6
1407071 Board of Governors of the Federal Reserve System FR Y-6 0MB Number 7100-0297 Approval expires September 30, 2018 Page 1 of2 Annual Report of Holding Companies-FR Y-6 Report at the close of business as of the end of fiscal year This Report is required by law: Section 5{c}(1 )(A) of the Bank Holding Company Act (12 U.S.C. § 1844(c)(1 )(A)); sections 8(a) and 13(a) of the International Banking Act (12 U.S.C. §§ 3106(a) and 3108(a)); sections 11 (a}{1 ), 25, and 25A of the Federal Reserve Act (12 U.S.C. §§ 248(a)(1), 602, and 611a); and sec- tions 113, 165, 312, 618, and 809 of the Dodd-Frank Act (12 U.S.C. This report form is to be filed by all top-tier bank holding compa- nies, top-tier savings and loan holding companies, and U.S. inter- mediate holding companies organized under U.S. law, and by any foreign banking organization that does not meet the require- ments of and is not treated as a qualifying foreign banking orga- nization under Section 211.23 of Regulation K (12 C.F.R. § 211.23). (See page one of the general instructions for more detail of who must file.) The Federal Reserve may not conduct or spon- sor , and an organization (or a person) is not required to respond to, an information collection unless it displays a currently valid 0MB control number. §§ 5361 , 5365, 5412, 1850a(c}{1}, and 5468(b)(1)). Return to the appropriate Federal Reserve Bank the original and the number of copies specified. NOTE: The Annual Report of Holding Companies must be signed by one director of the top-tier holding company. This individual should also be a senior official of the top-tier holding company. In the event that the top-tier holding company does not have an individual who is a senior official and is also a director, the chairman of the board must sign the report. If the holding company is an ESOP/ESOT formed as a corporation or is an LLC, see the General Instructions for the authorized individual who must sign the report. 1, Preston G. Smith Name of the Holding Company Director and Official Vice President & Director Title of the Holding Company Director and Official attest that the Annual Report of Holding Companies (including the supporting attachments) for this report date has been pre- pared in conformance with the instructions issued by the Federal Reserve System and are true and correct to the best of my knowledge and belief. With respect to infonnation regarding individuals contained in this report, the Reporter certifies that it has the authority to provide this infonnation to the Federal Reserve. The Reporter also certifies that it has the authority, on behalf of each individual, to consent or object to public release of infonnation regarding that individual. The Federal Reserve may assume, in the absence of a request for confidential treatment submitted in accordance with the Board's "Rules Regarding Availabilit ~roJji.iaf ion," 12 C.FR. Part 261, that the Reporter · · uaJ.,cons_~t.9 . ublic release of all details in t in. · kJ nature of Holding Company Director and Official 03/27/2017 Date of Signature For holding companies l1.Q1 registered with the SEC- Indicate status of Annual Report to Shareholders: [8] is included with the FR Y-6 report D will be sent under separate cover D is not prepared For Federal Reserve Bank Use Only RSSDID C.I. Date of Report (top-tier holding company's fiscal year-end}: December 31, 2016 Month / Day / Year None Reporter's Legal Entity Identifier (LEI) (20-Character LEI Code) Reporter's Name, Street, and Mailing Address MGB Bancshares Inc Legal Title of Holding Company 511 Lake Land Blvd (Mailing Address of the Holding Company) Street / P.O. Box Mattoon IL _6_19 _3 '- 8 '----- City State Zip Code Physical Location (if different from mailing address) Person to whom questions about this report should be directed: Tracy J Albin _S_e_c_ re _t_ ary --'-------- Name Title 217-234-7900 Area Code I Phone Number / Extension 217 -234-7929 Area Code / FAX Number talbin@fnbbankingcenters.com E-mail Address www.fnbbank i ngcenters.com Address (URL) for t he Holding Company·s web page Is confidential treatment requested for any portion of this report submission? ... .... ....................... In accordance with the General Instructions for this report (check only one), 1. a letter justifying this request is being provided along with the report ....... .... .. .. . .......... ........ .. ... .... .... ....... D 2. a letter justifying this request has been provided separately ............... ................ ......... .. ...... . .. ......... D NOTE: Information for which confidential treatment is being requested must be provided separately and labeled as "confidential ." Public reporting burden for this information collection is estimated to vary from 1.3 to 101 hours per response. with an average of 5.50 hours per response, including time to gather and maintain data in the required form and to review instructions and complete the information collection. Send comments regarding this burden estimate or an y other aspect of this collection of information, including suggestions for reducing this burden to: Secretary, Board of Governors of the Federal Reserve System. 20th and C Streets, NW. Washington, DC 20551 , and to the Office of Management and Budget, Paperwork Reduction Project (7100-0297), Washington, DC 20503. 1 21 2016

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Page 1: Annual Report of Holding Companies-FR Y-6/media/others/banking/... · NOTE: The Annual Report of Holding Companies must be signed by one director of the top-tier holding company

1407071

Board of Governors of the Federal Reserve System

FR Y-6 0MB Number 7100-0297 Approval expires September 30, 2018 Page 1 of2

Annual Report of Holding Companies-FR Y-6

Report at the close of business as of the end of fiscal year

This Report is required by law: Section 5{c}(1 )(A) of the Bank Holding Company Act (12 U.S.C. § 1844(c)(1 )(A)); sections 8(a) and 13(a) of the International Banking Act (12 U.S.C. §§ 3106(a) and 3108(a)); sections 11 (a}{1 ), 25, and 25A of the Federal Reserve Act (12 U.S.C. §§ 248(a)(1), 602, and 611a); and sec­tions 113, 165, 312, 618, and 809 of the Dodd-Frank Act (12 U.S.C.

This report form is to be filed by all top-tier bank holding compa­nies, top-tier savings and loan holding companies, and U.S. inter­mediate holding companies organized under U.S. law, and by any foreign banking organization that does not meet the require­ments of and is not treated as a qualifying foreign banking orga­nization under Section 211.23 of Regulation K (12 C.F.R. § 211.23). (See page one of the general instructions for more detail of who must file.) The Federal Reserve may not conduct or spon­sor, and an organization (or a person) is not required to respond to, an information collection unless it displays a currently valid 0MB control number.

§§ 5361 , 5365, 5412, 1850a(c}{1}, and 5468(b)(1)). Return to the appropriate Federal Reserve Bank the original and the number of copies specified.

NOTE: The Annual Report of Holding Companies must be signed by one director of the top-tier holding company. This individual should also be a senior official of the top-tier holding company. In the event that the top-tier holding company does not have an individual who is a senior official and is also a director, the chairman of the board must sign the report. If the holding company is an ESOP/ESOT formed as a corporation or is an LLC, see the General Instructions for the authorized individual who must sign the report. 1, Preston G. Smith

Name of the Holding Company Director and Official

Vice President & Director Title of the Holding Company Director and Official

attest that the Annual Report of Holding Companies (including the supporting attachments) for this report date has been pre­pared in conformance with the instructions issued by the Federal Reserve System and are true and correct to the best of my knowledge and belief.

With respect to infonnation regarding individuals contained in this report, the Reporter certifies that it has the authority to provide this infonnation to the Federal Reserve. The Reporter also certifies that it has the authority, on behalf of each individual, to consent or object to public release of infonnation regarding that individual. The Federal Reserve may assume, in the absence of a request for confidential treatment submitted in accordance with the Board's "Rules Regarding Availabilit ~roJji.iafion," 12 C.FR. Part 261, that the Reporter · · uaJ.,cons_~t.9. ublic release of all details in t in. · kJ

nature of Holding Company Director and Official

03/27/2017 Date of Signature

For holding companies l1.Q1 registered with the SEC-Indicate status of Annual Report to Shareholders:

[8] is included with the FR Y-6 report

D will be sent under separate cover

D is not prepared

For Federal Reserve Bank Use Only

RSSDID C.I.

Date of Report (top-tier holding company's fiscal year-end}:

December 31, 2016 Month / Day / Year

None Reporter's Legal Entity Identifier (LEI) (20-Character LEI Code)

Reporter's Name, Street, and Mailing Address

MGB Bancshares Inc Legal Title of Holding Company

511 Lake Land Blvd (Mailing Address of the Holding Company) Street / P.O. Box

Mattoon IL _6_19_3'-8'-----City State Zip Code

Physical Location (if different from mailing address)

Person to whom questions about this report should be directed: Tracy J Albin _S_e_c_re_t_ary--'--------Name Title

217 -234-7900 Area Code I Phone Number / Extension

217 -234-7929 Area Code / FAX Number

[email protected] E-mail Address

www.fnbbankingcenters.com Address (URL) for the Holding Company·s web page

Is confidential treatment requested for any portion ~ of this report submission? ... .... ....................... ~ In accordance with the General Instructions for this report (check only one),

1. a letter justifying this request is being provided along with the report ....... .... .. .. ........... ........ .. ... .. .. .... ....... D

2. a letter justifying this request has been provided separately ............... ................ ......... .. ...... ... ......... D

NOTE: Information for which confidential treatment is being requested must be provided separately and labeled as "confidential."

Public reporting burden for this information collection is estimated to vary from 1.3 to 101 hours per response. with an average of 5.50 hours per response, including time to gather and maintain data in the required form and to review instructions and complete the information collection. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to: Secretary, Board of Governors of the Federal Reserve System. 20th and C Streets, NW. Washington, DC 20551 , and to the Office of Management and Budget, Paperwork Reduction Project (7100-0297), Washington, DC 20503.

121

2016

Page 2: Annual Report of Holding Companies-FR Y-6/media/others/banking/... · NOTE: The Annual Report of Holding Companies must be signed by one director of the top-tier holding company

MGB BANCSHARES, INC.

FRY-6, Report Item 2a: ORGANIZATION CHART

ORGANIZATION CHART

MGB BANCSHARES, INC. Mattoon, Illinois USA

Incorporated in the State of Delaware USA LEI: None

100% Ownership The First National Bank Mattoon, Illinois USA

National Bank Association Organized under the Laws of the United States of America LEI: None

MOB Bancshares, Inc. currently owns one subsidiary, The First National Bank, Mattoon, Illinois.

Common Stock Issued Shares owned by MOB Bancshares, Inc. Percentage of ownership

30,000 shares 30,000 shares 100%

100% Ownership MGB Statutory Trust I Mattoon, Illinois USA

Trust Formed Pursuant to Chapter 38 of Title 12 of the Delaware Code LEI: None

MOB Bancshares, Inc. owns 100% of MOB Statutory Trust I

MOB Bancshares, Inc. does not own over 5% of any other company, bank, or bank holding company.

Page 3: Annual Report of Holding Companies-FR Y-6/media/others/banking/... · NOTE: The Annual Report of Holding Companies must be signed by one director of the top-tier holding company

Re-suits: AUst of brand'les for your depository JnstituOon: ftRST NATION Al BANK, TH[ (10 _ltSSO: 388940). This depository lnst ltu llon Is held by MG8 BANCSHARES. INC. (1407071 ) of MATTOON, IL The data are as of 12/31/2016. 01t1 reflects lnfor m1tlon that w.s received and procened through 01/10/2017,

!ts:ond••tNO and Y!rific.tUon S••es 1. In the Data Action column of uch bf•nch row, enter one or more of the acUon-. s~ifltd b«low 2. If required, enter the date In the Effective Dat e column -OK: If the bf1n(h Information t$ eotrttt. enter "()I( In the O.ta Action coklmn.

Close: If I bf Inch ll1ted w1s sotd Of doud, enter 'Cose In the O.ta Ac.tion cofumn 1nd the sale or dosure date In the EffKtlve Dlte column. Oeltte: If I bf.anch listed was never owned by this depository iMtltuUon, enter ·oelete· In the Oat• Action co4umn. • ~ = U a report1ble brand, is mlssln1, Insert a row, .add the brlnch data, .and enter 'Add' ln t he Data Action column and the open!n1 or .cqulsitlon date In the Effective Date cofumn.

If printing thk 11st, vou may ne~ to adjust your P'lt se-tup In M S Excel. Try usJna landicape orienti11tion, Pitt u:.une, artd/or let•I sJu:d p,lptt.

SUt»m11s1on Procfdo!:t When you art n~shed, send a saved copy to your FR8 contaC1. See the detailed Instructions on this site for more lnlorm1Uon. If you are e•malHng thh to your FR8 contact, put yoyr lnnltuUon name, city and state m the subject line of the e-mail.

Note: To s,t1$ly the FR Y-10 repo,tina requl,-fflfllb, you mu$t ah-o wbmh fR Y-10 Oomeslk &ranch Sc.hfodulfi for uch bfanchwfth, oat, Attionof Ch.1n1t. C1ouo. ~·ete. or Add The FR Y-10 report m,y be s.ubm!tt~ In a hardcopyform1t or\111 the FR Y·lO Onl~ applleatlon • https://v10onllne.federal,eserve.1ov.

• FDIC UNINUM, Office Number, and IO_RSSO columns are fo, reference ontv. V~iflcat/on of tnese v•lues ls not required.

St rfftAddr"flS SU LAKE LAND BOULEVARD S06 MAIN STRE[T 1121 BROADWAY AVENUE EA.ST, SUITE 3

FDtC UNIHUM· Office Hum~· Head Offlc• He.ct Office ID w o• Comments 247& FIRST NATIONAL BANK THE 388940 Not Re ulfed Not R ulred FIRST NATIONAL BANK THE 388940 2019S7 3 FIRST NATIONAL BANK THE 388940

Page 4: Annual Report of Holding Companies-FR Y-6/media/others/banking/... · NOTE: The Annual Report of Holding Companies must be signed by one director of the top-tier holding company

FRY-6

MGB Bancshares, Inc. Mattoon, Illinois

Fiscal Year Ending December 31, 2016

Report Item 3: Securities Holders

Current Securities Holders with ownership, control or holdings of 5% or more with power to vote as-of fiscal year end.

Securities Holders not listed in 3(1 )(a) through (3)(1 )(c) that had ownership, control or holdings of 5% or more with power to vote during the fiscal year.

(1 )(a) (1 )(b) (1 )(c) (2)(a) (2)(b) (2)(c) Number and Number and

Country of Percentage of Each Country of Percentage of Each Name & Address (City, Citizenship or Class of Voting Name & Address Citizenship or Class of Voting State, Country) Incorporation Securities (City, State, Country) Incorporation Securities

Geroge L. Halenkamp Ill, USA 3,676 9.39% St. Louis, MO NONE Joan C. Halenkamp USA 2,755 7.04% Trustee for Joan C. Halenkamp Living Trust dated 6/28/1992, Chesterfield, MO Nora Hayes, Greenville, USA 2,450 6.26% IL Lawrence G. Martin, USA 4,000 10.28% Greenville, IL MGB Bancshares, Inc. USA 8,147 20.82% ESOP, Mattoon, IL Steven S. Schmitt, USA 3,177 8.12% Highland, IL

Page 5: Annual Report of Holding Companies-FR Y-6/media/others/banking/... · NOTE: The Annual Report of Holding Companies must be signed by one director of the top-tier holding company

Report Item 4: Insiders (1 ){a}(b)(c) and (2)(a)(b)(c)

(1)

Names & Address (City, State, Country)

George L. Halenkamp 111, St. Louis, MO USA Joan C. Halenkamp Trustee for Joan C. Halenkamp Living Trust dated 612811992, Chesterfield , MO

(2) (3)(a)

Principal Occupation if other Title & Position than with Holding with Holding Company Company

Marketing Representative

Retired Housewife

Chairman, Director & Shareholder Shareholder

FR Y-6

MGB Bancshares, Inc. Mattoon, Illinois

Fiscal Year Ending December 31, 2016

(3)(b)

Title & Position

(3)(c)

Title & Position with Other

with Subsidiaries Businesses (include names of (include names of subsidiaries) other businesses)

None

None

Marketing Representative, Novus International None

Lawrence G. Martin, Retired Insurance Greenville, IL USA Agent

President, Director Director (The First NIA

Preston G. Smith, NIA Greenville, IL USA

& Shareholder National Bank)

Vice President, Director & Shareholder

Director & President Director, Ben Tire (The First National Distributors Ltd. Bank)

(4)(a) (4)(b) (4)(c)

List names of other companies (includes partnerships) if 25% or more of voting securities are held

Percentage of (List names of Percentage of Voting Securities companies and Voting Securities in Subsidiaries percentage of in Holding (include names voting securities Company of subsidiaries) held)

9.39% None NIA-

7.04% None NIA

10.28% None NIA

4.60% None NIA

Page 6: Annual Report of Holding Companies-FR Y-6/media/others/banking/... · NOTE: The Annual Report of Holding Companies must be signed by one director of the top-tier holding company

Tracy J . Beem, N/A Secretary & Senior Vice N/A 0.01% None N/A Toledo, IL USA Shareholder President & Chief

Financial Officer (The First National Bank)

MGB Bancshares NA Shareholder N/A N/A 20.82% None N/A ESOP, Mattoon, IL USA