CUSIP No. 12612F101 | Page 1 of 5 |
SECURITIES AND
EXCHANGE COMMISSION
Washington, D.C. 20549
SCHEDULE 13G
(Rule 13d 102)
INFORMATION TO BE INCLUDED IN STATEMENTS FILED
PURSUANT
TO RULES 13d-1(b), (c) AND (d) AND AMENDMENTS
THERETO FILED PURSUANT TO 13d-2 (b)
(Amendment No. __)*
First Capital Bancorp, Inc.
(Name of Issuer)
Common Stock
(Title of Class of Securities)
12612F101
(CUSIP Number)
May 28, 2004
(Date of Event Which
Requires Filing of this Statement)
Check the appropriate box to designate the rule pursuant to which this Schedule is filed:
|_| Rule 13d-1(b)
|_| Rule 13d-1(c)
|X| Rule 13d-1(d)
1/The remainder of this cover page shall be filled out for a reporting persons initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter the disclosures provided in a prior cover page.
The information required in 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 (Act) or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act (however, see the Notes).
CUSIP No. 12612F101 | Page 2 of 5 |
1. | NAMES OF REPORTING PERSON | ||
SS OR I.R.S. IDENTIFICATION NO. OF ABOVE PERSON William R. Blanton |
2. | CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP | (a) |_| | |
N/A | (b) |_| |
3. | SEC USE ONLY | ||
4. | CITIZENSHIP OR PLACE OF ORGANIZATION | ||
United States of America |
NUMBER OF SHARES |
5. | SOLE VOTING POWER 1,048,805 |
||
BENEFICIALLY OWNED BY |
6. | SHARED VOTING POWER 0 |
||
EACH REPORTING |
7. | SOLE DISPOSITIVE POWER 1,048,805 |
||
PERSON WITH | 8. | SHARED DISPOSITIVE POWER 0 |
9. | AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 1,048,805 |
||
10. | CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES
CERTAIN SHARES N/A |
|_| | |
11. | PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9 20.3% |
||
12. | TYPE OF REPORTING PERSON IN |
||
CUSIP No. 12612F101 | Page 3 of 5 |
First Capital Bancorp, Inc.
3320
Holcomb Bridge Road, N.W., Suite A
Norcross, Georgia 30092
William R. Blanton
3320
Holcomb Bridge Road, N.W., Suite A
Norcross, Georgia 30092
United States of America
Common Stock
12612F101
Not applicable.
(a) Amount beneficially owned: 1,048,805
(b) Percent of class: 20.3%
(c) Number of shares as to which such person has
(i) sole power to vote or direct the vote: 1,048,805
(ii) shared power to vote or direct the vote: 0
(iii) sole power to dispose or to direct the disposition of: 0
(iv) shared power to dispose or direct the disposition of: 0
CUSIP No. 12612F101 | Page 4 of 5 |
Not Applicable.
Not applicable.
Not applicable.
Not applicable.
Not applicable.
Not applicable.
CUSIP No. 12612F101 | Page 5 of 5 |
After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct.
Date: February 14, 2005 | |||||
Signature: /s/ William R. Blanton | |||||
Name: William R. Blanton |