UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | SEC 1473 (7-02) | ||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number. |
1. Title of Derivative Security (Instr. 4) |
2. Date Exercisable and Expiration Date (Month/Day/Year) |
3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) |
4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 5) |
6. Nature of Indirect Beneficial Ownership (Instr. 5) |
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Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Trbovich Kenneth D 1110 MAPLE STREET, P.O. BOX 300 ELMA, NY 14059-0300 |
 |  |  President |  |
Kenneth D. Trbovich | 10/05/2012 | |
**Signature of Reporting Person | Date |
* | If the form is filed by more than one reporting person, see Instruction 5(b)(v). |
** | Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
(1) | As of the date hereof, includes 2,296.90 shares allocated to the reporting person's account under the Company's Employee Stock Ownership Trust (the "ESOT") as well as shares allocated to the ESOT accounts of the reporting person's father, Dr. Nicholas Trbovich, and the reporting person's brothers, Michael Trbovich and Nicholas Trbovich, Jr., that the reporting person is required to report pursuant to Rule 16a-8(b)(2). The reporting person disclaims beneficial interest in the 85,739.05 shares allocated to his family members' ESOT accounts. |