Board of Governors of the Federal Reserve System
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FR Y-6 0MB Number 7100-0297 Approval expires November 30, 2019 Page 1 of2
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:Q { Annual Report of Holding Companies-FR Y-6 ¢·
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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)
This report form is to be filed by all top-tier bank holding companies, top-tier savings and loan holding companies, and U.S. intermediate holding companies organized under U.S. law, and by any foreign banking organization that does not meet the requirements of and is not treated as a qualifying foreign banking organization under Section 211.23 of Regulation K (12 C.F.R. § 211.23). (See page one of the general instructions for more detail of who must file.) The Federal Reserve may not conduct or sponsor, and an organization (or a person) is not required to respond to, an information collection unless it displays a currently valid 0MB control number.
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. §§ 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 ESOPIESOT formed as a corporation or is an LLC, see the General Instructions for the authorized individual who must sign the report. I, Charles Wagner
Name of the Holding Company Director and Official
President Title of the Holding Company Director and Official
attest that the Annual Report of Holding Companies (including the supporting attachments) for this report date has been prepared in conformance with the instructions issued by the Federal Reserve System and are true and correct to the best of my knowledge and belief.
With respect to 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 Rep99r gflfj_ individual consent to public release of all details in thF/j:,epop con<J]rninJJ !hat indiviJl9al.
{AvG K-c Wo:Y':= /f ,,_ Signature of Holding Company Director and Offi l'E 03/31/2017 Date of Signature
For holding companies [1QJ_ registered with the SEC-Indicate status of Annual Report to Shareholders:
D is included with the FR Y-6 report
~ 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, 2017 Month/ Day / Year
549300085RKRL 1 WWVD41 Reporter's Legal Entity Identifier (LEI) (20-Character LEI Code)
Reporter's Name, Street, and Mailing Address
Coastal Banking Company Legal Title of Holding Company
1891 S 14th St (Mailing Address of the Holding Company) Street/ P.O. Box
Fernandina Beach FL 32034 -------
City State Zip Code
36 Sea Island Parkway Beaufort, SC 29907 Physical Location (if different from mailing address)
Person to whom questions about this report should be directed: Thomas Flournoy CFO ------------Name Title
904-321-2917 Area Code/ Phone Number/ Extension
904-321-5687 Area Code/ FAX Number
tom. flou [email protected] E-mail Address
www.coastalbank:ing.com Address (URL) for the Holding Company's web page
:~i~~:~~~n~~~~~:!~~~t- r~~u~~ted. f~-~ ~ny. ~~~i-~~- ~-f· .. ~ 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, 2oth and C Streets, NW, Washington, DC 20551, and to the Office of Management and Budget, Paperwork Reduction Project (7100-0297), Washington, DC 20503. 03/2018
For Use By Tiered Holding Companies
FR Y-6 Page 2 of 2
Top-tiered holding companies must list the names, mailing address, and physical locations of each of their subsidiary holding companies below.
Legal Title of Subsidiary Holding Company Legal Title of Subsidiary Holding Company
(Mailing Address of the Subsidiary Holding Company) Street/ P.O. Box (Mailing Address of the Subsidiary Holding Company) Street/ P.O. Box
City State Zip Code City State Zip Code
Physical Location (if different from mailing address) Physical Location (if different from mailing address)
Legal Title of Subsidiary Holding Company Legal Title of Subsidiary Holding Company
(Mailing Address of the Subsidiary Holding Company) Street/ P.O. Box (Mailing Address of the Subsidiary Holding Company) Street/ P.O. Box
City State Zip Code City State Zip Code
Physical Location (if different from mailing address) Physical Location (if different from mailing address)
Legal Title of Subsidiary Holding Company Legal Title of Subsidiary Holding Company
(Mailing Address of the Subsidiary Holding Company) Street/ P.O. Box (Mailing Address of the Subsidiary Holding Company) Street/ P.O. Box
City State Zip Code City State Zip Code
Physical Location (if different from mailing address) Physical Location (if different from mailing address)
Legal Title of Subsidiary Holding Company Legal Title of Subsidiary Holding Company
(Mailing Address of the Subsidiary Holding Company) Street/ P.O. Box (Mailing Address of the Subsidiary Holding Company) Street/ P.O. Box
City State Zip Code City State Zip Code
Physical Location (if different from mailing address) Physical Location (if different from mailing address)
12/2012
Form FRY-6
Coastal Banking Company, Inc. Beaufort, South Carolina
Fiscal Year Ending December 31, 2017
Report Item
1: Three copies of the annual report to shareholders will be forwarded to you separately upon completion.
2a: Organization Chart
Coastal Banking Company, Inc. Beaufort, SC
Incorporated in South Carolina
1. & 2. Owns all common securities of the Trust 3. Owns 100% of bank
1. Coastal Banking Company
Trust I Beaufort, SC
Est. in South Carolina
2. Coastal Banking Company Trust II
Beaufort, SC Est. in South Carolina
3. CBC National Bank Fernandina Beach, FL
LEI Number:
549300085RKRL I WWVD4 l
2b: Submitted electronically via Reporting Central on April 2, 2018.
3: (1 )There were no shareholders with ownership, control or holding of 5% or more with power to vote as of fiscal year ending 12/31/2017: (2)There were no shareholders with ownership, control or holding of 5% or more with power to vote during the year ending 12/31/2017
4: Insiders
Results: A list of branches for your holding company: COASTAL BANKING COMPANY, INC. (2855905) of BEAUFORT, SC.
The data are as of 12/31/2017. Data reflects information that was received and processed through 01/10/2018.
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 in the Effective Date column
Actions OK: If the branch information is correct, enter 'OK' in the Data Action column.
\
Change: ff the branch information is incorrect or incomplete, revise the data, enter 'Change' in the Data Action column and the date when this information first became valid in the Effective Date column.
Close: If a branch listed was sold or closed, enter 'C lose ' in the Data Action column and the sale or closure date in the Effective Date column. De lete: If a branch listed was never owned by this depository institution, enter 'Dele te ' in the Data Action column . Add: If a reportable branch is missing, insert a row, add the branch data, and enter 'Add' in the Data Action column and the opening or acquisition date in the Effective Date column.
If printing this list, you may need to adjust your page setup in MS Excel. Try using landscape orientation, page scaling, 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 information. If you are e-mailing this to your FRB contact, put your institution name, city and state in the subject l!ne of the e-mail.
Note: To satisfy the FR Y·lO reporting requirements, you must also submit FR Y-10 Domestic Branch Schedules for each branch with a Data Action of Change, Close, Dele te, or Add . The FR Y-10 report may be submitted in a hardcopy format or via the FR Y-10 Online application - https://ylOonline.federalreserve.gov.
• FDIC UNINUM, Office Number, and ID_RSSD columns are for reference only. Verificat ion of these values is not required .
Data Action Effective Date Branch Service Tvae Branch ID RSSD• Poaular Name Street Address City State Zip Code
OK Full Service (Head Office) 2855914 CBC NATIONAL BANK 1891 SOUTH 14TH STREET FERNANDINA BEACH Fl 32034
OK Full Service 3503696 OCALA MAIN OFFICE 910 SW 1ST AVENUE OCALA FL 34471
OK Full Service 4353012 WEST HIGHWAY 40 BRANCH 5860 WEST HIGHWAY 40 OCALA FL 34482
OK Full Service 4776929 PINELLAS BRANCH 2505 BURNSED BLVD THE VILLAGES FL 32163
OK Full Service 3610059 LADY'S ISLAND BRANCH 36 SEA ISLAND PARKWAY LADYS ISLAND SC 29907
OK Full Service 3591929 PORT ROYAL BRANCH 1700 RIBAUT ROAD PORT ROYAL SC 29935
County Country
NASSAU UNITED STATES
MARION UNITED STATES
MARION UNITED STATES
SUMTER UNITED STATES
BEAUFORT UNITED STATES
BEAUFORT UNITED STATES
FDIC UNINUM' Office Number• Head Office Head Office ID RSSD' Comments 77699 0 CBC NATIONAL BANK 2855914 Not Required Not Required CBC NATIONAL BANK 2855914 Not Required Not Required CBC NATIONAL BANK 2855914 Not Required Not Required CBC NATIONAL BANK 2855914
481046 6 CBC NATIONAL BANK 2855914
462451 3 CBC NATIONAL BANK 2855914
1uirector (U), t:xecut1ve umcer 1uate ot last (EO), Principal Shareholder (S) Name of Company City, State Position Held Ownership% update
JPP LLC Ocala, FL Managing Member 100.0% Vice
JOPA 484, Inc. Ocala, FL President/Treasurer 50.0% John Q Adams /D) Adams & Company, PA Ocala, FL President 100.0% 3/27/2018
ACA Construction Grp, Kenneth C Ausley (D) LLC Ocala, FL Project Manager 20.0% 3/27/2018
1 Christina H. Bryan (D) Hall Investments Fernandina Beach, FL Owner and Director 33.33% 3/27/2018
Rodeffer, Garner and Minor Orthodontics, L.C. Fernandina Beach, FL Director 16.70% Rodeffer and Garner Orthodontics, P.A. Jacksonville, FL Director 50.0%
D. Tod Garner Familv, LLC Fernandina Beach, FL Director 27.0%
J Twenty-nine Eleven, LLC Fernandina Beach, FL Director 25.0%
2 Suellen Rodeffer Garner /Dl Garner Partners, Inc Fernandina Beach, FL Director/Sec. 27.0% 3/27/2018 White :squirrel Properties, LLC Beaufort, SC President 100.0%
Sea Island Rentals Beaufort, SC President 51 .0%
Affordable Home Rentals Beaufort, SC President 100.0% 1 H ana H uuamy t-ropenies,
3 Mark B. Heles (D) LLC Beaufort, SC President 50.5% 3/27/2018
Coastal BankinQ Co. Inc. Beaufort, SC Director <1%
Hazzard Creek, LLC Beaufort, SC Owner and Director 100% H and H Quality Properties, LLC Beaufort, SC VP/Treasurer 49.50%
Island Pines, LLC Beaufort, SC Owner and Director 100% Veterinary Wellness Care, LLC Beaufort, SC Owner and Director 100% James w. Ho1aen ana Go.,
4 James W. Holden Jr. /Dl LLC Beaufort, SC Owner and Director 100% 3/27/2018
5 Ladson F. Howell (D) None 3/27/2018
Athena Corooration Beaufort, SC President 38%
Village Renaissance, Inc Beaufort, SC Manager & Treasurer 25%
Pinkerton Investments, LP Beaufort, SC Managing Partner 100% Pinkerton Management, LLC Beaufort, SC ManaQinq Member 50% Diocese of the Episcopal Church Beaufort, SC Trustee 13% St. Marks Episcopal Church Charleston, SC Treasurer 11% t-'1nKerton 1rrevocao1e
7 Robert B. Pinkerton /Dl Family Trust Beaufort, SC Trustee 100% 3/27/2018
8 Michael Sanchez (D, EO) Coastal Banking Co. Inc. Beaufort, SC CEO 1.55% 3/27/2018
Morrow Insurance Group, Inc of Fernandina Beach Fernandina Beach, FL Owner-President 100% Primeco Insurance Agency, Inc. Marietta, GA President 50%
9 Edward E. Wilson (D) Amelia HR Solutions Fernandina Beach, FL President 100% 3/27/2018 1 Managing \jenera1
10 Marshall E. Wood (D) Santa Maria Partnership Fernandina Beach, FL Partner 30% 3/27/2018
Executive Officers
12 Thomas J Flournoy None 3/27/2018
13 Charles A Wagner (EO) WLG Luxury Rentals, LLC Cumming, GA Member 16.67% 3/27/2018 vice
14 W. Durand Childers (EO) CFI, Inc. Cordele, GA President/Treasurer 50% 3/27/2018
15 0. Mitchell Smith (EO) DI, LLC Albany, GA Member 25% 3/27/2018
16 Brynn Stensrud (EO) None 3/27/2018
Form FR Y-6 Coastal Banking Company, Inc.
Fiscal Year Ending December 31, 2017 Report Item 4: Insiders (1), (2), (3)(a)(b)(c), and (4)(a)(b)(c)
(1)(a) (2) (3)(a) (3)(b) (3)(c) (4)(a) (4)(b) (4)(c) Names & Principal Title & Title& Title & Percentage Percentage List names Address Occupation Position Position Position of Voting of Voting of other (City, State, if other with with with Other Shares in Shares in companies Country) than with Holding Subsidiaries Businesses Holding Subsidiaries if 25% or
Holding Company Company more of
Company (includes voting options vested securities
but not are held
exercised)
John Q. Adams Accounting Director Director Manging Member 1.01% none JPP, LLC 100% Ocala, FL CBC National Bank JPP, LLC USA
Vice PresidenVTreasurer JOPA 484, Inc. 50% JOPA 484, Inc.
President Adams & Company, PA 100%
Adams & Company, PA
Kenneth C. Ausley Construction Director Director Project Manager 0.83% none none Ocala, FL CBC National Bank ACA Construction Group, LLC USA
Christina H. Bryan Petroleum Director Director Owner & Director 0.00% none Hall Investments 33.33% Fernandina Beach, FL Distribution CBC National Bank Hall Investments USA Consultant
Suellen Rodeffer Gamer Orthodontist Director Director Director 1.93% none Rodeffer, Gamer & Minor Orthodontics, LC. 16.70% Fernandina Beach, FL CBC National Bank Rodeffer, Gamer & Minor USA Orthodontics, L.C.
Director & Secretary Gamer Partners, Inc. 50% Gamer Partners, Inc.
Director Rodeffer & Gamer Orthodontics, P.A. 50% Rodeffer & Gamer Orthodontics, P.A.
Director D. Tod Gamer Family, LLC. 27% D. Tod Gamer Family, LLC
J Twenty-nine Eleven, LLC J Twenty-nine Eleven, LLC 25%
Mark B. Heles Real Estate & Director Director President 1.01% none H & H Quality Properties, LLC, 50.5% Beaufort, SC Human Resources CBC National Bank H & H Quality Properties, LLC USA
President Affordable Home Rentals, Inc., 100% Affordable Home Rentals , Inc.
President Sea Island Rentals, Inc., 51% Sea Island Rentals, Inc.
President White Squirrel Properties, LLC 100% White Squirrel Properties, LLC
James W. Holden, Jr., DVM Veterinarian Director & Director Owner & Director 0.65% none Veterinary Wellness Care, LLC 100%
Beaufort, SC Secretary CBC National Bank Veterinary Wellness Care, LLC USA
VP/Treasurer H & H Quality Properties. LLC 49.5% H and H Quality Properties, LLC
Owner & Director James W. Holden & Company, LLC 100% James W. Holden & Co, LLC
Owner & Director Hazard Creek, LLC 100% Hazard Creek, LLC
Owner & Director Island Pines, LLC 100%
Island Pines, LLC
Ladson F. Howell Retired Director & Director None 0.43% none none
Beaufort, SC Attorney Vice- CBC National Bank USA Chairman
Robert B. Pinkerton Manufacturing Director Director President 0.71% none Athena Corporation 50%
Beaufort, SC CBC National Bank Athena Corporation
USA Treasurer Village Renaissance, Inc. 25% Village Renaissance, Inc.
Managing Member Pinkerton Management Group 50%
Pinkerton Management Group
Managing Partner Pinkerton Investments 100%,
Pinkerton Investments
Trustee Pinkerton Irrevocable Family Trust 100% Page 1
Report Item 4: Insiders (1), (2), (3)(a)(b)(c), and (4)(a)(b)(c)
(1)(a) (2) (3)(a) Names & Principal Title & Address Occupation Position (City, State, if other with Country) than with Holding
Holding Company Company
Michael G. Sanchez NIA Chairman & Fernandina Beach, FL PresidenUCEO USA
Charles K. Wagner NIA Director Alpharetta, GA USA
Edward E. Wilson Insurance Director Fernandina Beach, FL Agent USA
Marshall E. Wood Attorney Director Fernandina Beach,FL USA
W . Durand Childers NIA NIA Fernandina Beach, FL USA
Thomas J. Flournoy NIA CFO Fernandina Beach, FL USA
Brynn Stensrud NIA NIA Alpharetta, GA USA
0 . Mitchell Smith NIA NIA Fernandina Beach, FL USA
Form FR Y-6 Coastal Banking Company, Inc.
Fiscal Year Ending December 31, 2017
(3)(b) Title & Position with Subsidiaries
Chairman & CEO CBC National Bank
President CBC National Bank
Director CBC National Bank
Director CBC National Bank
Executive Vice President CBC National Bank
Executive Vice PresidenVCFO CBC National Bank
Executive Vice President CBC National Bank
Executive Vice President CBC National Bank
(3)(c) (4)(a) Tille & Percentage Position of Voting with Other Shares in Businesses Holding
Company
(includes
options vested
but not
exercised) Pinkerton Irrevocable Famrly Trust
None 1.99%
Owner 1.62% Zonia Holdings, Inc.
Member CK Luxury Rentals, LLC
Member WLG Luxury Rentals, LLC
Owner & President 1.37% Morrow Insurance Group, Inc. of Fernandina Beach
President Primeco Insurance Agency, Inc.
President Amelia HR Solutions
Managing General Partner 0.97% Santa Maria Partnership
Vice President & Treasurer 0.67% CFI, Inc.
None 0.07%
None 0.55%
None 0.11%
(4)(b) (4)(c) Percentage List names of Voting of other Shares in companies Subsidiaries if 25%or
more of
voting
securities
are held
none none
none Zonia Holdings, Inc. 100%
CK Luxury Rentals, LLC 50%
none Morrow Insurance Group, Inc of Fernandina Beach 100%
Primeco Insurance Agency, Inc. 50%
Amelia HR Solutions 100%
none Santa Maria Partnership 30%
none CFI, Inc. 50%
none none
none none
none none
NOTE: We were advised by counsel that Childers and Stensrud meet the SEC definition of affiliates of Coastal Banking Company, Inc. based on their influence over strategic decisions with in both the bank and holding company, so we have always cons idered them as insiders of both entities. You are correct that neither of them are employees or officers of the holding company, Coastal Banking Company, Inc., however both are actively involved in management of both entities.
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