Annual Report of Holding Companies-FR Y-6/media/others/banking/financial... · 1839252. Board of...

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1839252 Board of Governors of the Federal Reserve System FRY-6 0MB Number 7100--0297 Approval expires September 30, 2018 Page 1 of 2 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: Secti on 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- ti ons 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 (1 2 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. David Schultz Name of the Holding Co mpany Director and Official President li tle 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. Wtth respect to information regarding individuals contained in this report, the Reporter certifies that it has the authority to provide this information 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 information 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 Availability of Information, " 12 C.F.R. Part 261, that the Reporter fil1si. individual consent to public release of all _g_etails in the rep concemin that individual. · .. ; _,{) Da te of Signature For holding companies n.Qf. registered with the SEC- Indicate status of Annual Report to Shareholders: is included wi th the FR Y-6 report D wi ll 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/ Y ear None Reporter's Legal Entity Identifi er (LEI) (20-Character LEI Cod e) Reporter's Name, Street, and Mailing Address Bonduel Bancorp Inc. Legal litle of Holding Company 130 N Cecil SUPO Box 68 (Mailing Address of the Holding Company) Street / P.O. Box Bonduel WI Ci ty State Physical Location (if diff erent from mailing address) 54107 Zip Code Person to whom questions about this report should be directed: David Schultz President Name 715-758-2141 Area Code I Phone Number / Extension 715-758-2823 Area Code / FAX Number [email protected] E-ma il Address litle Addr ess (URL) for the Holding Company's web page O=No 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 justifyi ng 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 hour s 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 t o: 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, Paperworil Reduction Project (71 00--0297). Washingt on, DC 20503. 1212016

Transcript of Annual Report of Holding Companies-FR Y-6/media/others/banking/financial... · 1839252. Board of...

Page 1: Annual Report of Holding Companies-FR Y-6/media/others/banking/financial... · 1839252. Board of Governors of the Federal Reserve System . FRY-6 0MB Number 7100--0297 Approval expires

1839252

Board of Governors of the Federal Reserve System

FRY-6 0MB Number 7100--0297 Approval expires September 30, 2018 Page 1 of 2

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 (1 2 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. David Schultz

Name of the Holding Company Director and Official

President litle 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.

Wtth respect to information regarding individuals contained in this report, the Reporter certifies that it has the authority to provide this information 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 information 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 Availability of Information," 12 C.F.R. Part 261, that the Reporter fil1si. individual consent to public release of all

_g_etails in the rep concemin that individual. · .. ; _,{)

Date of Signature

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

~ 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

Bonduel Bancorp Inc. Legal litle of Holding Company

130 N Cecil SUPO Box 68 (Mailing Address of the Holding Company) Street / P.O. Box

Bonduel WI City State

Physical Location (if different from mailing address)

54107 Zip Code

Person to whom questions about this report should be directed: David Schultz President Name

715-758-2141 Area Code I Phone Number / Extension

715-758-2823 Area Code / FAX Number

[email protected] E-mail Address

litle

Address (URL) for the Holding Company's web page

O=No 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, Paperworil Reduction Project (7100--0297). Washington, DC 20503.

1212016

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Bonduel Bancorp Inc. 130 N Cecil St/PO Box 68

Bonduel WI 54107 Incorporated in the State of Wiscosnin

Form FR Y-6 Fiscal Year Ending December 31 , 2016

Incorporated in Wisconsin Bonduel Bancorp, Inc.

Bonduel, WI LEI= none

100%

IJncorporated in Wisconsin I Bonduel State Bank

Bonduel, WI LEI= none

100%

Incorporated in Nevada Bonduel Investment Corporation

Las Vegas, NV LEl=none

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ftnutu:: A hst of bAnchet. foe your deposrtOfY lmtltuuon Neut STA ..... IA /I• ._.1o1, lllji,~torviMfitutionls~dbyliiUfti.out... "'" Nie. QR't~ ol Nl..

~ dlta are uof ._ 3 Data reflecu lnformA11on tMt ...,n received and PfO<essed thfouth rl/fD/ 'lfJ16

RfCOftcliftk>n and Ytrifadon st,e> 1.. 1n I.he Dau Action c~umn or e.ch tw.nch row, enter Of'H! Of mCMe of the- a<uons specified be4ow

2 tf required, enter tM d1te m th« EffKtfve Date cCMumn

-· Ok. tf the bnM'h lnfom,abon ti correct,. ente1 n• ln the Data Action coiumn a.., tf the br.nch w,format1on ,, incorrect or lncompleie, rwiM the chi., enter In 1ti. Dita Adlon column ind tM d.11e WMn thl, lnlom,1Uon flrst beume v.ltd HI 1he EffectN'e Date column

,_Jcii.. tf a tnnch listed wH IOld Of clowd. ent·ernr In tM Data Action coiumn and ~wleot dosuredlte In IM Etfectivt01te cotumn

o ... -. tf • branch hsted WH never o~ bv rh1, depos;ttory 1mt11Ubon. enter In 1he Oaui Action column

..._: If a repo,t"Able br.nch 1, miu.inc. tnsert a row, ~ the btar,ch data, and enter..._. In the Data Action ro4umn and the openmc Of acqu1sihon d•tc In the Effectfve Oa1e column

tf pfln11nt 1h11 hst. you may nHd to Ml,u,t 'tOl.if pqt setup .n MS bee! Trv usina landscape onenhlhon, pa,e i.uhnc, and/or le:sal 11zed pape,

Submb.slon Prqgdure When you are hni~. s.end • uwd copy to your FR8 contact Sn the deu1led tnRf\lCl1on1on 1his ,ue for fflCM'e 1nform•Oon

If y0u are e,,,m11hn1 thlS to your FRB con1Kt. put 'fOUf fflt1tu11on name, otv and 1t1te In the IObjed line of !he e-m11I

Notr To s.atisfv the FR V· lO re.portin& requirements 'fOU mUit al,,o wbm1t f'R Y-10 Oomeshc: 8'anc:h xh,e,dulH for Heh bunch wllh • Oat. Adlon or~

The FR Y-10 repof1 maybe s.ubmitted 1n I hMdcopy format or VY the FR Y-lOOnllne appllcabon http1J/ylOonl1ne: .fecteBlreSttt"e ICY

• FOK: UNINUM, Office Humber. and ID_RSSO columns are fOf reference only VenfiaiUon of the:H v11uei II not tequ1red

Dau Action Effecdn Date &ranch Se.tvke T e ut.,Name Street Addrns

OK Full ServKe Head Office 35646 BONDUEL STAT( BANK 130 NORrn CECIL STRlfT

Coun Coun FOfC UNINUM• Office Number• He.Ml Offlc.e

SHA.WA.NO UNITED STAID 7168 0 BONOUElSTATtBANIC

Hud Offlu ID RSso• Comments

3S646

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SECURITIES HOLDERS

Report Items 3: securities holders

Form FR Y-6 Bonduel Bancorp, Inc.

Bonduel, WI 54107 Fiscal Year Ending 12/31/2016

Current securities holders with ownership, control or holdings of 5% or more with Securities holders not listed in 3(1 )(a) through 3(1 )© that had ownership

nower to vote as of fiscal year endinq 12/31/2016 control or holdinas of 5%or more with power to vote during fiscal year 12/31/2011

(1 )(a) Name, city, state ,country (1 )(b) country of (1)©#and % of (2)(a) Name, city, state,country {2)(b) coutnry of (2)© # and % of each

citizenship each class securities citizenship class securities

David Clark USA 5000 shares-6.1009% NONE

Shawano WI 54166 common stock

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REPORT ITEM 4: INSIDERS

NAME, ADDRESS,

CITY & SATE

James Bleick

Zachow WI 54182

Robert Wendt Jr.

Bonduel WI 54107

Allen O Kohn

Krakow WI 54137

David D Schultz

Bonduel WI 54107

Richard Kucksdorf

Bonduel WI 54107

PRINCIPAL

OCCUPATION

IF OTHER THAN WITH

BANK HOLDING CO

Graf Creamery

NIA

Farmer

CEO

N/A

Form FR Y-6

December 31 , 2016

TITLE & POSITION TITLE&POSITION TITLE&POSITION PERCENT AGE % VOTING NAME OF

BANK HOLD CO W/SUBSIDIARIES WITH OTHER VOTE SHARES SHARE IN OTHER

Director/Chairman Director

Director Director

Director Director

Director/President CEO/Secretary

Director Director

BUSINESSES BANK HOLD CO SUBSIDIARY COMPANY

President 2.1719

N/A 0.5124

Owner 0.0488

N/A 0.1586

N/A 0.0671

None

None

None

None

None

IF 25%0R MORE VOTE

None

None

None

None

None