-----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, DYJkOC+VAC5fXgrxvaMBKqi6hPUgItxE5rMOVWtwi80Q8ZxKHBVJpeVB6Lyn1rZa cR5ISY4JBhUxtG/AhqNj2Q== 0000950144-02-007256.txt : 20020709 0000950144-02-007256.hdr.sgml : 20020709 20020708180304 ACCESSION NUMBER: 0000950144-02-007256 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20020626 FILED AS OF DATE: 20020709 COMPANY DATA: COMPANY CONFORMED NAME: HERBERT ADAM W JR CENTRAL INDEX KEY: 0001177175 DIRECTOR FILING VALUES: FORM TYPE: 3 MAIL ADDRESS: STREET 1: 10901 BURNT MILL ROAD STREET 2: APT. 1001 CITY: JACKSONVILLE STATE: FL ZIP: 32256-2856 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: FLORIDA BANKS INC CENTRAL INDEX KEY: 0001058802 STANDARD INDUSTRIAL CLASSIFICATION: NATIONAL COMMERCIAL BANKS [6021] IRS NUMBER: 582364573 STATE OF INCORPORATION: FL FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 333-50867 FILM NUMBER: 02698205 BUSINESS ADDRESS: STREET 1: 5210 BELFORT ROAD SUITE 310 CITY: JACKSONVILLE STATE: FL ZIP: 32256 BUSINESS PHONE: 9042962329 MAIL ADDRESS: STREET 1: 5210 BELFORT ROAD SUITE CITY: JACKSONVILLE STATE: FL ZIP: 32256 3 1 g77177e3.htm FLORIDA BANKS/ADAM HERBERT, JR Florida Banks/Adam Herbert, Jr
 

FORM 3

U.S. SECURITIES AND EXCHANGE COMMISSION

Washington, DC 20549
         
INITIAL 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(f) of the Investment Company Act of 1940
                 
1. Name and Address of Reporting Person(1)   2. Date of Event Requiring Statement
(Month/Day/Year) 		  4. Issuer Name and Ticker or Trading Symbol
      Florida Banks, Inc. (FLBK)
(Last)(First)(Middle)
 
Herbert, Jr. Adam W.
  6/26/02  
5. Relationship of Reporting Person to Issuer

(Check all applicable)
  		      6. If Amendment, Date of Original
(Month/Day/Year)
(Street)
10901 Burnt Mill Rd., Apt. 1001
  3. IRS Number of Reporting Person, (Voluntary)
  		  x Director
o  Officer (give title below)
  		  o 10% Owner
o  Other (specify below)
  		   
(City)(State)(Zip)
 
Jacksonville, Florida 32256-2856
              7. Individual or Joint/Group Filing (Check applicable line)
x  Form filed by One Reporting Person
o  Form filed by
More Than
One Reporting
Person
TABLE I — NON-DERIVATIVE SECURITIES BENEFICIALLY OWNED
             
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.  4)
Common Stock
  200   D    
 
           
 
           
 
           
 
           
 
           
 
           
 
           

(1)  If the form is filed by more than one Reporting Person, see Instruction 5(b)(v).

Reminder:  Report on a separate line for each class of securities beneficially owned directly or indirectly.

(Print or Type Responses)

(Over)

 

FORM 3 (continued)

Table  II — Derivative Securities Beneficially Owned

(e.g., Puts, Calls, Warrants, Options, Convertible Securities)
                     
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)
 
   
Date
Exercisable 		 
Expiration
Date 		 

Title 		  Amount or
Number of Shares 		   
                     
 
                   
 
                   
 
                   
 
                   
 
                   
 
                   
 
                   
 
                   
  
         
    /s/ Adam W. Herbert, Jr.   July 5, 2002
   
 
    ** Signature of Reporting Person 
  		  Date

         ** 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 provided

is insufficient, See Instruction 6 for procedure.
Page 2
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