FORM 3 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
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1. Name and Address of Reporting Person*
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 05/25/2004 |
3. Issuer Name and Ticker or Trading Symbol
FIRST PACTRUST BANCORP INC [ FPBT ] |
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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5. If Amendment, Date of Original Filed
(Month/Day/Year) |
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6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Beneficially Owned | |||
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1. Title of Security (Instr. 4) | 2. Amount of Securities Beneficially Owned (Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 4. Nature of Indirect Beneficial Ownership (Instr. 5) |
Common Stock | 206,000 | I | See Note 1 |
Common Stock | 268,000 | I | See Note 2 |
Common Stock | 43,680 | I | See Note 3 |
Common Stock | 4,300 | I | See Note 4 |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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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: Direct (D) or Indirect (I) (Instr. 5) | 6. Nature of Indirect Beneficial Ownership (Instr. 5) | ||
Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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Explanation of Responses: |
Remarks: |
1) These securities are owned by Investors of America Limited Partnership ("Investors") and may be deemed to be indirectly owned by First Capital America, Inc. ("First Capital"), James F. Dierberg, Trustee of the James F. Dierberg Living Trust Dated 20/8/85 ("JFD Lvg Trust") and James F. Dierberg II ("JFDII"). Members of the Dierberg Family and the Dierberg Family Trusts are shareholders of First Capital and First Securities America, Inc. ("FSA"), the General Partner of Investors. JFD II is the son of James F. Dierberg, the Trustee of JFD Lvg Trust. First Capital, Lvg Trust and JFD II disclaim beneficial ownership of these securities. 2) These securities are owned by First Capital and may be deemed to be indirectly owned by Investors, JFD Lvg Trust and JFD II. Members of the Dierberg Family and the Dierberg Family Trusts are shareholders of First Capital and FSA, the General Partner of Investors. JFD II is the son of James F. Dierberg, the Trustee of JFD Lvg Trust. Investors, JFD Lvg Trust and JFD II disclaim beneficial ownership of these securities. 3) These securities are owned by JFD Lvg Trust and may be deemed to be indirectly owned by Investors, First Capital and JFD II. Members of the Dierberg Family and the Dierberg Family Trusts are shareholders of First Capital and FSA, the General Partner of Investors. JFD II is the son of James F. Dierberg, the Trustee of JFD Lvg Trust. Investors, First Capital and JFD II disclaim beneficial ownership of these securities. 4) These securities are owned bay JFD II and may be deemed to be indirectly owed by Investors, First Capital and JFD Lvg Trust. Members of the Dierberg Family and Dierberg Family Trusts are shareholders of First Capital and FSA, General Partner of Investors. JFD II is the son of James F. Dierberg, the Trustee of JFD Lvg Trust; Investors First Capital and JFD Lvg Trust disclaim beneficial ownership of these securities. |
James F. Dierberg, President of First Securities America, Inc., the General Partner of Investors of America Limited Partnership | 06/29/2007 | |
** Signature of Reporting Person | Date | |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | ||
* 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). | ||
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. | ||
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 Number. |