-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, CDVbyrlb9YmIECzEOZYkjIl3xmnlYYV0XfaI2CA62a8pVIP+gO4Odvd8JYPunuqg 03WeuCzfGBr00BfwweDLaw== 0000950144-98-014274.txt : 19990101 0000950144-98-014274.hdr.sgml : 19990101 ACCESSION NUMBER: 0000950144-98-014274 CONFORMED SUBMISSION TYPE: SC 13D/A PUBLIC DOCUMENT COUNT: 2 FILED AS OF DATE: 19981231 GROUP MEMBERS: A LEE HANSON GROUP MEMBERS: BRYAN A CORR GROUP MEMBERS: CHRISTINA M CURRIER GROUP MEMBERS: CORR R C JR GROUP MEMBERS: DORIS J CORR GROUP MEMBERS: J R WHITLOCK SR GROUP MEMBERS: JIMMY C SMITH GROUP MEMBERS: JOAN M CURRIER GROUP MEMBERS: JOHN DAVID CURRIER GROUP MEMBERS: ONEONTA TELEPHONE CO INC GROUP MEMBERS: TINA M CORR GROUP MEMBERS: WILLIAM S WITTMEIER JR SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: COMMUNITY BANCSHARES INC /DE/ CENTRAL INDEX KEY: 0000752195 STANDARD INDUSTRIAL CLASSIFICATION: STATE COMMERCIAL BANKS [6022] IRS NUMBER: 630868361 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13D/A SEC ACT: SEC FILE NUMBER: 005-41163 FILM NUMBER: 98779687 BUSINESS ADDRESS: STREET 1: MAIN ST P O BOX 1000 CITY: BLOUNTSVILLE STATE: AL ZIP: 35031 BUSINESS PHONE: 2054291000 MAIL ADDRESS: STREET 1: MAIN STREET PO BOX 1000 CITY: BLOUNTSVILLE STATE: AL ZIP: 35031 FORMER COMPANY: FORMER CONFORMED NAME: BLOUNTSVILLE BANCSHARES INC DATE OF NAME CHANGE: 19860602 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: CORR R C JR CENTRAL INDEX KEY: 0001072558 STANDARD INDUSTRIAL CLASSIFICATION: [] IRS NUMBER: 630373495 STATE OF INCORPORATION: AL FILING VALUES: FORM TYPE: SC 13D/A BUSINESS ADDRESS: STREET 1: P.O BOX 1500 CITY: ONEONTA STATE: AL ZIP: 35121 BUSINESS PHONE: 2056253581 SC 13D/A 1 COMMUNITY BANCSHARES INC 1 SECURITIES AND EXCHANGE COMMISSION WASHINGTON, DC 20549 ---------- SCHEDULE 13D (RULE 13D-101) INFORMATION TO BE INCLUDED IN STATEMENTS FILED PURSUANT TO RULE 13D-1(A) AND AMENDMENTS THERETO FILED PURSUANT TO RULE 13D-2(A) (AMENDMENT NO. 1)(1) COMMUNITY BANCSHARES, INC. (Name of Issuer) Common Stock, par value $.10 per share (Title of Class of Securities) 20343H 10 6 (CUSIP Number) J. Fred Kingren, Esq. Feld, Hyde, Lyle, Wertheimer & Bryant, P.C. 2000 SouthBridge Parkway, Suite 500 Birmingham, Alabama 35209 (205) 802-7575 (Name, Address and Telephone Number of Person Authorized to Receive Notices and Communications) General Update (Date of Event Which Requires Filing of this Statement) If the Reporting Person has previously filed a Statement on Schedule 13G to report the acquisition that is the subject of this Statement on Schedule 13D, and is filing this Statement on Schedule 13D because of Rule 13d-1(e), 13d- 1(f) or 13d-1(g), check the following box [ ]. Note: Statements on Schedule 13D filed in paper format shall include a signed original and five copies of the Statement on Schedule 13D, including all exhibits. See Rule 13d-7(b) for other parties to whom copies are to be sent. (Continued on following pages) (Page 1 of 14 Pages) - -------- (1) The remainder of this Cover Page shall be filled out for the Reporting Person's initial filing of this Statement on Schedule 13D with respect to the subject class of securities, and for any subsequent amendment containing information which would alter disclosures provided in a prior Cover Page. The information required on the remainder of this Cover Page shall not be deemed to be "filed" for the purpose of Section 18 of the Securities Exchange Act of 1934 (the "Act") or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act. 2 CUSIP NO. 20343H 10 6 13D, AMENDMENT NO. 1 PAGE 2 OF 30 PAGES 1 NAMES OF REPORTING PERSONS I.R.S. IDENTIFICATION NOS. OF ABOVE PERSONS (ENTITIES ONLY) R. C. Corr, Jr. 2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (a) [X] (b) [ ] 3 SEC USE ONLY 4 SOURCE OF FUNDS PF 5 CHECK BOX IF DISCLOSURE OF LEGAL PROCEEDINGS IS REQUIRED PURSUANT TO ITEM 2(d) OR 2(e) [ ] 6 CITIZENSHIP OR PLACE OF ORGANIZATION United States of America NUMBER OF 7 SOLE VOTING POWER SHARES None BENEFICIALLY 8 SHARED VOTING POWER OWNED BY 280,356 Shares EACH 9 SOLE DISPOSITIVE POWER REPORTING None PERSON 10 SHARED DISPOSITIVE POWER WITH 280,356 Shares 11 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 280,356 Shares 12 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES CERTAIN SHARES [ ] 3 CUSIP NO. 20343H 10 6 13D, AMENDMENT NO. 1 PAGE 3 OF 30 PAGES 13 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (11) 6.6% 14 TYPE OF REPORTING PERSON IN 4 CUSIP NO. 20343H 10 6 13D, AMENDMENT NO. 1 PAGE 4 OF 30 PAGES 1 NAMES OF REPORTING PERSONS I.R.S. IDENTIFICATION NOS. OF ABOVE PERSONS (ENTITIES ONLY) Doris J. Corr 2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (a) [X] (b) [ ] 3 SEC USE ONLY 4 SOURCE OF FUNDS Not Applicable 5 CHECK BOX IF DISCLOSURE OF LEGAL PROCEEDINGS IS REQUIRED PURSUANT TO ITEM 2(d) OR 2(e) [ ] 6 CITIZENSHIP OR PLACE OF ORGANIZATION United States of America NUMBER OF 7 SOLE VOTING POWER SHARES None BENEFICIALLY 8 SHARED VOTING POWER OWNED BY 322,172 Shares EACH 9 SOLE DISPOSITIVE POWER REPORTING None PERSON 10 SHARED DISPOSITIVE POWER WITH 322,172 Shares 11 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 322,172 Shares 12 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES CERTAIN SHARES [ ] 5 CUSIP NO. 20343H 10 6 13D, AMENDMENT NO. 1 PAGE 5 OF 30 PAGES 13 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (11) 7.6% 14 TYPE OF REPORTING PERSON IN 6 CUSIP NO. 20343H 10 6 13D, AMENDMENT NO. 1 PAGE 6 OF 30 PAGES 1 NAMES OF REPORTING PERSONS I.R.S. IDENTIFICATION NOS. OF ABOVE PERSONS (ENTITIES ONLY) Bryan A. Corr 2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (a) [X] (b) [ ] 3 SEC USE ONLY 4 SOURCE OF FUNDS Not Applicable 5 CHECK BOX IF DISCLOSURE OF LEGAL PROCEEDINGS IS REQUIRED PURSUANT TO ITEM 2(d) OR 2(e) [ ] 6 CITIZENSHIP OR PLACE OF ORGANIZATION United States of America NUMBER OF 7 SOLE VOTING POWER SHARES 5,333 Shares BENEFICIALLY 8 SHARED VOTING POWER OWNED BY 183,538 Shares EACH 9 SOLE DISPOSITIVE POWER REPORTING 5,333 Shares PERSON 10 SHARED DISPOSITIVE POWER WITH 183,538 Shares 11 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 188,871 Shares 12 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES CERTAIN SHARES [ ] 7 CUSIP NO. 20343H 10 6 13D, AMENDMENT NO. 1 PAGE 7 OF 30 PAGES 13 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (11) 4.5% 14 TYPE OF REPORTING PERSON IN 8 CUSIP NO. 20343H 10 6 13D, AMENDMENT NO. 1 PAGE 8 OF 30 PAGES 1 NAMES OF REPORTING PERSONS I.R.S. IDENTIFICATION NOS. OF ABOVE PERSONS (ENTITIES ONLY) Tina M. Corr 2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (a) [X] (b) [ ] 3 SEC USE ONLY 4 SOURCE OF FUNDS Not Applicable 5 CHECK BOX IF DISCLOSURE OF LEGAL PROCEEDINGS IS REQUIRED PURSUANT TO ITEM 2(d) OR 2(e) [ ] 6 CITIZENSHIP OR PLACE OF ORGANIZATION United States of America NUMBER OF 7 SOLE VOTING POWER SHARES None BENEFICIALLY 8 SHARED VOTING POWER OWNED BY 32,176 Shares EACH 9 SOLE DISPOSITIVE POWER REPORTING None PERSON 10 SHARED DISPOSITIVE POWER WITH 32,176 Shares 11 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 32,176 Shares 12 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES CERTAIN SHARES [ ] 9 CUSIP NO. 20343H 10 6 13D, AMENDMENT NO. 1 PAGE 9 OF 30 PAGES 13 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (11) .8% 14 TYPE OF REPORTING PERSON IN 10 CUSIP NO. 20343H 10 6 13D, AMENDMENT NO. 1 PAGE 10 OF 30 PAGES 1 NAMES OF REPORTING PERSONS I.R.S. IDENTIFICATION NOS. OF ABOVE PERSONS (ENTITIES ONLY) Joan M. Currier 2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (a) [X] (b) [ ] 3 SEC USE ONLY 4 SOURCE OF FUNDS Not Applicable 5 CHECK BOX IF DISCLOSURE OF LEGAL PROCEEDINGS IS REQUIRED PURSUANT TO ITEM 2(d) OR 2(e) [ ] 6 CITIZENSHIP OR PLACE OF ORGANIZATION United States of America NUMBER OF 7 SOLE VOTING POWER SHARES None BENEFICIALLY 8 SHARED VOTING POWER OWNED BY 138,334 Shares EACH 9 SOLE DISPOSITIVE POWER REPORTING None PERSON 10 SHARED DISPOSITIVE POWER WITH 138,334 Shares 11 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 138,334 Shares 12 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES CERTAIN SHARES [ ] 11 CUSIP NO. 20343H 10 6 13D, AMENDMENT NO. 1 PAGE 11 OF 30 PAGES 13 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (11) 3.3% 14 TYPE OF REPORTING PERSON IN 12 CUSIP NO. 20343H 10 6 13D, AMENDMENT NO. 1 PAGE 12 OF 30 PAGES 1 NAMES OF REPORTING PERSONS I.R.S. IDENTIFICATION NOS. OF ABOVE PERSONS (ENTITIES ONLY) John David Currier 2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (a) [X] (b) [ ] 3 SEC USE ONLY 4 SOURCE OF FUNDS Not Applicable 5 CHECK BOX IF DISCLOSURE OF LEGAL PROCEEDINGS IS REQUIRED PURSUANT TO ITEM 2(d) OR 2(e) [ ] 6 CITIZENSHIP OR PLACE OF ORGANIZATION United States of America NUMBER OF 7 SOLE VOTING POWER SHARES NONE BENEFICIALLY 8 SHARED VOTING POWER OWNED BY 7,880 Shares EACH 9 SOLE DISPOSITIVE POWER REPORTING None PERSON 10 SHARED DISPOSITIVE POWER WITH 7,880 Shares 11 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 7,880 Shares 12 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES CERTAIN SHARES [ ] 13 CUSIP NO. 20343H 10 6 13D, AMENDMENT NO. 1 PAGE 13 OF 30 PAGES 13 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (11) .2% 14 TYPE OF REPORTING PERSON IN 14 CUSIP NO. 20343H 10 6 13D, AMENDMENT NO. 1 PAGE 14 OF 30 PAGES 1 NAMES OF REPORTING PERSONS I.R.S. IDENTIFICATION NOS. OF ABOVE PERSONS (ENTITIES ONLY) Christina M. Currier 2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (a) [X] (b) [ ] 3 SEC USE ONLY 4 SOURCE OF FUNDS Not Applicable 5 CHECK BOX IF DISCLOSURE OF LEGAL PROCEEDINGS IS REQUIRED PURSUANT TO ITEM 2(d) OR 2(e) [ ] 6 CITIZENSHIP OR PLACE OF ORGANIZATION United States of America NUMBER OF 7 SOLE VOTING POWER SHARES 10,454 Shares BENEFICIALLY 8 SHARED VOTING POWER OWNED BY None EACH 9 SOLE DISPOSITIVE POWER REPORTING 10,454 Shares PERSON 10 SHARED DISPOSITIVE POWER WITH None 11 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 10,454 Shares 12 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES CERTAIN SHARES [ ] 15 CUSIP NO. 20343H 10 6 13D, AMENDMENT NO. 1 PAGE 15 OF 30 PAGES 13 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (11) .2% 14 TYPE OF REPORTING PERSON IN 16 CUSIP NO. 20343H 10 6 13D, AMENDMENT NO. 1 PAGE 16 OF 30 PAGES 1 NAMES OF REPORTING PERSONS I.R.S. IDENTIFICATION NOS. OF ABOVE PERSONS (ENTITIES ONLY) Oneonta Telephone Company, Inc. 2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (a) [X] (b) [ ] 3 SEC USE ONLY 4 SOURCE OF FUNDS Not Applicable 5 CHECK BOX IF DISCLOSURE OF LEGAL PROCEEDINGS IS REQUIRED PURSUANT TO ITEM 2(d) OR 2(e) [ ] 6 CITIZENSHIP OR PLACE OF ORGANIZATION State of Alabama NUMBER OF 7 SOLE VOTING POWER SHARES None BENEFICIALLY 8 SHARED VOTING POWER OWNED BY 120,000 Shares EACH 9 SOLE DISPOSITIVE POWER REPORTING None PERSON 10 SHARED DISPOSITIVE POWER WITH 120,000 Shares 11 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 120,000 Shares 12 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES CERTAIN SHARES [ ] 17 CUSIP NO. 20343H 10 6 13D, AMENDMENT NO. 1 PAGE 17 OF 30 PAGES 13 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (11) 2.8% 14 TYPE OF REPORTING PERSON CO 18 CUSIP NO. 20343H 10 6 13D, AMENDMENT NO. 1 PAGE 18 OF 30 PAGES 1 NAMES OF REPORTING PERSONS I.R.S. IDENTIFICATION NOS. OF ABOVE PERSONS (ENTITIES ONLY) A. Lee Hanson 2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (a) [X] (b) [ ] 3 SEC USE ONLY 4 SOURCE OF FUNDS Not Applicable 5 CHECK BOX IF DISCLOSURE OF LEGAL PROCEEDINGS IS REQUIRED PURSUANT TO ITEM 2(d) OR 2(e) [ ] 6 CITIZENSHIP OR PLACE OF ORGANIZATION United States of America NUMBER OF 7 SOLE VOTING POWER SHARES 73,648 Shares BENEFICIALLY 8 SHARED VOTING POWER OWNED BY None EACH 9 SOLE DISPOSITIVE POWER REPORTING 73,648 Shares PERSON 10 SHARED DISPOSITIVE POWER WITH None 11 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 73,648 Shares 12 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES CERTAIN SHARES [ ] 19 CUSIP NO. 20343H 10 6 13D, AMENDMENT NO. 1 PAGE 19 OF 30 PAGES 13 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (11) 1.7% 14 TYPE OF REPORTING PERSON IN 20 CUSIP NO. 20343H 10 6 13D, AMENDMENT NO. 1 PAGE 20 OF 30 PAGES 1 NAMES OF REPORTING PERSONS I.R.S. IDENTIFICATION NOS. OF ABOVE PERSONS (ENTITIES ONLY) Jimmy C. Smith 2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (a) [X] (b) [ ] 3 SEC USE ONLY 4 SOURCE OF FUNDS Not Applicable 5 CHECK BOX IF DISCLOSURE OF LEGAL PROCEEDINGS IS REQUIRED PURSUANT TO ITEM 2(d) OR 2(e) [ ] 6 CITIZENSHIP OR PLACE OF ORGANIZATION United States of America NUMBER OF 7 SOLE VOTING POWER SHARES 4,850 Shares BENEFICIALLY 8 SHARED VOTING POWER OWNED BY None EACH 9 SOLE DISPOSITIVE POWER REPORTING 4,850 Shares PERSON 10 SHARED DISPOSITIVE POWER WITH None 11 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 4,850 Shares 12 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES CERTAIN SHARES [ ] 21 CUSIP NO. 20343H 10 6 13D, AMENDMENT NO. 1 PAGE 21 OF 30 PAGES 13 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (11) .1% 14 TYPE OF REPORTING PERSON IN 22 CUSIP NO. 20343H 10 6 13D, AMENDMENT NO. 1 PAGE 22 OF 30 PAGES 1 NAMES OF REPORTING PERSONS I.R.S. IDENTIFICATION NOS. OF ABOVE PERSONS (ENTITIES ONLY) J. R. Whitlock, Sr. 2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (a) [X] (b) [ ] 3 SEC USE ONLY 4 SOURCE OF FUNDS Not Applicable 5 CHECK BOX IF DISCLOSURE OF LEGAL PROCEEDINGS IS REQUIRED PURSUANT TO ITEM 2(d) OR 2(e) [ ] 6 CITIZENSHIP OR PLACE OF ORGANIZATION United States of America NUMBER OF 7 SOLE VOTING POWER SHARES 6,230 Shares BENEFICIALLY 8 SHARED VOTING POWER OWNED BY None EACH 9 SOLE DISPOSITIVE POWER REPORTING 6,230 Shares PERSON 10 SHARED DISPOSITIVE POWER WITH None 11 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 6,230 Shares 12 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES CERTAIN SHARES [ ] 23 CUSIP NO. 20343H 10 6 13D, AMENDMENT NO. 1 PAGE 23 OF 30 PAGES 13 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (11) .2% 14 TYPE OF REPORTING PERSON IN 24 CUSIP NO. 20343H 10 6 13D, AMENDMENT NO. 1 PAGE 24 OF 30 PAGES 1 NAMES OF REPORTING PERSONS I.R.S. IDENTIFICATION NOS. OF ABOVE PERSONS (ENTITIES ONLY) William S. Wittmeier, Jr. 2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (a) [X] (b) [ ] 3 SEC USE ONLY 4 SOURCE OF FUNDS Not Applicable 5 CHECK BOX IF DISCLOSURE OF LEGAL PROCEEDINGS IS REQUIRED PURSUANT TO ITEM 2(d) OR 2(e) [ ] 6 CITIZENSHIP OR PLACE OF ORGANIZATION United States of America NUMBER OF 7 SOLE VOTING POWER SHARES 1,260 Shares BENEFICIALLY 8 SHARED VOTING POWER OWNED BY None EACH 9 SOLE DISPOSITIVE POWER REPORTING 1,260 Shares PERSON 10 SHARED DISPOSITIVE POWER WITH None 11 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 1,260 Shares 12 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES CERTAIN SHARES [ ] 25 CUSIP NO. 20343H 10 6 13D, AMENDMENT NO. 1 PAGE 25 OF 30 PAGES 13 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (11) .1% 14 TYPE OF REPORTING PERSON IN 26 CUSIP NO. 20343H 10 6 13D, AMENDMENT NO. 1 PAGE 26 OF 30 PAGES INTRODUCTORY NOTE This Amendment No. 1 to the Statement on Schedule 13D (this "Amendment") amends the Statement on Schedule 13D filed with the Securities and Exchange Commission on November 3, 1998, on behalf of the Corr Family Group, R. C. Corr, Jr. and Doris J. Corr (the "Original Filing"). The Original Filing is hereby amended to revise each of the Items indicated in this Amendment. ITEM 2. IDENTITY AND BACKGROUND. The persons filing this Statement on Schedule 13D are R. C. Corr, Jr., Doris J. Corr, Bryan A. Corr, Tina M. Corr, Joan M. Currier, John David Currier, Christina M. Currier, Oneonta Telephone Company, Inc. ("OTELCO"), A. Lee Hanson, Jimmy C. Smith, J. R. Whitlock, Sr. and William S. Wittmeier, Jr. (individually, a "Reporting Person", and, collectively, the "Reporting Persons"). Information with respect to each of the Reporting Persons is given solely by such Reporting Person, and no Reporting Person assumes responsibility for the accuracy or completeness of information furnished by another Reporting Person. By executing this Amendment, each of the Reporting Persons agrees that this Amendment is filed on behalf of such Reporting Person. Certain information with respect to each of the Reporting Persons is set forth on Schedule I, which is attached hereto and incorporated herein by reference. The Reporting Persons are filing this Amendment because they may be deemed a "group" for purposes of Section 13(d)(3) of the Securities Exchange Act of 1934, as amended (the "Exchange Act"), although each of the Reporting Persons disclaims any membership in, and the existence of, such a group other than the group which is comprised of R. C. Corr, Jr., Doris J. Corr, Bryan A. Corr, Tina M. Corr, Joan M. Currier, John David Currier, Christiana M. Currier and OTELCO. Neither the filing of this Amendment nor any statement contained herein shall be deemed to be an admission by any of the Reporting Persons that any other group exists. During the past five years, none of the Reporting Persons has been convicted in a criminal proceeding (excluding traffic violations or similar misdemeanors), nor has any of the Reporting Persons been a party to a civil proceeding of a judicial or administrative body of competent jurisdiction and, as a result of such proceeding, was or is subject to a judgment, decree or final order enjoining future violations of, or prohibiting or mandating activities subject to, Federal or State securities laws or finding any violation with respect to such laws. ITEM 4. PURPOSE OF TRANSACTION. R. C. Corr, Jr., A. Lee Hanson, Jimmy C. Smith, J. R. Whitlock, Sr. and William S. Wittmeier, Jr. have made stockholder proposals to the Issuer, in accordance with Rule 14a-8 of the Securities and Exchange Commission, for the purpose of amending the By-Laws of the Issuer to (i) separate the positions of Chairman of the Board and President of the Issuer, (ii) appoint a committee of stockholder representatives to review the actions of the Board of Directors and management of the Issuer, (iii) restrict the composition of the Board of Directors to Directors who are independent, with the exception of one management representative who will be the President of the Issuer, (iv) declassify the Board of Directors of the Issuer, and (v) require that the independent auditor of the Issuer be a regional or national certified public accounting firm. A. Lee Hanson, Jimmy C. Smith, J. R. Whitlock, Sr. and William S. Wittmeier, Jr. are filing this Amendment as Reporting Persons because they may be deemed to be members of a "group" for purposes of Section 27 CUSIP NO. 20343H 10 6 13D, AMENDMENT NO. 1 PAGE 27 OF 30 PAGES 13(d)(3) of the Exchange Act, although each of them disclaims any membership in, and the existence of, such a group as discussed in Item 2 hereof, which discussion is hereby incorporated herein by reference. On December 17, 1998, R. C. Corr, Jr., A. Lee Hanson, Jimmy C. Smith, J. R. Whitlock, Sr. and William S. Wittmeier, Jr., together with Bryan A. Corr, who is a stockholder and a Director of the Issuer, met with Kennon R. Patterson, Sr. and Bishop K. Walker, Jr., who are the Chairman and Vice-Chairman of the Board of the Issuer, for the purpose of addressing the concerns underlying the above-described stockholder proposals. Each of the proponents of the above-described stockholder proposals expressed to management of the Issuer his individual concerns, including the excessive compensation of management and the number of related transactions between the Issuer and various members of management and members of their families. Management indicated at the meeting that it would make a response to the persons present at the meeting, but did not specify the time frame in which it would do so. It is anticipated that each of the Reporting Persons will evaluate the response of management of the Issuer and, depending on such response, may engage in communications with one or more stockholders of the Issuer, one or more officers of the Issuer and/or one or more members of the Board of Directors of the Issuer, including, but not limited to, its operations. Without regard to what Management's response may be, R. C. Corr, Jr. and Doris J. Corr, as stockholders of the Issuer, have requested that the Issuer provide them with a current list of its stockholders. The stockholder list will permit some or all of the Reporting Persons to communicate with other stockholders of the Issuer on matters of mutual interest, including, if necessary, the solicitation of proxies for use in connection with the 1999 Annual Meeting of Stockholders. The Reporting Persons have no present intention of purchasing any additional shares of Common Stock other than the 100,000 shares of Common Stock which R. C. Corr, Jr. attempted to acquire as discussed in Item 3 of the Original Filing, which discussion is hereby incorporated herein by reference. The Reporting Persons intend to review their investments in the Issuer on a continuing basis and may, depending upon their evaluation of the Issuer's business and prospects and the Issuer's progress toward maximizing stockholder value, determine to increase or decrease or to dispose of their positions in the Issuer. In making any such determination, the Reporting Persons will also take into consideration other available business opportunities and general economic conditions. Except as described in this Item 4, none of the Reporting Persons has any plans or proposals as of the date hereof that relate to or would result in, (i) the acquisition by any person of additional securities of the Issuer or the disposition of any such securities, (ii) an extraordinary corporate transaction, such as a merger, reorganization or liquidation, involving the Issuer or any of its subsidiaries, (iii) a sale or transfer of a material amount of assets of the Issuer or any of its subsidiaries, (iv) any change in the present Board of Directors or management of the Issuer, including any plans or proposals to change the number or term of Directors or to fill any existing vacancies on the Board, (v) any material change in the present capitalization or dividend policy of the Issuer, (vi) any other material change in the Issuer's business or corporate structure, (vii) changes in the Issuer's charter or By-Laws or other actions which may impede the acquisition of control of the Issuer by any person, (viii) causing a class of securities of the Issuer to be delisted from any national securities exchange or to cease to be authorized to be quoted in an inter-dealer quotation system of a registered national securities association, (ix) causing a class of equity securities of the Issuer to become eligible for termination of registration pursuant to Section 12 (g)(4) of the Exchange Act, and (x) any action similar to any of those enumerated in clauses (i) through (ix) above. ITEM 5. INTEREST IN SECURITIES OF THE ISSUER. (a), (b) The Reporting Persons beneficially own an aggregate of 464,003 shares of Common Stock, constituting approximately 11.0% of the shares of Common Stock reported by the Issuer as outstanding as of September 30, 1998. Schedule II, which is attached hereto and incorporated herein by reference, sets forth certain information with respect 28 CUSIP NO. 20343H 10 6 13D, AMENDMENT NO. 1 PAGE 28 OF 30 PAGES to the shares of Common Stock owned by each Reporting Person and the power of each Reporting Person to vote or to dispose of the shares of Common Stock owned by such Reporting Person. Each Reporting Person disclaims beneficial ownership of the shares of Common Stock beneficially owned by each of the other Reporting Persons except to the extent reflected in the notes to Schedule II. (c) On October 16, 1998, R.C. Corr, Jr. attempted to acquire 100,000 shares of Common Stock as discussed in Item 3 of the Original Filing, which discussion is hereby incorporated herein by reference. (d) No person other than the Reporting Persons has the right to receive or the power to direct the receipt of dividends from, or the proceeds from the sale of, the shares of Common Stock beneficially owned by the Reporting Persons. (e) Not applicable. ITEM 6. CONTRACTS, ARRANGEMENTS, UNDERSTANDINGS OR RELATIONSHIPS WITH RESPECT TO SECURITIES OF THE ISSUER. Of the 6,230 shares of Common Stock beneficially owned by J. R. Whitlock, Sr., 2,475 shares are pledged by him as collateral to the Issuer in connection with the extension to him of a $90,050 revolving line of credit by Community Bank, a subsidiary of the Issuer. The line of credit and pledge of the 2,475 shares of Common Stock are evidenced by the document attached hereto as Exhibit 1, which document is hereby incorporated herein by reference. There are no other contracts, arrangements, understandings or relationships (legal or otherwise) to which any of the Reporting Persons is a party with respect to any shares of Common Stock except the understandings and relationships discussed in Items 4 and 5 of this Statement on Schedule 13D, which discussions are hereby incorporated herein by reference. ITEM 7. MATERIAL TO BE FILED AS EXHIBITS. 1. Variable/Single Interest Note, Disclosure, and Security Agreement, dated April 20, 1998, in the original principal amount of $90,050 drawn by J. R. Whitlock Sr. to the order of Community Bank. 29 CUSIP NO. 20343H 10 6 13D, AMENDMENT NO. 1 PAGE 29 OF 30 PAGES SIGNATURES After reasonable inquiry and to the best of his or her knowledge and belief, each of the Reporting Persons does hereby certify that the information set forth in this Amendment No. 1 to the Statement on Schedule 13D is true, complete and correct. Dated: December 29, 1998 R. C. CORR, JR. ------------------------------- R. C. Corr, Jr. DORIS J. CORR ------------------------------- Doris J. Corr BRYAN A. CORR ------------------------------- Bryan A. Corr TINA M. CORR ------------------------------- Tina M. Corr JOAN M. CURRIER ------------------------------- Joan M. Currier JOHN DAVID CURRIER ------------------------------- John David Currier CHRISTINA M. CURRIER ------------------------------- Christina M. Currier A. LEE HANSON ------------------------------- A. Lee Hanson JIMMY C. SMITH ------------------------------- Jimmy C. Smith J. R. WHITLOCK, SR. ------------------------------- J. R. Whitlock, Sr. 30 CUSIP NO. 20343H 10 6 13D, AMENDMENT NO. 1 PAGE 30 OF 30 PAGES WILLIAM S. WITTMEIER, JR. ------------------------------- William S. Wittmeier, Jr. ONEONTA TELEPHONE COMPANY, INC. By: BRYAN A. CORR ----------------------------- Bryan A. Corr, Its President and Chief Executive Officer 31 SCHEDULE I INFORMATION RELATING TO THE REPORTING PERSONS
Principal Business Address of Corporation or Organization in Name and Business Present Principal Which Principal or Residence Address Occupation of Occupation of Reporting of Reporting Person Reporting Person Person is Conducted - -------------------- ----------------- -------------------------- R.C. Corr, Jr. (1) Chairman of the Board and 600 Third Avenue East 600 Third Avenue East Employee - Oneonta Telephone Oneonta, Alabama 35121 Oneonta, Alabama 35121 Company, Inc. (4) Employee - North Alabama Cellular, LLC (5) Doris J. Corr (1) Vice President, Secretary, 600 Third Avenue East 600 Third Avenue East Treasurer, Director and Employee Oneonta, Alabama 35121 Oneonta, Alabama 35121 - Oneonta Telephone Company, Inc. (4) Employee - North Alabama Cellular, LLC (5) Bryan A. Corr (1) (2) President, Chief Executive Officer, 600 Third Avenue East 600 Third Avenue East Director and Employee - Oneonta, Alabama 35121 Oneonta, Alabama 35121 Oneonta Telephone Company, Inc. (4) Employee - North Alabama Cellular, LLC (5) Tina M. Corr (2) Employee - Oneonta Telephone 600 Third Avenue East 600 Third Avenue East Company, Inc. (4) Oneonta, Alabama 35121 Oneonta, Alabama 35121 Employee - North Alabama Cellular, LLC (5) Joan M. Currier (1) (3) President, Secretary, Treasurer, 100 Fourth Avenue West 600 Third Avenue East Director and Employee - Comfort Oneonta, Alabama 35121 Oneonta, Alabama 35121 Lifestyles, Inc. (6) John David Currier (3) President, Secretary, Treasurer, 1712-A Second Avenue East 600 Third Avenue East Director and Employee - Quality Oneonta, Alabama 35121 Oneonta, Alabama 35121 Transit Sales, Inc. (7) Christina M. Currier (3) Full-time Student - Foy Student Union 600 Third Avenue East Auburn University Auburn, Alabama 36830 Oneonta, Alabama 35121
32
Principal Business Address of Corporation or Organization in Name and Business Present Principal Which Principal or Residence Address Occupation of Occupation of Reporting of Reporting Person Reporting Person Person is Conducted - -------------------- ----------------- -------------------------- Oneonta Telephone Company, Inc. (4) 600 Third Avenue East 600 Third Avenue East Oneonta, Alabama 35121 Oneonta, Alabama 35121 A. Lee Hanson Private Investor No. 5 Greenbriar Lane No. 5 Greenbriar Lane Oneonta, Alabama 35121 Oneonta, Alabama 35121 Jimmy Charles Smith President and Employee - 1630 2nd Avenue East 1630 2nd Avenue East Jimmy Smith Chev-Olds, Inc. (8) Oneonta, Alabama 35121 Oneonta, Alabama 35121 J. R. Whitlock, Sr. Location Manager and Employee - 3410 Rocky Hollow Road 3410 Rocky Hollow Road Austin Powder Company (9) Blountsville, Alabama 35031 Blountsville, Alabama 35031 William S. Wittmeier, Jr. President, Secretary, Director and 1 Creek Side Way S.W. 1 Creek Side Way S.W. Employee - Rome, Georgia 30165 Rome, Georgia 30165 Wittmeier Real Estate Services, Inc. (10)
- --------------------- (1) R. C. Corr, Jr. and Doris J. Corr are spouses. Bryan A. Corr and Joan M. Currier are the children of R. C. Corr, Jr. and Doris J. Corr. (2) Bryan A. Corr and Tina M. Corr are spouses. (3) Joan M. Currier and John David Currier are spouses. Christina M. Currier is the child of Joan M. Currier and John David Currier. (4) All of the outstanding shares of Class A Common Stock, par value $.10 per share (i.e., voting shares), of Oneonta Telephone Company, Inc., an Alabama corporation ("OTELCO"), are held by Doris J. Corr and Bryan A. Corr. R. C. Corr, Jr., Doris J. Corr and Joan M. Currier serve OTELCO in the positions indicated in this Schedule I. There are no other officers or Directors of OTELCO. The principal business of OTELCO is providing local telephone service through a local exchange network, long-distance telephone service, cable television, dial-up Internet access and advertising in Oneonta, Alabama and surrounding areas. (5) North Alabama Cellular, LLC ("NACELL") is a 98%-owned subsidiary of OTELCO. The principal business of NACELL is operating, acquiring, constructing and disposing of cellular telephone systems in North Alabama. I-2 33 (6) The principal business of Comfort Lifestyles, Inc. is the operation of a domiciliary in Oneonta, Alabama. (7) The principal business of Quality Transit Sales, Inc. is the sale of medium- to heavy-duty trucks in Oneonta, Alabama. (8) The principal business of Jimmy Smith Chev-Olds, Inc. is the operation of a new car dealership selling Chevrolet, Chrysler, Plymouth, Dodge, Jeep-Eagle and Oldsmobile vehicles in Oneonta, Alabama. (9) The principal business of Austin Powder Company is the manufacture, sale and distribution of commercial explosives. (10) The principal business of Wittmeier Real Estate Services, Inc. is performing real estate appraisals in the Rome, Georgia area. I-3 34 SCHEDULE II INFORMATION RELATING TO BENEFICIAL OWNERSHIP OF SHARES OF COMMON STOCK OF THE ISSUER BY THE REPORTING PERSONS
Number and Percentage of Number of Shares of Number of Shares of Shares of Common Stock With Common Stock With Common Stock Respect to Which the Respect to Which the Beneficially Owned Reporting Person Has Reporting Person Has Name of -------------------------------- Sole Voting and Shared Voting and Reporting Person Number Percentage(1) Dispositive Power Dispositive Power ---------------- ------ ---------- -------------------- -------------------- R. C. Corr, Jr. 280,356 (2) 6.6% - 280,356 Doris J. Corr 322,172 (3) 7.6% - 322,172 Bryan A. Corr 188,871 (4) 4.5% 5,333 183,538 Tina M. Corr 32,176 (5) * - 32,176 Joan M. Currier 138,334 (6) 3.3% - 138,334 John David Currier 7,880 (7) * - 7,880 Christina M. Currier 10,454 * 10,454 - Oneonta Telephone Company, 120,000 2.8% - 120,000 Inc. A. Lee Hanson 73,648 1.7% 73,648 - Jimmy C. Smith 4,850 * 4,850 - J. R. Whitlock, Sr. 6,230 * 6,230 - William S. Wittmeier, Jr. 1,260 * 1,260 1,260 R. C. Corr, Jr., Doris J. Corr, 378,015 8.9% 15,787 362,228 Bryan A. Corr, Tina M. Corr, Joan M. Currier, John David Currier, Christina M. Currier and Oneonta Telephone Company, Inc. as a Group
- ---------- (1) Percentages are determined on the basis of 4,231,320 shares of Common Stock reported by the Issuer as being outstanding on September 30, 1998. (2) Includes (i) 160,356 shares held with Doris J. Corr as a joint tenant with right of survivorship and (ii) 120,000 shares held by Oneonta Telephone Company, Inc. ("OTELCO"). (3) Includes (i) 160,356 shares held with R.C. Corr, Jr. as a joint tenant with right of survivorship, (ii) 10,454 shares held as Co- 35 Custodian with Bryan A. Corr for her minor granddaughter, Lauren M. Corr, (iii) 10,454 shares held as Co-Custodian with Bryan A. Corr for her minor granddaughter, Kelly B. Corr, ( iv) 10,454 shares held as Co-Custodian with Bryan A. Corr for her minor grandson, Bryan A. Corr, Jr., (v) 10,454 shares held as Co-Custodian with Joan M. Currier for her minor grandson, John D. Currier, Jr., and (vi) 120,000 shares held by OTELCO. (4) Includes (i) 32,176 shares held with Tina M. Corr as a joint tenant with right of survivorship, (ii) 10,454 shares held as Co-Custodian with Doris J. Corr for his minor daughter, Lauren M. Corr, (iii) 10,454 shares held as Co-Custodian with Doris J. Corr for his minor daughter, Kelly B. Corr, (iv) 10,454 shares held as Co-Custodian with Doris J. Corr for his minor son, Bryan A. Corr, Jr., (v) 5,333 shares subject to currently exercisable stock options, and (vi) 120,000 shares held by OTELCO. (5) Held with Bryan A. Corr as a joint tenant with right of survivorship. (6) Includes (i) 7,880 shares held with John David Currier as a joint tenant with right of survivorship, (ii) 10,454 shares held as Co-Custodian with Doris J. Corr for her minor son, John D. Currier, Jr., and (iii) 120,000 shares held by OTELCO. (7) Held with Joan M. Currier as a joint tenant with right of survivorship. * Less than 1%. II-2 EX-99.1 2 VARIABLE/SINGLE INTEREST DISCLOSURE & SECURITY AGR 1 EXHIBIT 1 2 COMMUNITY BANK - ONEONTA J R WHITLOCK, SR. Loan Number 2022892 P O BOX 370 9 GREENBRIAR LN Date 04/20/1998 ONEONTA, AL 35121 ONEONTA, AL 35121 Maturity Date 04/20/1999 Loan Amount $90,050.00 LENDER'S NAME AND ADDRESS BORROWER'S NAME AND ADDRESS Renewal Of ___________ "You" means the Lender, "I" includes each Borrower above, ###-##-#### its successors and assigns. jointly and severally TERMS FOLLOWING A [ ] APPLY ONLY IF CHECKED NOTE - For value received, I promise to pay to you, or your order, at your address above, the principal sum of: ------------------- NINETY THOUSAND FIFTY AND 00/100 Dollars $90,050.00, - -------------------------------------------------------------------------------------------------------------- ----------- plus interest from APRIL 20, 1998 at the rate of 9.500% per year until 04/20/1999 ----------------------------- --------------------- -----------------------------. ADDITIONAL FINANCE CHARGES - [ ] I agree to pay a refundable interest surcharge fee of $________________. [ ] I agree to pay a processing fee of $________________. The processing fee is [ ] refundable. [ ] nonrefundable. Fees will be [ ] paid in cash [ ] paid pro rata over the term of the loan. [ ] withheld from the proceeds. (Fees withheld from the proceeds are included in the principal sum). [ ] VARIABLE RATE - The rate above may change so as always to be __________________________________________________________________ _______________________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________ ___________. The interest rate may not change more than _____________% each ___________________________________________________ The annual interest rate in effect on the note will not at any time be more than ________% or less than _______%. The interest rate in effect on this note may change (as often as) ________________________________ (assuming there is a change in the base rate) and an increase in the interest rate will cause an increase in [ ] the amount of each scheduled payment. [ ] the amount due at maturity. [ ] the number of payments. PAYMENT. I will pay this note as follows: (a) [X] Interest due: AT MATURITY 04/20/1999 -------------------------------------------------------------------------------------------------------- Principal due: ________________________________________________________________________________________________________ (b) [ ] This note has ______ payments. The first payment will be in the amount of $____________ and will be due _______________ ___________________. A payment of $_____________ will be due on the _______ day of each ___________________________________ thereafter. The final payment of the entire unpaid balance of principal and interest will be due _________________________. INTEREST - Interest accrues on a DAILY basis. POST MATURITY INTEREST - Interest will accrue after maturity on ------------------- the unpaid balance of this note on the same basis as interest [ ] MINIMUM INTEREST CHARGE - I agree to pay a minimum interest accrues before maturity, unless a specific post-maturity charge of $__________ if I pay this loan off before you have interest rate is agreed to in the next sentence. earned that much in interest. [X] LATE CHARGE - I agree to pay a late charge on the portion of [ ] Interest will accrue at the rate of ______________% per year any payment made more than 15 days after it is due equal to on the balance of this note not paid at maturity, including ------ maturity by acceleration. 5% OF BALANCE NOT TO EXCEED $100.00. - ---------------------------------------------------------------. THE PURPOSE OF THIS LOAN IS LINE OF CREDIT ----------------------------------- - ----------------------------------------------------------------------------------------------------------------------------------- SECURITY - You have certain rights that may affect my property as explained on page 2. This loan [X] is [ ] is not further secured. (a) [X] This loan is secured by STOCK POWER, dated 4/20/98. ----------- ------- (b) [X] Security Agreement - I give you a security interest in the Property described below. The rights I am giving you in this Property and the obligations this agreement secures are defined on page 2 of this agreement. 275 SHARES COMMUNITY BANCSHARES INC STOCK CERT # 252 550 SHARES CERT # 1705 515 SHARES CERT # 3240 750 SHARES CERT # 1778 60 SHARES CERT # 3772 700 SHARES CERT # 2368 65 SHARES CERT # 3993 200 SHARES CERT # 2662 3115 SHARES CERT # 5647 This Property will be used for BUSINESS purposes. ---------------- ANNUAL PERCENTAGE RATE FINANCE CHARGE AMOUNT FINANCED TOTAL OF PAYMENTS I have the right to receive at The cost of my credit The dollar amount the The amount of credit The amount I will have this time an itemization of as a yearly rate credit will cost me provided to me or paid when I have made all the Amount Financed on my behalf scheduled payments. XX YES - I want 9.561% $8,604.75 $90,000.00 $98,604.75 -------- an itemization. - --------------------------------------------------------------------------------------------------- NO - I do not want My Payment Schedule will be: -------- an itemization. - ----------------------------------------------------------------------------------------------------------------------------------- Number of Payments Amount of Payments When Payments Are Due - ----------------------------------------------------------------------------------------------------------------------------------- 1 $98,604.75 04/20/1999 "e" means an estimate. - ----------------------------------------------------------------------------------------------------------------------------------- $ $ .00 Filing Fees - ----------------------------------------------------------------------------------------------------------------------------------- $ $ .00 Nonfiling Insurance - ----------------------------------------------------------------------------------------------------------------------------------- $ - ----------------------------------------------------------------------------------------------------------------------------------- [X] This note has a demand feature. [X] This note is payable on demand and all disclosures are based on an assumed maturity of one year [ ] Variable Rate [ ] My loan contains a variable rate feature. Disclosures about the variable rate feature have been provided to (Check One) me earlier. [ ] The annual percentage rate may increase during the term of this transaction if ____________________________ ___________________________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________________________ Any increase will take the form of ________________________________________________________________________________________________ If the rate increases by __________________% in ___________________________, the __________________________________________________ will increase to _________________________. The rate may not increase more often than once _____________, and may not increase more than ____________% each _______________________________________________________. The rate will not go above _____________________%. Security - I am giving security interest in: [X] (brief description of other property) [ ] the goods or property being purchased. STOCK [X] collateral securing other loans with you may also secure this loan.
3 [ ] Required Deposit - The annual percentage rate does not take into account my required deposit. Prepayment - If I pay off this note early, I [ ] may [XX] will not have to pay a penalty. [ ] If I pay off this note early, I may be entitled to a refund of part of the interest surcharge. [XX] If I pay off this note early, I [ ] may [XX] will not be entitled to a refund of part of the processing fee. [XX] Assumption - Someone buying the property securing this obligation cannot assume the remainder of the obligation on the original terms. I can see my contract documents for any additional information about nonpayment, default, any required repayment before the scheduled date, and prepayment refunds and penalties. CREDIT INSURANCE - Credit life insurance and credit disability insurance are not required to obtain credit, and will not be provided unless I sign and agree to pay the additional costs. - ------------------------------------------------------------------------------------- Type Premium Term - ------------------------------------------------------------------------------------- Credit Life NA NA - ------------------------------------------------------------------------------------- Credit Disability NA NA - ------------------------------------------------------------------------------------- Joint Credit Life NA NA - ------------------------------------------------------------------------------------- - ------------------------------------------------------------------------------------- I [ ] do [XX] do not want credit life insurance. I [ ] do [XX] do not want credit disability insurance. I [ ] do [XX] do not want joint credit life insurance. I [ ] do [ ] do not want insurance ----------------------------------------- X DOB 00/00/0000 - ------------------------------------------------------------------------------------- X DOB - ------------------------------------------------------------------------------------- PROPERTY INSURANCE - I may obtain property insurance from anyone I want that is acceptable to you, or may provide it through an existing policy. If I get the insurance from or through you I will pay $___________________ for _________________ of coverage. SINGLE INTEREST INSURANCE - I may obtain single interest insurance from anyone I want that is acceptable to you, or may provide it through an existing policy. If I get the insurance from or through you I will pay $__________________ for _______________ of coverage. (Optional) Signed __________________________________________________ For Lender (SEAL) Title ____________________________________________________________________ VARIABLE/SIMPLE INTEREST NOTE, DISCLOSURE, AND SECURITY AGREEMENT (C) 1981, 1988 Bankers Systems, Inc. St. Cloud MN (1-800-397-2341) Form NDaS-VSI-AL 9/10/94 [Recycle Logo] "Right to receive money from you" means: (a) Any deposit account balance I have with you; (b) Any money owed to me on an item presented to you or in your possession for collection or exchange; and (c) Any repurchase agreement or other nondeposit obligation. "Any amount due and payable under this note" means the total amount of which you are entitled to demand payment under the terms of this note at the time you set off. This total includes any balance the due date for which you property accelerate under this note. If my fight to receive money from you is also owned by someone who has not agreed to pay this note, your right of set-off will apply to my interest in the obligation and to any other amounts I could withdraw on my sole request or endorsement. Your right of set-off does not apply to an account or other obligation where my rights arise only in a representative capacity. It also does not apply to any individual Retirement Account or other tax-deferred retirement account. You will not be liable for the dishonor of any check when the dishonor occurs because you set off this debt against any of my accounts. I agree to hold you harmless from any such claims arising as a result of your exercise of your right of set-off. OTHER SECURITY - Any present or future agreement securing any other debt I owe you also will secure the payment of this loan. Property securing another debt will not secure this loan if such property is my principal dwelling and you fail to provide any required notice of right of rescission. Also, property securing another debt will not secure this loan to the extent such property is in household goods. OBLIGATIONS INDEPENDENT - I understand that my obligation to pay this loan is independent of the obligation of any other person who has also agreed to pay it. You may, without notice, release me or any of us, give up any right you may have against any of us, extend new credit to any of us, or renew or change this note one or more times and for any term, and I will still be obligated to pay this loan. You may, without notice, fail to perfect your security interest in, impair, or release any security and I will still be obligated to pay this loan. WAIVER - I waive (to the extent permitted by law) demand, presentment, protest, notice of dishonor and notice of protest. PRIVACY - I agree that from time to time you may receive credit information about me from others, including other lenders and credit reporting agencies. I agree that you may furnish on a regular basis credit and experience information regarding my loan to others seeking such information. To the extent permitted by law, I agree that you will not be liable for any claim arising from the use of information provided to you by others or for providing such information to others. FINANCIAL STATEMENTS - I will give you any financial statements or information that you feel is necessary. All financial statements and information I give you will be correct and complete. PURCHASE MONEY LOAN - If this is a Purchase Money Loan, you may include the name of the seller on the check or draft for this loan. ITEMIZATION OF AMOUNT FINANCED AMOUNT GIVEN TO ME DIRECTLY $ 90,000.00 ------------- AMOUNT PAID ON MY (LOAN) ACCOUNT $ ------------- ORIGINATION FEE $ 50.00 ------------- MOUNTS PAID TO OTHERS ON MY BEHALF: to Insurance Companies $ ------------- to Public Officials $ ------------- $ - ----------------------------------- ------------- $ - ----------------------------------- ------------- $ - ----------------------------------- ------------- (less) PREPAID FINANCE CHARGE(S) $ 50.00 ------------- Amount Financed $ 90,000.00 ------------- (Add all items financed and subtract prepaid finance charges.) - -------------------------------------------------------------------------------- Signatures and Seals: in witness whereof, I have signed my name and affixed my seal on this 20 day of April 1998. By doing so, I agree to the terms of this note and security agreement (including those on page 2) and acknowledge receipt of at least one copy on today's date. COSIGNERS - SEE NOTICE ON PAGE 2 BEFORE SIGNING. CAUTION - IT IS IMPORTANT THAT YOU THOROUGHLY READ THE CONTRACT BEFORE YOU SIGN IT. Signature /s/ J. R. WHITLOCK, SR. (SEAL) --------------------------------------------------------------------- J. R. WHITLOCK, SR. Signature (SEAL) ---------------------------------------------------------------------- CONSUMER LOAN - NOT FOR OPEN-END CREDIT (page 1 of 2) Attach FTC "Preservation of Consumer Claims and Defenses" Notice if Applicable (page 2 of 2)
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