-----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, Hdv4iN3RSJS2h+H2AW3hWLu1Z+qfoLmlAFfzSknQS3dNhkYnERO40l8z/hFVM+HN IRlq2XwVtIztbrCAv/ALKw== 0000950130-00-000368.txt : 20000203 0000950130-00-000368.hdr.sgml : 20000203 ACCESSION NUMBER: 0000950130-00-000368 CONFORMED SUBMISSION TYPE: 5/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 19991231 FILED AS OF DATE: 20000202 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: LAKELAND BANCORP INC CENTRAL INDEX KEY: 0000846901 STANDARD INDUSTRIAL CLASSIFICATION: STATE COMMERCIAL BANKS [6022] IRS NUMBER: 222953275 STATE OF INCORPORATION: NJ FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 5/A SEC ACT: SEC FILE NUMBER: 000-17820 FILM NUMBER: 520140 BUSINESS ADDRESS: STREET 1: 250 OAK RIDGE RD CITY: OAK RIDGE STATE: NJ ZIP: 07438 BUSINESS PHONE: 9736972000 MAIL ADDRESS: STREET 1: 250 OAK RIDGE RD CITY: OAKRIDGE STATE: NJ ZIP: 07438 COMPANY DATA: COMPANY CONFORMED NAME: BOHUNY BRUCE G CENTRAL INDEX KEY: 0001077736 STANDARD INDUSTRIAL CLASSIFICATION: [] DIRECTOR STATE OF INCORPORATION: NJ FILING VALUES: FORM TYPE: 5/A BUSINESS ADDRESS: STREET 1: LAKELAND BANK STREET 2: 250 OAK RIDGE RD CITY: OAK RIDGE STATE: NJ ZIP: 07438 BUSINESS PHONE: 9736972000 MAIL ADDRESS: STREET 1: LAKELAND BANK STREET 2: 250 OAK RIDGE RD CITY: OAK RIDGE STATE: NJ ZIP: 07438 5/A 1 ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP FORM 5 /------------------------------/ / OMB APPROVAL / /------------------------------/ / OMB Number: 3235-0362 / / Expires: February 1, 1994 / / Estimated average burden / / hours per response...... 1.0 / /------------------------------/ +--------+ U.S. | FORM 5 | 1 of 3 SECURITIES AND EXCHANGE COMMISSION +--------+ Washington, D.C. 20549 [_] Check box if no longer subject ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP to Section 16. Form 4 or Form 5 Filed pursuant to Section 16(a) of the Securities obligations may Exchange Act of 1934, Section 17(a) of the continue. See Public Utility Holding Company Act of 1935 or Instruction 1(b). Section 30(f) of the Investment Company Act of 1940 [_] Form 3 Holdings Reported [_] Form 4 Transactions Reported - -------------------------------------------------------------------------------- 1. Name and Address of Reporting Person BOHUNY, BRUCE G. ---------------------------------------------------------------------------- (Last) (First) (Middle) C/O LAKELAND BANCORP, INC. 250 OAK RIDGE ROAD ---------------------------------------------------------------------------- (Street) OAK RIDGE, N.J. 07438 ---------------------------------------------------------------------------- (City) (State) (Zip) 2. Issuer Name and Ticker or Trading Symbol LAKELAND BANCORP, INC. ----------------------------------- 3. I.R.S. or Social Security Number of Reporting Person (Voluntary) ###-##-#### -------------- 4. Statement for Month/Year 12/99 --------------------------------------------------- 5. If Amendment, Date of Original (Month/Year) 12/98 -------------------------------- 6. Relationship of Reporting Person to Issuer (Check all applicable) [X] Director [X] Officer [ ] 10% Owner [ ] Other (give title below) (specify below) VICE PRESIDENT 1.07 -------------- - ------------------------------------------------------------------------------- Table I--Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
- ------------------------------------------------------------------------------------------------------------------------------------ 1. Title of Security 2. Trans- 3. Trans- 4. Securities Acquired (A) 5. Amount of 6. Owner- 7. Nature (Instr. 3) action action or Disposed of (D) Securities ship of In- Date Code (Instr. 3, 4 and 5) Beneficially Form: direct LAKELAND BANCORP, INC. (Month/ (Instr. 8) Owned at the Direct Bene- Day/ end of (D) or ficial Year) Issuer's Indirect Owner- (A) or Fiscal Year (I) ship Amount (D) Price (Instr. 3 and 4) (Instr. 4) (Instr. 4) - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ COMMON 2/15/99 DRP 63 A 19.00 D *1 - ------------------------------------------------------------------------------------------------------------------------------------ " 5/15/99 DRP 69 A 17.75 D *1 - ------------------------------------------------------------------------------------------------------------------------------------ " 8/16/99 G 168 A N/K D *1 - ------------------------------------------------------------------------------------------------------------------------------------ " 12/15/99 P 50 A N/K D *1 - ------------------------------------------------------------------------------------------------------------------------------------ " 7/15/99 J 5,652 A 15.50 107,792 D *1 - ------------------------------------------------------------------------------------------------------------------------------------ " 2/15/99 DRP 64 A 19.00 I *2 - ------------------------------------------------------------------------------------------------------------------------------------ " 5/14/99 DRP 69 A 17.75 I *2 - ------------------------------------------------------------------------------------------------------------------------------------ " 8/19/99 DRP 82 A 14.87 I *2 - ------------------------------------------------------------------------------------------------------------------------------------ " 11/15/99 DRP 89 A 15.50 16,533 I *2 - ------------------------------------------------------------------------------------------------------------------------------------ " 8/16/99 G 383 D N/K 383 I *3 - ------------------------------------------------------------------------------------------------------------------------------------ Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
FORM 5 (continued) Table II--Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
- ----------------------------------------------------------------------------------------------------------------------------- 1. Title of Derivative 2. Conver- 3. Trans- 4. Transac- 5. Number of Deriv- Security (Instr. 3) sion or action tion Code ative Securities Exercise Date (Instr. 8) Acquired (A) or Price of (Month/ Disposed of (D) Deriv- Day/ (Instr. 3, 4, and 5) ative Year) Security --------------------------- (A) (D) - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ------------------------------------------------------------------------------------------------------------------------------------ 6. Date Exer- 7. Title and Amount of 8. Price 9. Number 10. Owner- 11. Na- cisable and Underlying Securities of of Deriv- ship ture Expiration (Instr. 3 and 4) Deriv- ative of De- of In- Date ative Secur- rivative direct (Month/Day/ Secur- ities Secu- Bene- Year) ity Bene- rity: ficial (Instr. 5) ficially Direct Owner- -------------------------------------------- Owned (D) or ship Date Expira- Amount or at End Indi- (Instr. 4) Exer- tion Title Number of of Year rect (1) cisable Date Shares (Instr. 4) (Instr. 4) - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------
Explanation of Responses: /s/ Bruce G. Bohuny 1-26-2000 -------------------------------- ----------------- **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. /------------------------------/ / OMB APPROVAL / /------------------------------/ / OMB Number: 3235-0362 / / Expires: February 1, 1994 / / Estimated average burden / / hours per response...... 1.0 / /------------------------------/ +--------+ U.S. | FORM 5 | 2 of 3 SECURITIES AND EXCHANGE COMMISSION +--------+ Washington, D.C. 20549 [_] Check box if no longer subject ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP to Section 16. Form 4 or Form 5 Filed pursuant to Section 16(a) of the Securities obligations may Exchange Act of 1934, Section 17(a) of the continue. See Public Utility Holding Company Act of 1935 or Instruction 1(b). Section 30(f) of the Investment Company Act of 1940 [_] Form 3 Holdings Reported [_] Form 4 Transactions Reported - -------------------------------------------------------------------------------- 1. Name and Address of Reporting Person BOHUNY BRUCE G. ---------------------------------------------------------------------------- (Last) (First) (Middle) C/O LAKELAND BANCORP, INC. 250 OAK RIDGE ROAD ---------------------------------------------------------------------------- (Street) OAK RIDGE, N.J. 07438 ---------------------------------------------------------------------------- (City) (State) (Zip) 2. Issuer Name and Ticker or Trading Symbol LAKELAND BANCORP, INC. ----------------------------------- 3. I.R.S. or Social Security Number of Reporting Person (Voluntary) ###-##-#### -------------- 4. Statement for Month/Year 12/99 --------------------------------------------------- 5. If Amendment, Date of Original (Month/Year) 12/98 -------------------------------- 6. Relationship of Reporting Person to Issuer (Check all applicable) [X] Director [X] Officer [_] 10% Owner [_] Other (give title below) (specify below) VICE PRESIDENT 1.07 -------------- - ------------------------------------------------------------------------------- Table I--Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
- ------------------------------------------------------------------------------------------------------------------------------------ 1. Title of Security 2. Trans- 3. Trans- 4. Securities Acquired (A) 5. Amount of 6. Owner- 7. Nature (Instr. 3) action action or Disposed of (D) Securities ship of In- Date Code (Instr. 3, 4 and 5) Beneficially Form: direct LAKELAND BANCORP, INC. (Month/ (Instr. 8) Owned at Direct Bene- Day/ End of (D) or ficial Year) Issuer's Indirect Owner- (A) or Fiscal Year (I) ship Amount (D) Price (Instr. 3 and 4) (Instr. 4) (Instr. 4) - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ COMMON 12/31/98 3,198 I *4 - ------------------------------------------------------------------------------------------------------------------------------------ " 2/15/98 DRP 5 A 19.00 I *5 - ------------------------------------------------------------------------------------------------------------------------------------ " 5/14/99 DRP 6 A 17.75 I *5 - ------------------------------------------------------------------------------------------------------------------------------------ " 8/19/99 DRP 6 A 14.87 I *5 - ------------------------------------------------------------------------------------------------------------------------------------ " 11/15/99 DRP 7 A 13.85 1,257 I *5 - ------------------------------------------------------------------------------------------------------------------------------------ " 12/31/99 T 8,251 D N/K 0 I *6 - ------------------------------------------------------------------------------------------------------------------------------------ " 2/15/99 5 A 19.00 I *7 - ------------------------------------------------------------------------------------------------------------------------------------ " 5/14/99 6 A 17.75 I *7 - ------------------------------------------------------------------------------------------------------------------------------------ " 8/19/99 7 A 14.87 I *7 - ------------------------------------------------------------------------------------------------------------------------------------ " 11/15/99 8 A 13.85 1,392 I *7 - ------------------------------------------------------------------------------------------------------------------------------------ Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
FORM 5 (continued) Table II--Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
- ----------------------------------------------------------------------------------------------------------------------------- 1. Title of Derivative 2. Conver- 3. Trans- 4. Transac- 5. Number of Deriv- Security (Instr. 3) sion or action tion Code ative Securities Exercise Date (Instr. 8) Acquired (A) or Price of (Month/ Disposed of (D) Deriv- Day/ (Instr. 3, 4, and 5) ative Year) Security --------------------------- (A) (D) - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - -----------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------ 6. Date Exer- 7. Title and Amount of 8. Price 9. Number 10. Owner- 11. Na- cisable and Underlying Securities of of Deriv- ship ture Expiration (Instr. 3 and 4) Deriv- ative of De- of In- Date ative Secur- rivative direct (Month/Day/ Secur- ities Secu- Bene- Year) ity Bene- rity: ficial (Instr. 5) ficially Direct Owner- -------------------------------------------- Owned (D) or ship Date Expira- Amount or at End Indi- (Instr. 4) Exer- tion Title Number of of Year rect (1) cisable Date Shares (Instr. 4) (Instr. 4) - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------
Explanation of Responses: *1 Owned solely by Bruce G. Bohuny *2 Owned solely by Judy Bohuny, wife of Bruce G. Bohuny *3 Owned by Est. of Emma Bohuny, Bruce G. Bohuny - executor *4 Held by Merrill Lynch - Bruce G. Bohuny, owner *5 Held in name of Brooks - Bruce G. Bohuny, owner *6 Held in name of Bruce D. Bohuny, son of Bruce G. Bohuny *7 Held in name of Zurick Group - Bruce G. Bohuny, partner /s/ Bruce G. Bohuny 1-26-2000 -------------------------------- ----------------- **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. /------------------------------/ / OMB APPROVAL / /------------------------------/ / OMB Number: 3235-0362 / / Expires: February 1, 1994 / / Estimated average burden / / hours per response...... 1.0 / /------------------------------/ +--------+ U.S. | FORM 5 | 3 of 3 SECURITIES AND EXCHANGE COMMISSION +--------+ Washington, D.C. 20549 [_] Check box if no longer subject ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP to Section 16. Form 4 or Form 5 Filed pursuant to Section 16(a) of the Securities obligations may Exchange Act of 1934, Section 17(a) of the continue. See Public Utility Holding Company Act of 1935 or Instruction 1(b). Section 30(f) of the Investment Company Act of 1940 [_] Form 3 Holdings Reported [_] Form 4 Transactions Reported - -------------------------------------------------------------------------------- 1. Name and Address of Reporting Person BOHUNY BRUCE G. ---------------------------------------------------------------------------- (Last) (First) (Middle) C/O LAKELAND BANCORP, INC. 250 OAK RIDGE ROAD ---------------------------------------------------------------------------- (Street) OAK RIDGE, N.J. 07438 ---------------------------------------------------------------------------- (City) (State) (Zip) 2. Issuer Name and Ticker or Trading Symbol LAKELAND BANCORP, INC. ----------------------------------- 3. I.R.S. or Social Security Number of Reporting Person (Voluntary) ###-##-#### ----------- 4. Statement for Month/Year 12/99 --------------------------------------------------- 5. If Amendment, Date of Original (Month/Year) 12/98 -------------------------------- 6. Relationship of Reporting Person to Issuer (Check all applicable) [X] Director [X] Officer [_] 10% Owner [_] Other (give title below) (specify below) VICE PRESIDENT 1.07 -------------- - ------------------------------------------------------------------------------- Table I--Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
- ------------------------------------------------------------------------------------------------------------------------------------ 1. Title of Security 2. Trans- 3. Trans- 4. Securities Acquired (A) 5. Amount of 6. Owner- 7. Nature (Instr. 3) action action or Disposed of (D) Securities ship of In- Date Code (Instr. 3, 4 and 5) Beneficially Form: direct (Month/ (Instr. 8) Owned at Direct Bene- LAKELAND BANCORP, INC. Day/ End of (D) or ficial Year) Issuer's Indirect Owner- (A) or Fiscal Year (I) ship Amount (D) Price (Instr. 3 and 4) (Instr. 4) (Instr. 4) - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ COMMON 7/15/99 J 5200 A 15.50 5200 I *8 - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly
FORM 5 (continued) Table II--Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
- ----------------------------------------------------------------------------------------------------------------------------- 1. Title of Derivative 2. Conver- 3. Trans- 4. Transac- 5. Number of Deriv- Security (Instr. 3) sion or action tion Code ative Securities Exercise Date (Instr. 8) Acquired (A) or Price of (Month/ Disposed of (D) Deriv- Day/ (Instr. 3, 4, and 5) ative Year) Security --------------------------- (A) (D) - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - -----------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------ 6. Date Exer- 7. Title and Amount of 8. Price 9. Number 10. Owner- 11. Na- cisable and Underlying Securities of of Deriv- ship ture Expiration (Instr. 3 and 4) Deriv- ative of De- of In- Date ative Secur- rivative direct (Month/Day/ Secur- ities Secu- Bene- Year) ity Bene- rity: ficial (Instr. 5) ficially Direct Owner- -------------------------------------------- Owned (D) or ship Date Expira- Amount or at End Indi- (Instr. 4) Exer- tion Title Number of of Year rect (1) cisable Date Shares (Instr. 4) (Instr. 4) - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------
Explanation of Responses: G - Gift DRP - Dividend Reinvestment Plan P - Purchase J - Acquired through merger of High Point with Lakeland Bancorp /s/ Bruce G. Bohuny 1-26-2000 -------------------------------- ----------------- **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. -----END PRIVACY-ENHANCED MESSAGE-----