Annual Statement of Changes in Beneficial Ownership (5)
February 13 2019 - 11:26AM
Edgar (US Regulatory)
FORM 5
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue.
See
Instruction 1(b).
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Form 3 Holdings Reported
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Form 4 Transactions Reported
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0362
Estimated average burden
hours per response...
1.0
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Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
*
DERRICO GEORGIA S
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2. Issuer Name
and
Ticker or Trading Symbol
Southern National Bancorp of Virginia Inc [SONA]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director
_____ 10% Owner
__
X
__ Officer (give title below)
_____ Other (specify below)
Executive chairman
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(Last)
(First)
(Middle)
2954 BURRLAND LANE
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3. Statement for Issuer's Fiscal Year Ended
(MM/DD/YYYY)
12/31/2018
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(Street)
THE PLAINS, VA 20198
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
___ Form Filed by One Reporting Person
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X
_ Form Filed by More than One Reporting Person
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1.Title of Security
(Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code
(Instr. 8)
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4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I)
(Instr. 4)
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7. Nature of Indirect Beneficial Ownership
(Instr. 4)
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Amount
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(A) or (D)
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Price
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Common Stock
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459224
(1)
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D
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Common Stock
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750
(2)
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D
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Common Stock
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105375
(3)
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I
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By IRA
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Common Stock
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45235
(4)
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I
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By IRA
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Common Stock
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7627.65
(5)
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I
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By 401k Plan
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Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (
e.g.
, puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security
(Instr. 3)
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2. Conversion or Exercise Price of Derivative Security
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3. Trans. Date
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3A. Deemed Execution Date, if any
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4. Trans. Code
(Instr. 8)
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5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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6. Date Exercisable and Expiration Date
(MM/DD/YYYY)
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7. Title and Amount of Securities Underlying Derivative Security
(Instr. 3 and 4)
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8. Price of Derivative Security
(Instr. 5)
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9. Number of Derivative Securities Beneficially Owned at End of Issuer's Fiscal Year
(Instr. 4)
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10. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
(Instr. 4)
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11. Nature of Indirect Beneficial Ownership
(Instr. 4)
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(A)
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(D)
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Date Exercisable
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Expiration Date
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Title
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Amount or Number of Shares
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Employee Stock Option
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$7.04
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7/27/2011
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7/27/2020
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Common Stock
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10000
(6)
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10000
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D
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Employee Stock Option
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$7.2
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3/21/2012
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3/21/2021
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Common Stock
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40000
(7)
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50000
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D
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Employee Stock Option
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$7.92
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12/5/2013
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12/5/2022
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Common Stock
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40000
(8)
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90000
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D
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Employee Stock option
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$9.14
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6/21/2014
(9)
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6/21/2023
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Common Stock
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40000
(10)
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130000
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D
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Employee Stock Option
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$10.47
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7/22/2015
(11)
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7/22/2024
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Common Stock
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48000
(12)
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178000
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D
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Employee Stock Option
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$11.43
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6/19/2016
(13)
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6/19/2025
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Common Stock
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48000
(14)
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226000
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D
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Employee Stock Option
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$11.99
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6/16/2017
(15)
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6/16/2026
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Common Stock
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48000
(16)
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274000
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D
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Explanation of Responses:
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(1)
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These shares are owned jointly. Georgia S. Derrico and R. Roderick Porter are married.
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(2)
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These shares are owned by Georgia S. Derrico.
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(3)
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These shares are held in an IRA owned by Georgia S. Derrico.
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(4)
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These shares are held in an IRA owned by R. Roderick Porter
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(5)
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These shares are held in a 401k plan as follows: 3794.6065 by Georgia S. Derrico and 3833.0412 by R. Roderick Porter
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(6)
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These options are owned as follows: 5000 by Georgia S. Derrico and 5000 by R Roderick Porter
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(7)
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These options are owned as follows: 20000 by Georgia S Derrico and 20000 by R Roderick Porter
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(8)
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These options are owned as follows: 20000 by Georgia S Derrico and 20000 by R Roderick Porter
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(9)
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These options are exercisable as follows: 8000 by 6/21/14, 8000 on 6/21/15, 8000 on 6/21/16, 8000 on 6/21/17, 8000 on6/21/18
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(10)
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These options are owned as follows: 20000 by Georgia S Derrico and 20000 by R Roderick Porter
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(11)
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These options are exercisable as follows: 9600 on 7/22/15, 9600 on 7/22/16, 9600 on 7/22/17, 9600 on 7/22/18, 9600 on 7/22/16
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(12)
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The options are owned as follows: 24000 by Georgia S Derrico and 24000 by R Roderick Porter
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(13)
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These options are exercisable as follows: 9600 6/19/16, 9600 on 6/19/17, 9600 on 6/19/18, 9600 on 6/19/19, 9600 on 6/19/20
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(14)
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These options are owned as follows: 24000 by Georgia S Derrico and 24000 by R Roderick Porter
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(15)
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These options are exercisable as follows: 9600 on 6/16/17, 9600 on 6/16/18, 9600 on 6/16/19, 9600 on 6/16/20, 9600 on 6/16/21
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(16)
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These options are owned as follows: 24000 by Georgia S Derrico and 24000 by R Roderick Porter
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Reporting Owners
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Reporting Owner Name / Address
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Relationships
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Director
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10% Owner
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Officer
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Other
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DERRICO GEORGIA S
2954 BURRLAND LANE
THE PLAINS, VA 20198
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Executive chairman
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PORTER R RODERICK
2954 BURRLAND LANE
THE PLAINS, VA 20198
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Vice Chairman
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Signatures
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/s/ Georgia S. Derrico
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2/11/2019
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**
Signature of Reporting Person
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Date
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/s/ R. Roderick Porter
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2/11/2019
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**
Signature of Reporting Person
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Date
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
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*
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If the form is filed by more than one reporting person,
see
Instruction 4(b)(v).
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**
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Intentional misstatements or omissions of facts constitute Federal Criminal Violations.
See
18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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Note:
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File three copies of this Form, one of which must be manually signed. If space is insufficient,
see
Instruction 6 for procedure.
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Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number.
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