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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN 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. | |||
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. | SEC 1474 (9-02) |
1. Title of Derivative Security (Instr. 3) |
2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) |
5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4, and 5) |
6. Date Exercisable and Expiration Date (Month/Day/Year) |
7. Title and Amount of Underlying Securities (Instr. 3 and 4) |
8. Price of Derivative Security (Instr. 5) |
9. Number of Derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) |
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Options to purchase | $ 9.3 | 04/23/2005 | J(3) | 0 (3) | 04/23/2005 | 04/23/2012 | common stock | 2,000 | $ 0 | 2,000 (4) | D (5) |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
BARTLETT JOHN L C/O GOUVERNEUR SAVINGS LOAN ASSOC 42 CHURCH ST. BOX 297 GOUVERNEUR, NY 13642-0297 |
Vice President |
JOHN L BARTLETT | 04/25/2005 | |
**Signature of Reporting Person | Date |
* | If the form is filed by more than one reporting person, see Instruction 4(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) | Not an acquisition or disposition - represents 200 shares, or 20% of total awarded to officer and previously held by Management Recognition Plan Trust (MRP), which vested for the one year period ending April 23, 2005. |
(2) | D 1,325 shares / I 400 shares by MRP |
(3) | Not an acquisition or disposition - represents 500 options to purchase common stock which vested for the one year period ending April 23, 2005, which were awarded to the officer and previously by the plan. |
(4) | 20% of the options vested and were exercisable on each of April 23, 2003, 2004 and 2005. an equal amount will vest on April 23, 2006 and 2007. |
(5) | D 1,000 options / I 1,000 options by plan |