3 1 fm3rodebaugh.txt SEC FORM 3 FILING --------------------------------------- OMB APPROVAL --------------------------------------- OMB Number 3235-104 Expires: December 31, 2001 Estimated average burden Hours per response...0.5 --------------------------------------- UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 FORM 3 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 RODEBAUGH MARK H. -------------------------------------------------------------------------------- (Last) (First) (Middle) 1800 MAPLE GLEN ROAD -------------------------------------------------------------------------------- (Street) SACRAMENTO CA 95864 -------------------------------------------------------------------------------- (City) (State) (Zip) ================================================================================ 2. Date of Event Requiring Statement (Month/Day/Year) 01/10/02 ================================================================================ 3. IRS or Social Security Number of Reporting Person (Voluntary) ###-##-#### ================================================================================ 4. Issuer Name and Ticker or Trading Symbol REDWOOD EMPIRE BANCORP (REBC) ================================================================================ 5. Relationship of Reporting Person to Issuer (Check all applicable) [ ] Director [ ] 10% Owner [ ] Officer (give title below) [ x ] Other (specify below) Subsidiary Director ================================================================================ 6. If Amendment, Date of Original (Month/Day/Year) ================================================================================ 7. Individual or Joint/Group Filing (Check Applicable Line) x Form Filed by One Report Person --- Form filed by More than One Reporting Person --- ================================================================================ Table I -- Non-Derivative Securities Beneficially Owned ================================================================================
-------------------------------------------------------------------------------- 1. Title of Security 2. Amount of 3. Ownership 4. Nature of (Instr. 4) Securities Form: Indirect Beneficially Direct (D) Beneficial Owned or Indirect (I) Ownership (Instr. 4) (Instr. 5) -------------------------------------------------------------------------------- Common Stock 100 D -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- --------------------------------------------------------------------------------
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. Potential persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a current valid OMB Number. (Over) SEC 1474 (3-99) FORM 3 (contined) Table II -- Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
------------------------------------------------------------------------------------------------------- 1. Title of 2. Date Exer- 3. Title and 4. Conver- 5. Owner- 6. Nature of Derivative cisable and Amount of sion or ship Indirect Security and Expira- Securities Exercise Form of Beneficial (Instr. 4) tion Date Underlying Price of Deriva- Ownership (Month/Day/ Derivative Deriva- tive (Instr. 5) Year) Security tive Security: (Instr. 4) Security Direct (D) or Indirect (I) (Instr. 5) ------------------------------------------ Date Expir- Title Amount Exer- tion or cisable Date Number of Shares ------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------- -------------------------------------------------------------------------------------------------------
Explanation of Responses: /s/ Mark H. Rodegaugh 01/10/02 ----------------------------------------------------- --------- ** 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. Potential persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a current valid OMB Number. Page 2