0001003297-12-000448.txt : 20121023 0001003297-12-000448.hdr.sgml : 20121023 20121023111625 ACCESSION NUMBER: 0001003297-12-000448 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20121022 FILED AS OF DATE: 20121023 DATE AS OF CHANGE: 20121023 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SMITHEAL GREEN III CENTRAL INDEX KEY: 0001241533 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-11709 FILM NUMBER: 121155935 MAIL ADDRESS: STREET 1: 1090 VALLEY ROAD CITY: DYERSBURG STATE: TN ZIP: 38024 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: FIRST CITIZENS BANCSHARES INC /TN/ CENTRAL INDEX KEY: 0000719264 STANDARD INDUSTRIAL CLASSIFICATION: STATE COMMERCIAL BANKS [6022] IRS NUMBER: 621180360 STATE OF INCORPORATION: TN FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: COURT ST STREET 2: P O BOX 370 CITY: DYERSBURG STATE: TN ZIP: 38024-0370 BUSINESS PHONE: 9012854410 MAIL ADDRESS: STREET 1: P O BOX 370 CITY: DYERSBURG STATE: TN ZIP: 38025-0370 4 1 smithheal.xml PRIMARY DOCUMENT X0306 4 2012-10-22 0000719264 FIRST CITIZENS BANCSHARES INC /TN/ FIZN 0001241533 SMITHEAL GREEN III 1090 VALLEY ROAD DYERSBURG TN 38024 1 0 0 0 Common Capital Stock 2012-10-22 2012-10-22 4 P 0 1334 39 A 3407 I Spouse Common Capital Stock 30655 D /s/ Green Smitheal III 2012-10-22