type Responses)
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ATTACHMENT TO FORM 3
NAME AND ADDRESS OF REPORTING PERSON: Citizens Banking Corporation
One Citizens Banking Center
Flint, Michigan 48502
DATE OF EVENT REQUIRING STATEMENT: 04/18/99
ISSUER NAME AND TICKER OR TRADING SYMBOL: F&M Bancorporation, Inc. (FMBK)
Explanation of Responses:
(1) Exercise of the option is subject to the occurrence of one of
several Purchase Events which are set forth in the option and which are
summarized as follows: (a) the acquisition by any person other than the
Reporting Person of beneficial ownership of 20% or more of the then outstanding
common stock of the Issuer, (b) Issuer or any of its subsidiaries, without
having received the prior written consent of the Reporting Person, shall have
entered into an agreement to engage in an Acquisition Transaction (as defined
below) with any person other than the Reporting Person or the Board of Directors
of Issuer shall have recommended that the shareholders of Issuer approve or
accept any Acquisition Transaction with any person other than the Reporting
Person, (c) Issuer or any of its subsidiaries, without having received the prior
written consent of the Reporting Person, shall have authorized, recommended,
proposed or publicly announced its intention to authorize, recommend or propose,
to engage in an Acquisition Transaction with any person other than the Reporting
Person or the Board of Directors of Issuer shall have publicly withdrawn or
modified, or publicly announced its interest to withdraw or modify, in any
manner adverse to the Reporting Person, its recommendation that the stockholders
of Issuer approve the transactions contemplated by the Agreement and Plan of
Merger, dated April 18, 1999, by and between the Reporting Person and the Issuer
(the "Plan"), (d) any person (other than the Reporting Person) shall have
acquired beneficial ownership or the right to acquire beneficial ownership of
10% or more of the outstanding shares of the common stock of the Issuer, (e) any
person other than the Reporting Person shall have made a bona fide proposal to
Issuer or its stockholders, by public announcement or written communication that
is or becomes the subject of public disclosure, to engage in an Acquisition
Transaction (including, without limitation, any situation in which any person
other than the Reporting Person shall have commenced or shall have filed a
registration statement under the Securities Act of 1933, as amended, with
respect to, a tender offer or exchange offer to purchase any shares of Issuer
Common Stock such that, upon consummation of such offer, such person would own
or control 10% or more of the then outstanding shares of the common stock of
Issuer, (f) after a proposal is made by a third party to Issuer or its
shareholders to engage in an Acquisition Transaction, Issuer shall have breached
any covenant or obligation contained in the Plan and such breach would entitle
the Reporting Person to terminate the Plan, or (g) any person other than the
Reporting Person, other than in connection with a transaction to which the
Reporting Person has given its prior written consent, shall have filed an
application or notice with the Board of Governors of the Federal Reserve System
or other governmental authority or regulatory or administrative agency or
commission for approval to engage in an Acquisition Transaction. "Acquisition
Transaction" means (i) a merger or consolidation, or any similar transaction,
involving Issuer or any of Issuer's bank subsidiaries or any of Issuer's other
subsidiaries, which either individually or in the aggregate would constitute a
"significant subsidiary" (as defined in Rule 1-02 of Regulation S-X promulgated
by the Securities and Exchange Commission) ("Material Subsidiaries"), (ii) a
purchase, lease or other acquisition of all or substantially all of the assets
of Issuer or any Material Subsidiary, (iii) a purchase or other acquisition
(including by way of merger,
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consolidation, share exchange or otherwise) of securities representing 20% or
more of the voting power of Issuer or a Material Subsidiary or (iv) any
substantially similar transaction.
(2) The option will terminate upon the earliest to occur of certain
events which are set forth in the option and which are summarized as follows:
(a) immediately prior to the Effective Time as contemplated by the Plan, (b) 12
months after the first occurrence of a Purchase Event, (c) 18 months after the
termination of the Plan following the occurrence of certain Preliminary Purchase
Events (as defined in the option), (d) termination of the Plan in accordance
with the terms thereof prior to the occurrence of a Purchase Event or a
Preliminary Purchase Event (other than a termination of the Plan by the
Reporting Person pursuant to Section 7.1(c)(i) thereof) or (e) 12 months after
the termination of the Plan by the Reporting Person pursuant to Section
7.1(c)(i) thereof.
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