FORM F.R. Y-6. REPORT ITEM 2a BANCSHARES OF CLOVIS, INC. FISCAL YEAR ENDED DECEMBER 31, 2016
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1 AMENDED
2 FORM F.R. Y-6 REPORT ITEM 2a WESTER BANCSHARES OF CLOVIS, INC. ORGANIZATIO CHART FISCAL YEAR ENDED DECEMBER 31, 216 Western Bancshares of Clovis, Inc. Carlsbad, New Mexico (Incorporated in ew Mexico) I I Owns 1% of Western Bank of Clovis Clovis, New Mexico (Incorporated in New Mexico) I I I I I Owns 13% of Western Data Services, Inc. Carlsbad, ew Mexico (Incorporated in ew Mexico) **NO ENTITY HAS A LEI**
3 Results: A list of branches for your depository institution WESTERN BA k Of OV'I.. (IC RS "" b4s1;,.. ThlS depository institution is held bywe lern BANC,HARES O LOV INC of.arl5bad NM The data are as of Data reflects information that was received and processed through Jl/ /,tol 7 Reconciliation and Verification Steps 1. In the Data Action column of each branch row, enter one or more of the actions specified below 2. If required, enter the date m the Effective Date column Actions Ott If the branch mformat,on is correct, enter :)t( In the Data Action column. Change: If the branch information is incorrect or incomplete, revise the data, enter hia"lgt- 1n the Data Action column and the date when this information first became valid m the Effective Date column. Close; If a branch listed was sold or closed, enter lo in the Data Action column and the sale or closure date m the Ef fectjve Date column. Delete: If a branch listed was never owned by this depository institution, enter Dt 1et ' m the Data Action column Add: If a reportable branch is missing, msert a row, add the branch data, and enter A.ml m the Data Action column and the opening or acqu1sit1on date,n the Effective Date column If printing this hst, you may need to adjust your page setup 1n MS Excel. Try using landscape onentation, page scahng, and/or legal sized paper. Submission Procedure When you are finished, send a saved copy to your FRB contact. See the detailed instructions on this site for more mformat1on If you are ing this to your FRB contact, put your inst1tut1on name, city and state m the subject lme of the Note: To satisfy the FR Y-1 reporting requirements, you must also submit FR Y-1 Domestic Branch Schedules for each branch with a Data Action of riar-ge Clos.e DeletE. or.:1 The FR Y-1 report may be submitted in a hardcopy format or via the FR Y-1 Online application - gov FDIC UNINUM, Office Number, and ID_RSSO columns are for reference only. Venficat1on of these values 1s not requ1red Data Action Effective Date Branch Service Type OK full Service (Head Office) OK Full Service Branch ID RSso Po ular Name Street Address WESTERN BANK Of QOVl5 91 PILE STREET PORTALES BRANCH 22 N CHICAGO FDIC UNINUM Office Number Head Office WESTERN BANK Of CLOVIS 2544 WESTERN BANK Of CLOVIS Head Office ID RSSD* Comments 64DSS
4 FORM F.R. Y-6 WESTERN BANCSHARES OF CLOVIS, TNC. STOCK FISCAL YEAR ENDING DECEMBER 31, 216 SHAREHOLDERS OWNING OR CONTROLLING 5% OR MORE REPORT ITEM 3(1) NAME/ADDRESS COUNTRY OF CITIZE:-.SHIP OR INCORP Of SHARES O\\"\'ED, CO'ITROLLED OR HELD WITH POWER TO VOTE '' OF SHARES OW:SED COITTROLLED OR HFLD WITII POWLR TO VOTE LIBNAB & Co. United States c/o Western Commerce Bank Trust Dept. Carlsbad, NM Kidd Generational Education United States Trust c/o Western Commerce Bank Trust Dept. Carlsbad, NM 9, * 11,677.89** 19.% 23.46% Robert Chad Lydick Clovis, NM United States 6, % Pardue Limited Company Carlsbad, NM United States 6, % Leah C. Shaffer Enids, OK United States 6, % * LIBNAB & Co. is the nominee name for the Western Commerce Bank Trust Department with 3, I shares voted by Vick ye Faulk, managing partner of KMD LLC # 1, 3, I shares voted by Renai Kidd, managing partner of KMD LLC #2, and 3, I shares voted by Dion Kidd-Johnson, managing partner of KMD LLC #3. ** Kidd Generational Educational Trust is voted by Tawnya Henry, Melissa Arnold, or Sara H. Canberg as trustees of the Trust.
5 FORM F.R. Y-6 WESTERN BA CSHARES OF CLOVIS, INC. STOCK FISCAL YEAR ENDTNG DECEMBER 3 I, 2 I 6 SHAREHOLDERS NOT LISTED I THE YEAR-E D LIST, OWNI G OR CONTROLLING 5% OR MORE REPORT ITEM 3(2) t-.ame! ADDRESS COUNTRY OF CITIZEt-.SHIP OR INCORP # OF SHARES OWNED. CO 'TROLLCD OR IIELD WITH POWER TO VOTI:. OF SHARES OWNED C'1TROLLED OR IIELD ll'ith POWER TO VOTE one
6 Form FR Y-6 WESTERN BANCSHARES OF CLOVIS, INC. Carlsbad, New Mexico Fiscal Year Ending December 31, 216 (1) (2) (3)(a) (3)(b) (3)(c) (4)(a) (4)(b) (4)(c) List names of other companies (includes partnerships) if 25% or Principal Percentage of Percentage of Voting more of voting securities Occupation if other Title & Position with Title & Position with Other Voting Securities Securities in Subsidiaries are held (List names of Names & Address (City, than with holding Title & Position with Subsidiaries (include Businesses (include names in holding (include names of companies and percentage State, Country) company holding company names of subsidiaries) of other businesses) company subsidiaries) of voting securities held) Western Banchshares of M Don Kidd Western Bank. Clovis Clovis, Inc Bank Consultants, Inc Carlsbad, NM, USA Banker PresidenVDirector (CEO/Director) (PresidenVD1rector) O 8% Western Bank, Clovis % 1% Western Bancshares of Alamogordo, Inc (Pres1denVD1rector) K&W Farms- 51% Western Bank, Alamogordo (Chairman/CEO/Director) Western Commerce Banchshares of Carlsbad, Inc (Pres1denVDirector) Western Commerce Bank (Cha1rmanlCEO/Director) Bank Consultants. Inc (PresidenVDirector) K & W Farms (Owner) Jason Wyatt Western Bank. Clovis Western Banchshares of Carlsbad, NM, USA Banker Director (Pres1denVD1rector) Clovis, inc (Director) % Western Bank, CloVJS % None Western Bank, Alamogordo (Director) Western Bancshares of Alamogordo. Inc (Director) Western Commerce Bank (Pres1denVD1rector) Western Commerce Bancshares of Carlsbad. Inc (Director) Twilla Thomason (Trustee) LIBNAB & Co (nominee name) Western Commerce Bank Trust Department Western Bank Clovis Lovington, NM. USA Trust Officer Shareholder (None) None % Western Bank. Clovis % None
7 AMENDED
8 AMENDED
9 WESTERN BANCSHARES OF CLOVIS, INC. (Parent Only) BALANCE SHEET FOR THE YEARS ENDED DECEMBER 31, 216 AND 215 ASSETS 12/31/216 12/31/215 CASH CASH SURRENDER VALUE-LIFE INSURANCE DIVIDEND RECEIVABLE INVESTMENT IN SUBSIDIARY-82 shares, 1% of Western Bank common stock (at equity in net assets) GOODWILL-Net of accumulated amortization of (21) $511,485 $ 13,61 7,886, ,491 $ 12,797 7,511, ,491 TOT AL ASSETS $ 8,752,543 $ 8,376,473 LIA BILIT IES AND SHAREHO LDERS' EQ UITY LIABILITIES: NOTE PAYABLE - WCB #1 NOTE PAYABLE - WCB #2 CVS LIFE INSURANCE PAYABLE TOTAL LIABILITIES SHAREHOLDERS' EQUITY: Common Stock-$5. par value, 85, shares authorized, 82,89 issued and outstanding Paid-in capital in excess of par Retained earnings Less: Unrealized Gains/(Losses) 41,445 1,113,518 9,377,247 (29) 41,445 1,113,518 9,1,25 (57) Subtotal 1,91,181 1,525,111 Less 32, shares held in Treasury (2,148,638) (2,148,638) Total Shareholders' Equity 8,752,543 8,376,473 TOTAL LIABILITIES AND SHAREHOLDERS' EQUITY $ 8,752,543 $ 8,376,473
10 WESTERN BANCSHARES OF CLOVIS, INC. (Parent Only) STATEMENT OF INCOME AND EXPENSE FOR THE YEARS ENDED DECEMBER 31, 216 AND 215 INCOME: 12/31/16 12/31/15 Dividend Income $ 41,656 $ 2,8 Total Income 41,656 2,8 EXPENSES: Interest Expense Deferred Compensation Payroll Tax Expense Amortization of Goodwill Legal and Accounting 1,12 5,724 Administrative expense 9,829 11,57 Consulting fees 45,176 45,124 Tax-other 25 Insurance Miscellaneous Total Expenses 65,15 62,355 NET INCOME (LOSS) BEFORE CREDIT FOR INCOME TAX AND EQUITY IN UNDISTRIBUTED EARNINGS OF SUBSIDIARY (23,494) (42,347) CREDIT FOR INCOME TAX 24,298 24,879 NET INCOME (LOSS) BEFORE EQUITY IN UNDISTRIBUTED EARNINGS OF SUBSIDIARY 84 (17,468) EQUITY IN UNDISTRIBUTED EARNINGS OF SUBSIDIARY 375, ,327 NET INCOME (LOSS) $ 376,42 $ 449,859
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