-----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, ABf1PaKdNiP+G6IS95QuVZ6RtQ/K0VNCG1NUQWPAnHVwe1/Zyudu6LYqMD664uz/ FgZh1I01AqCDd0s16pvdlw== 0000895813-02-000138.txt : 20020712 0000895813-02-000138.hdr.sgml : 20020711 20020711172530 ACCESSION NUMBER: 0000895813-02-000138 CONFORMED SUBMISSION TYPE: 5/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20011231 FILED AS OF DATE: 20020711 COMPANY DATA: COMPANY CONFORMED NAME: BONNELL STEPHEN C CENTRAL INDEX KEY: 0001079775 OFFICER FILING VALUES: FORM TYPE: 5/A BUSINESS ADDRESS: STREET 1: N28 W22367 FOX WOOD LANE CITY: WAUKESHA STATE: WI ZIP: 53186 MAIL ADDRESS: STREET 1: N28 W22367 FOX WOOD LANE CITY: WAUKESHA STATE: WI ZIP: 53186 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: CIB MARINE BANCSHARES INC CENTRAL INDEX KEY: 0000861955 STANDARD INDUSTRIAL CLASSIFICATION: STATE COMMERCIAL BANKS [6022] IRS NUMBER: 371203599 STATE OF INCORPORATION: WI FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 5/A SEC ACT: 1934 Act SEC FILE NUMBER: 000-24149 FILM NUMBER: 02701356 BUSINESS ADDRESS: STREET 1: N27 W24025 PAUL COURT CITY: PEWAUKEE STATE: WI ZIP: 53072 BUSINESS PHONE: 4146956010 MAIL ADDRESS: STREET 1: N27 W24025 PAUL COURT CITY: PEWAUKEE STATE: WI ZIP: 53072 FORMER COMPANY: FORMER CONFORMED NAME: CENTRAL ILLINOIS BANCORP INC DATE OF NAME CHANGE: 19980427 5/A 1 x5-bonnel.txt UNITED STATES SECURITIES AND EXCHANGE COMMISSION WASHINGTON, D.C. 20549 FORM 5 ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP ( ) Check box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instructions 1(b). ( ) Form 3 Holdings Reported. ( ) Form 4 Transactions Reported. 1. Name and Address of Reporting Person: Bonnell, Stephen C. N28 W22367 Foxwood Lane Waukesha, WI 53186 2. Issuer Name and Ticker or Trading Symbol: CIB Marine Bancshares, Inc. (not listed) 3. IRS or Social Security Number of Reporting Person (Voluntary): 4. Statement for Month/Year: December, 2001 5. If Amendment, Date of Original (Month/Year): December, 2001 6. Relationship of Reporting Person(s) to Issuer (Check all applicable): ( ) Director ( ) 10% Owner (x) Officer (give title below) ( ) Other (specify below) Senior Vice President 7. Individual or Joint/Group Filing (Check Applicable Line): (x) Form filed by One Reporting Person ( ) Form filed by More than One Reporting Person
TABLE I - NON-DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED 5. Amount of Securities 6. 7. 2. Beneficially Ownership Nature of 1. Transaction 3. 4. Owned at End Form; Direct Indirect Title of Date Transaction Securities Acquired (A) or of Issuer's (D) or Beneficial Security (Month/Day/ Code Disposed of (D) Fiscal Year Indirect (I) Ownership (Instr. 3) Year) (Instr. 8) (Instr. 3, 4 and 5) (Instr. 3 and 4) (Instr. 4) (Instr. 4) ---------- ----------- ----------- -------------------------- ---------------- ------------ ---------- Code V Amount (A) or (D) Price ---- - ------ ---------- ----- Common Stock 11,550 D Common Stock 11,390.3(1) I By ESOP
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., Puts, Calls, Warrants, Options, Convertible Securities) 9. Number of 10. deriva- Ownership 5. tive Form of 11. Number of Securi- Deriva- Nature Derivative ties tive of 2. Securities 7. 8. Benefi- Security: Indirect Conversion 4. Acquired Title and Price of cially Direct Benefi- 1. or 3. Trans- (A) or 6. Amount of Deriva- Owned at (D) or cial Title of Exercise Transac- action Disposed Date Exercisable Underlying tive End Indirect Owner- Derivative Price of tion Date Code of (D) and Expiration Securities Security of Year (I) ship Security Derivative (Month/ (Instr. (Instr. 3, Date (Month/ (Instr. 3 (Instr. (Instr. (Instr. (Instr. (Instr. 3) Security Day/Year) 8) 4 or 5) Day/Year) and 4) 5) 4) 4) 4) ---------- ---------- --------- ------- ----------- ---------------- -------------- ------- --------- --------- -------- Amount or Date Expira- Number Exer- tion of (A) (D) cisable Date Title Shares ----- ----- ------- ------- ----- ------ Employee $4.95 (2) 06/30/03 Common 11,250 11,250 D Stock Stock Option (right to buy)(2) Employee $8.50 (3) 01/01/05 Common 7,500 7,500 D Stock Stock Option (right to buy)(3) Employee $10.87 (4) 04/25/06 Common 11,700 11,700 D Stock Stock Option (right to buy)(4) Employee $13.07 (5) 02/25/08 Common 13,200 13,200 D Stock Stock Option (right to buy)(5) Employee $16.23 (6) 07/29/09 Common 6,900 6,900 D Stock Stock Option (right to buy)(6) Employee $18.40 (7) 07/27/10 Common 9,881 9,881 D Stock Stock Option (right to buy)(7) Employee $22.89 11/29/01 A 5,912 (8) 11/29/11 Common 8,912 8,912 D Stock Stock Option (right to buy)(8) Explanation of Responses: (1) Represents shares allocated to the reporting person, at 12/31/01, pursuant to the issuer's ESOP. The amount reported was amended in July 2002 based upon information received from the ESOP's third party administrator. (2) The employee stock option vests in five equal annual installments which began on June 30, 1994. (3) The employee stock option vests in five equal annual installments which began on January 1, 1996. (4) The employee stock option vests in five equal annual installments which began on April 25, 1997. (5) The employee stock option vests in five equal annual installments which began on February 25, 1999. (6) The employee stock option vests in five equal annual installments which began on July 29, 2000. (7) The employee stock option vests in five equal annual installments beginning on July 27, 2001. (8) The employee stock option vests in five equal annual installments beginning on November 29, 2002.
/s/ Stephen C. Bonnell July 10, 2002 ----------------------------- ------------- Signature of Reporting Person Date
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