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IDoyle L Hoyer

PY FRY-4[] OM8 Nlanllw l1CIMIZ97 302011 1af2

Board of CJovemors of tha Fedaral Raeerve System

-

Annual Report of Holding Companies-FR Y-8

Dam of Report (toptiet holding companys fiscal year-end)

Manfl I 0 Ywr --middotmiddotmiddot middot--R1partai1111g Entlly ldenampr (UI) (20middotCl1111nt111 LEI Codi)

Reportere Name straat and Malling Addrasamp Fort Madison Legal Tiie d fltal6e canii-r P 0 Box329

Fort Madison IAGlr 7th st and Avenue G936 Avenue G

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N1111831 lh172 164 AreaCodiil- NL11T1berEldenlkln 319__bull3_76_1227Ma Code I FAX Hunir

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This report form la lo be ftlad by all top-tier bank holding compashynlea and to r savings and loan holding companlea organizedunder US law and by any llorelgn banking organization thatdo8s not meet the requirements ol and la nol Leated aa a qualifyshying b8fgn banking organization under Section 21123 ofRegulation K (12 CfR sect 21123) (See page one of lhe genanil lnstnlctlons for more detail of who mual fila) The FadaraI Reserve may not conduct or 1Ponsor and 1U1 otganlza6on (or a unleas it person) la not reqund ID respond to an lnfonnetlon collecllon

dlaplllys a Q11181111y valid OMB conlnJI number

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Report at tha close of buelneu as of the end of fleGal year This Report Is required by law Section 5(c)(1)(A) of Iha Bank Holdillg Company Act (12 USC I 1844 (c(1)(A)) SedJon 8(aof Iha lntematonal Banking Ad (12 USC sect 3106(a)) Secllomi

C11(a)(1) 25 and 25A of the Feder91 Reeerw Act (12 USsectsect 248a)(1) 602 and S11a) Section 21113(c) or Regulabon Ilt (12 c FR sect 21113(c)) and Section 2255(b) of Regulation Y (12 CFR sect 2255(b)) and aecllOll 10c)(2)(H) of 1he Horne Owners Loan Acl Return lo Ille appropriate Federal Relerve Bank the orfglnal and the number of mplea epedlld

holding company Thia ind1vldual should alao be a aenlor of Iha loptier hording company_ In the event ltlat lhe fDp-lfer holding company don not have anJrdMual wtla II a senior oftiLial and la also a dlntdor the chairmiddot

NOTE Thamp Annual Report Of Holding Comptmfas must be signed by one dl18Ctor of the

man ofU board mUllt afgn ltle repott

N111n ot thbull ean-n ONCDlrMd Olllal ______________lllle fll 11111 Holdilg Compny Di-tat and Olkill

attast lhat lhbull Annual Report of Haldlng Companies (lndudlngthe supporting attachments for 1tU nipart date has been preshypared ln confonnance Wllh the hllluclion6 l11ued bv the Federal Reserve Sys1am and we 1Ne and correct ID lhe beat of my

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Form FR Y-6

FORT MADISON FINANCIAL COMPANY

Fort Madison Iowa Fiscal Year Ending December 31 2015

Report Item

1 Not applicable

2a Organizational Chart

- -

middot 01AD oft

- middot- bull KeokukifnsuranceScinlfcesLU emiddot

j middot-middot - bull -middot -middot bullbull ltlo 1

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Our organization has no LEI to report

2b Domestic Branch Listing provided to the Federal Reserve Bank

1

es

Stata

Codbull

Results A list of branchn for your depository lnstltutfon KEOKUK SAVINGS BANK AND TRUST COMPANY (IO_RSSO 745646)

This depository lnsti1utlon lsheld by FORT MADISON FINANCIAL COMPANY (US7017) of FORT MADISON IA The data are as of 12112015 Oat reflKtsInformation thilt was recehled ilnd processed through 01072016

Aeconclllltlon bullnd Vertflatlon Ste

1 In the Data Action column of eilch branch row enter one or more of the actions specified below

2 If required enter the date 1n the EffKtfve Do1te column

OK If the b111nch Information Iscorrect enter OK In the Dflta Action tolumn

Chtn1e If the branch Information Is Incorrect or incomplete rfllse lhe data enter Chance In the Dato1 Action column and the date when this Information first became va11d In the Effective Date column

Close I( a b111nch listed was sold or closed enter Close Jn the Data Action column and the sale or closure date In thl EffKtive Ote column

Olete If a branch listed was nflerowned by this depository Institution enter DeH1e In the Dbulltbull Action column Add 1f a reportilble branch Is missing Insert a row add the branch do1ta and enter Add In the Do1ta Action column and the opening or acqulslllon date In the Effctlve Date column

If printing this Ust you may need to adjust your page setup in MS heel Try using landscape orientation page scaling andor legal sized paper

submission Procedure

When you are finished send a saved copy to yourFRScontact Stt the detalled lnstructkgtns on this site for moreinformition

If you ire e-maillnc this to your FRB contact put your Institution name city and state In the subject line of the e-mail

Hole To satisfy the FR Y-10reportin1 requirements you must also submit FA YmiddotlO Domestk Branch ScheduH for each b nch with a Data Action of Chance Ckgtse Delete or Add

The FR Y-10 report may be submitted In a hardcopy format or vla the FA YmiddotlOOnllne applkatlon-httpsylOonlinefderalreservegov

bull FDIC UNINUM Office Number and IO_RSSO columns arefor reference onty VerlficaUon of thMevalues Is not required

Ot Action Enctfvie Ote

OK

OK

OK

Branch Sn1ice T

FullServkeHeadOffice)

Full Servke

Full Service

Branch ID_ASSobull

745646

2098177

2099473

Popular Name

KEOKUK SAVINGS BANK AND TRUST

COMPANY

PARKING LOT BRANCH

MONTROSE BRANCH

Strfft Address

501 MAIN STREET

1606MAIN

35 SOUTH FIRST STREET

City

KEOKUK

KEOKUK

MONTROSE

IA

IA

IA

52612

52612

52619

County

LEE

LEE

LpoundE

Country

UNITED STATES

UNITTDSTATES

UNITED STATES

FDIC UNlNUM Office Numberbull Head Offitt KEOKUK SAVINGS BANK ANO TRUST

1234 0 COMPANY

KEOKUK SAVINGS BANK ANO TRUST

1 90229 2 COMPANY

KEOKUK SAVINGS BANK AND TRUST

190228 1 COMPANY

Head Office IO_RSSD

745646

745646

745646

Comments

es

Stata

Codbull

Results A list of branchn for your depository lnstltutfon KEOKUK SAVINGS BANK AND TRUST COMPANY (IO_RSSO 745646)

This depository lnsti1utlon lsheld by FORT MADISON FINANCIAL COMPANY (US7017) of FORT MADISON IA The data are as of 12112015 Oat reflKtsInformation thilt was recehled ilnd processed through 01072016

Aeconclllltlon bullnd Vertflatlon Ste

1 In the Data Action column of eilch branch row enter one or more of the actions specified below

2 If required enter the date 1n the EffKtfve Do1te column

OK If the b111nch Information Iscorrect enter OK In the Dflta Action tolumn

Chtn1e If the branch Information Is Incorrect or incomplete rfllse lhe data enter Chance In the Dato1 Action column and the date when this Information first became va11d In the Effective Date column

Close I( a b111nch listed was sold or closed enter Close Jn the Data Action column and the sale or closure date In thl EffKtive Ote column

Olete If a branch listed was nflerowned by this depository Institution enter DeH1e In the Dbulltbull Action column Add 1f a reportilble branch Is missing Insert a row add the branch do1ta and enter Add In the Do1ta Action column and the opening or acqulslllon date In the Effctlve Date column

If printing this Ust you may need to adjust your page setup in MS heel Try using landscape orientation page scaling andor legal sized paper

submission Procedure

When you are finished send a saved copy to yourFRScontact Stt the detalled lnstructkgtns on this site for moreinformition

If you ire e-maillnc this to your FRB contact put your Institution name city and state In the subject line of the e-mail

Hole To satisfy the FR Y-10reportin1 requirements you must also submit FA YmiddotlO Domestk Branch ScheduH for each b nch with a Data Action of Chance Ckgtse Delete or Add

The FR Y-10 report may be submitted In a hardcopy format or vla the FA YmiddotlOOnllne applkatlon-httpsylOonlinefderalreservegov

bull FDIC UNINUM Office Number and IO_RSSO columns arefor reference onty VerlficaUon of thMevalues Is not required

Ot Action Enctfvie Ote

OK

OK

OK

Branch Sn1ice T

FullServkeHeadOffice)

Full Servke

Full Service

Branch ID_ASSobull

745646

2098177

2099473

Popular Name

KEOKUK SAVINGS BANK AND TRUST

COMPANY

PARKING LOT BRANCH

MONTROSE BRANCH

Strfft Address

501 MAIN STREET

1606MAIN

35 SOUTH FIRST STREET

City

KEOKUK

KEOKUK

MONTROSE

IA

IA

IA

52612

52612

52619

County

LEE

LEE

LpoundE

Country

UNITED STATES

UNITTDSTATES

UNITED STATES

FDIC UNlNUM Office Numberbull Head Offitt KEOKUK SAVINGS BANK ANO TRUST

1234 0 COMPANY

KEOKUK SAVINGS BANK ANO TRUST

1 90229 2 COMPANY

KEOKUK SAVINGS BANK AND TRUST

190228 1 COMPANY

Head Office IO_RSSD

745646

745646

745646

Comments

Results A lfst ofbranches for your depository Institution FORT MADISON BANK amp TRUST CO jlDjlSSO 624246)

This depository Institution Is held by FORT MADISON FINANCIAL COMPANY (1l57037) of FORT MADISON IA

The dat1 are as of 1231lOIS Oatbull reflects lnformalicn that was received and processed throughOl072016

Reconcillation bullnd V1triflc11tion St1tps

1 In the ta Action column of each branch row enter one or more of the actions specified below

2 If required enter the date in the Effective Otlt calumn

OK If the brand Information is correct enter Ott in the Data Action column

Onc11 If the branch Information Is Incorrect or Incomplete revise the data enterChbulln1e In the Datbull Action column and the date when this information first became valid In the Effective Date column

Oow If a branch Usted wH sold or closed enter Ooot In the oi Action column 1nd the sale or dosure date tn the EffectJv Dbullte cclumn

Dlkte If a branch listed was ne11er owned by this depository Institution enttgtr Delete In the Otli Action column

Add If a reportable br1nch Is misslna Insert 1 row add the branch data and enterAdd In the Dab Action column and the opening or acqulsillon date In the Efftctlw Date column

If printing this list you may need to adjust your paae setup In MS Excel Try 1isinamp l1ndsape orientation page scling andor legal sired paper

Submission Procedure When you aite finished send a SI copy to your FRB contact See the detaBed lnnructions on this site fOf more lnforrnaUon

If you are e--mailing this 10 your FRB conUict put your lnrtitution name city and state In the subJect lioe of the e-m1il

Note Tc satisfy the FR V-10 rtportin1 requirements you must also submit FR Y-10 Domestic Branch Schldules for each branch with 1 Dlbl Action of Change CloseDelete or Add

The FR v-10 report may be submitted In 1 hardcopy format or via the FR YmiddotlO Onllne 1ppllcaton-httpslvlOcntlnercden1lreservegc11

bullFDIC UNINUM Office Number and ID_RSSO columns are for reference only Verification cf these 11alues Is not requfred

OK Fun Service (HeMf Office)

Fun Service

Ok Full Service

Sltfft Addrtss

7TH STREET ampAVENUE G

3140AGENCY STREET SUITt 100

4BTH STREIT amp AVINUE l

County Country

LEE UNITED STATES

DES MOINES UNITED STATES

LEE UNITED STAill

623 FORT MADISON BANK amp TRUST CO 419637 4 FORT MADISON BANK amp TRUST CO 186737 1 FORT MADISON BANK amp TRUST CO

624246

624246

624246

Name City State Country Country of Citizenship

Percentage

Voting

List each principal shareholder (10 or more) director trustee partner executive officer or

person exercising similar functions regardless of title or compensation of the bank holding company showing the following

1) Name and address (city and statecountry)

Doyle L Hoyer Fort Madison Iowa United States

2) Principal Occupation if other than with the bank holding company

3 Securities Holders

1)

Bertha G Hoyer Residuary Trust USA 998-1931 Voting

Number and of Each

Class of Securities

Fort Madison IA USA o - 0 Non-voting

Doyle L Hoyer Trustee

Bertha G Hoyer Marital Trust USA 938 -18150 Voting Fort Madison IA USA 0- 0 Non-voting

Doyle L Hoyer Trustee

James A amp Linda S Baier Fort USA 2584-50 Voting Madison IA USA 1473-50 Non-voting

Doyle L Hoyer Fort Madison IA USA 648 -1254 Voting USA 1473 - 50 Non-voting

2) NA

a NA

b) NA

c) NA

4 Insiders

Report Item 4 Directors and Officers

None

2

Name City State Country Country of Citizenship

Percentage

Voting

List each principal shareholder (10 or more) director trustee partner executive officer or

person exercising similar functions regardless of title or compensation of the bank holding company showing the following

1) Name and address (city and statecountry)

Doyle L Hoyer Fort Madison Iowa United States

2) Principal Occupation if other than with the bank holding company

3 Securities Holders

1)

Bertha G Hoyer Residuary Trust USA 998-1931 Voting

Number and of Each

Class of Securities

Fort Madison IA USA o - 0 Non-voting

Doyle L Hoyer Trustee

Bertha G Hoyer Marital Trust USA 938 -18150 Voting Fort Madison IA USA 0- 0 Non-voting

Doyle L Hoyer Trustee

James A amp Linda S Baier Fort USA 2584-50 Voting Madison IA USA 1473-50 Non-voting

Doyle L Hoyer Fort Madison IA USA 648 -1254 Voting USA 1473 - 50 Non-voting

2) NA

a NA

b) NA

c) NA

4 Insiders

Report Item 4 Directors and Officers

None

2

b)

3) Title or position with

a) the bank holding company

President and Director

all subsidiaries of the bank holding company

Director

c) ntle or position with any other business company in which the person is a director trustee partner or principal officer

Chairman -Glasgow Clothiers Inc Fort Madison Iowa

Partner - D amp J Farms LLC

Member of Executive Management Committee-Great River Entertainment

Director-Riverside Casino and Golf Resort

4) Number of shares and percentage of each class of voting securities owned controlled or held with power to vote in

a) The bank holding company 648 1254 Voting 1 473 50 Non-Voting 2121 6254 Total Voting

b) Subsidiaries of the bank holding company None

c) any other business company if more than 25 of its outstanding voting securities are held

Glasgow Clothiers Inc - 400 D amp J Farms - 500

Report Item 4 Directors and Officers

List each principal shareholder (10 or more) director trustee partner executive officer or person exercising similar functions regardless of title or compensation of the bank holding company showing the following

3

b)

1) Name and address (city and statecountry)

A Bertha Hoyer Residuary Trust Fort Madison Iowa United States -Doyle L Hoyer Trustee

B Bertha Hoyer Marital Trust Fort Madison Iowa United States -Doyle L Hoyer Trustee

2) Principal Occupation if other than with the bank holding company

None

3) Title or position with

a) the bank holding company

None

all subsidiaries of the bank holding company

None

c) Title or position with any other business company in which the person is a director trustee partner or principal officer

None

4) Number of shares and percentage of each class of voting securities owned controlled or held with power to vote in

a)

b)

The bank holding company

Subsidiaries of the bank hold

998 938

1936

ing comp

1931 Voting 18150 Voting 3746 Total Voting

any None

d) any other business companyvoting securities are held

if more than 25 of its outstanding

None

Report Item 4 Directors and Officers

4

1473

1) Name and address (city and statecountry)

James A Baier amp Linda 5 Baier Fort Madison Iowa United States

2) Principal occupation if other than with the bank holding company

3)

Owner automobile dealership Title or position with

a) the bank holding company

Chairman Treasurer and Director

b) all subsidiaries of the bank holding company

Director

c) Title or position with any other business company in which the person is a director trustee partner or principal officer

Partner - D amp J Farms LLC

Treasurer and Chairman -Jim Baier Inc Fort Madison Iowa

List each principal shareholder (10 or moreL director trustee partner executive officer or person exercising similar functions regardless of title or compensation of the bank holding company showing the following

4) Number of shares and percentage of each class of voting securities owned controlled or held with power to vote in

a) The bank holding company 2584 50 Voting 50 Non Voting

4057 5000 Total Voting

b) subsidiaries of the bank holding company

c) any other business company1 if more than 25 of its outstanding voting securities are held

James A Baier

5

• FR Y-6 Cover Page
• Report Items 1 Annual Report to Shareholders 2a Organization Chart
• Report Item 2b Domestic Branch Listing
• Report Items 3 Securities Holders 4 Insiders

b)

1) Name and address (city and statecountry)

A Bertha Hoyer Residuary Trust Fort Madison Iowa United States -Doyle L Hoyer Trustee

B Bertha Hoyer Marital Trust Fort Madison Iowa United States -Doyle L Hoyer Trustee

2) Principal Occupation if other than with the bank holding company

None

3) Title or position with

a) the bank holding company

None

all subsidiaries of the bank holding company

None

c) Title or position with any other business company in which the person is a director trustee partner or principal officer

None

4) Number of shares and percentage of each class of voting securities owned controlled or held with power to vote in

a)

b)

The bank holding company

Subsidiaries of the bank hold

998 938

1936

ing comp

1931 Voting 18150 Voting 3746 Total Voting

any None

d) any other business companyvoting securities are held

if more than 25 of its outstanding

None

Report Item 4 Directors and Officers

4

1473

1) Name and address (city and statecountry)

James A Baier amp Linda 5 Baier Fort Madison Iowa United States

2) Principal occupation if other than with the bank holding company

3)

Owner automobile dealership Title or position with

a) the bank holding company

Chairman Treasurer and Director

b) all subsidiaries of the bank holding company

Director

c) Title or position with any other business company in which the person is a director trustee partner or principal officer

Partner - D amp J Farms LLC

Treasurer and Chairman -Jim Baier Inc Fort Madison Iowa

List each principal shareholder (10 or moreL director trustee partner executive officer or person exercising similar functions regardless of title or compensation of the bank holding company showing the following

4) Number of shares and percentage of each class of voting securities owned controlled or held with power to vote in

a) The bank holding company 2584 50 Voting 50 Non Voting

4057 5000 Total Voting

b) subsidiaries of the bank holding company

c) any other business company1 if more than 25 of its outstanding voting securities are held

James A Baier

5

• FR Y-6 Cover Page
• Report Items 1 Annual Report to Shareholders 2a Organization Chart
• Report Item 2b Domestic Branch Listing
• Report Items 3 Securities Holders 4 Insiders

1473

1) Name and address (city and statecountry)

James A Baier amp Linda 5 Baier Fort Madison Iowa United States

2) Principal occupation if other than with the bank holding company

3)

Owner automobile dealership Title or position with

a) the bank holding company

Chairman Treasurer and Director

b) all subsidiaries of the bank holding company

Director

c) Title or position with any other business company in which the person is a director trustee partner or principal officer

Partner - D amp J Farms LLC

Treasurer and Chairman -Jim Baier Inc Fort Madison Iowa

List each principal shareholder (10 or moreL director trustee partner executive officer or person exercising similar functions regardless of title or compensation of the bank holding company showing the following

4) Number of shares and percentage of each class of voting securities owned controlled or held with power to vote in

a) The bank holding company 2584 50 Voting 50 Non Voting

4057 5000 Total Voting

b) subsidiaries of the bank holding company

c) any other business company1 if more than 25 of its outstanding voting securities are held

James A Baier

5

• FR Y-6 Cover Page
• Report Items 1 Annual Report to Shareholders 2a Organization Chart
• Report Item 2b Domestic Branch Listing
• Report Items 3 Securities Holders 4 Insiders