-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, SmXUTU004yraknAGPdd9aWdx28EtOtYm8OdRhYWJBiZlgjOkRxzea+8n7GEsiC/G Ip5MwVsn19nZEKOGFgHyXQ== 0000908834-96-000321.txt : 19961224 0000908834-96-000321.hdr.sgml : 19961224 ACCESSION NUMBER: 0000908834-96-000321 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 19961223 SROS: NASD SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: RIVER VALLEY BANCORP CENTRAL INDEX KEY: 0001015593 STANDARD INDUSTRIAL CLASSIFICATION: SAVINGS INSTITUTION, FEDERALLY CHARTERED [6035] IRS NUMBER: 351984567 STATE OF INCORPORATION: IN FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 000-21765 FILM NUMBER: 96685207 BUSINESS ADDRESS: STREET 1: 303 CLIFTY DR CITY: MADISON STATE: IN ZIP: 47250 BUSINESS PHONE: 8122734949 MAIL ADDRESS: STREET 1: 303 CLIFTY DR CITY: MADISON STATE: IN ZIP: 47250 COMPANY DATA: COMPANY CONFORMED NAME: FOUSE LARRY C CENTRAL INDEX KEY: 0001029473 STANDARD INDUSTRIAL CLASSIFICATION: [] OFFICER STATE OF INCORPORATION: IN FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 BUSINESS ADDRESS: STREET 1: RIVER VALLEY BANCORP STREET 2: 303 CLIFTY DRIVE CITY: MADISON STATE: IN ZIP: 47250 BUSINESS PHONE: 8122734949 3 1 FORM 3 - 12/20/1996 U.S. SECURITIES AND EXCHANGE COMMISSION WASHINGTON, D.C. 20549 FORM 3 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES 1. Name and Address of Reporting Person Fouse, Larry C. 7007 Carl Ross Drive Charlestown, Indiana 47111 2. Date of Event Requiring Statement (Month/Day/Year) 12/20/1996 3. IRS or Social Security Number of Reporting Person (Voluntary) 4. Issuer Name and Ticker or Trading Symbol River Valley Bancorp RIVR 5. Relationship of Reporting Person to Issuer (Check all applicable) ( ) Director ( ) 10% Owner (X) Officer (give title below) ( ) Other (specify below) Chief Financial Officer; Controller (1) 6. If Amendment, Date of Original (Month/Day/Year)
___________________________________________________________________________________________________________________________________ Table I -- Non-Derivative Securities Beneficially Owned | ___________________________________________________________________________________________________________________________________| 1. Title of Security |2. Amount of |3. Ownership |4. Nature of Indirect | | Securities | Form: | Beneficial Ownership | | Beneficially | Direct(D) or | | | Owned | Indirect(I) | | ___________________________________________________________________________________________________________________________________| Common Stock, without par value |107 |D | | - -----------------------------------------------------------------------------------------------------------------------------------| ___________________________________________________________________________________________________________________________________| ___________________________________________________________________________________________________________________________________ Table II -- Derivative Securitites Beneficially Owned | ___________________________________________________________________________________________________________________________________| 1.Title of Derivative |2.Date Exer- |3.Title and Amount | |4. Conver-|5. Owner- |6. Nature of Indirect | Security | cisable and | of Underlying | |sion or |ship: | Beneficial Ownership | | Expiration | Securities | |exercise |Form of | | | Date(Month/ |-----------------------|---------|price of |Deriv- | | | Day/Year) | |Amount |deri- |ative | | | Date | Expira- | |or |vative |Security: | | | Exer- | tion | Title |Number of|Security |Direct(D) or | | | cisable | Date | |Shares | |Indirect(I) | | ___________________________________________________________________________________________________________________________________| ___________________________________________________________________________________________________________________________________|
Explanation of Responses: (1) Chief Financial Officer and Controller of Citizens National Bank of Madison SIGNATURE OF REPORTING PERSON /s/ Larry C. Fouse DATE 12/20/96 -----END PRIVACY-ENHANCED MESSAGE-----