Annual Statement of Changes in Beneficial Ownership (5)
February 07 2023 - 05:37PM
Edgar (US Regulatory)
FORM 5
[ ] Check this box if no longer subject to Section
16. Form 4 or Form 5 obligations may continue. See
Instruction 1(b).
[ ] Form 3 Holdings Reported
[ ] Form 4 Transactions Reported |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
ANNUAL STATEMENT OF CHANGES IN BENEFICIAL
OWNERSHIP OF SECURITIES
|
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
|
|
1. Name
and Address of Reporting Person * Turner James S.
Jr. |
2. Issuer Name and Ticker or Trading
SymbolCapStar Financial Holdings, Inc. [CSTR] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)__X__
Director _____
10% Owner
_____ Officer (give title
below) _____ Other
(specify below)
|
(Last)
(First)
(Middle)
1201 DEMONBREUN ST, SUITE 700 |
3. Statement for Issuer's Fiscal Year Ended
(MM/DD/YYYY)
12/31/2022
|
(Street)
NASHVILLE, TN 37203
(City)
(State)
(Zip)
|
4. If Amendment, Date Original
Filed(MM/DD/YYYY)
|
6. 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
|
1.Title of Security
(Instr. 3) |
2. Trans. Date |
2A. Deemed Execution Date, if any |
3. Trans. Code
(Instr. 8) |
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5) |
5. Amount of Securities Beneficially Owned Following
Reported Transaction(s)
(Instr. 3 and 4) |
6. Ownership Form: Direct (D) or Indirect (I)
(Instr. 4) |
7. Nature of Indirect Beneficial Ownership
(Instr. 4) |
Amount |
(A) or (D) |
Price |
Common Stock |
5/19/2022 |
|
G |
61835 |
A |
$0.00 |
307037 (1) |
D |
|
Common Stock (2) |
|
|
|
|
|
|
72489 |
I |
James S. Turner |
Common Stock (2) |
|
|
|
|
|
|
96090 |
I |
Judith P Turner |
Common Stock (2) |
|
|
|
|
|
|
75643 |
I |
Family Private Trust LLC TTEE The Katherine Rose
Turner 1997 Grandchilds Trust |
Common Stock (2) |
|
|
|
|
|
|
75643 |
I |
Family Private Trust LLC TTEE The James Stephen
Turner III 2000 Grandchilds Trust |
Table II - Derivative Securities Acquired, Disposed of, or
Beneficially Owned (e.g., puts, calls, warrants, options,
convertible securities)
|
1. Title of Derivate Security
(Instr. 3) |
2. Conversion or Exercise Price of Derivative
Security |
3. Trans. Date |
3A. Deemed Execution Date, if any |
4. Trans. Code
(Instr. 8) |
5. Number of Derivative Securities Acquired (A) or
Disposed of (D)
(Instr. 3, 4 and 5) |
6. Date Exercisable and Expiration Date
(MM/DD/YYYY) |
7. Title and Amount of Securities Underlying
Derivative Security
(Instr. 3 and 4) |
8. Price of Derivative Security
(Instr. 5) |
9. Number of Derivative Securities Beneficially
Owned at End of Issuer's Fiscal Year
(Instr. 4) |
10. Ownership Form of Derivative Security: Direct
(D) or Indirect (I)
(Instr. 4) |
11. Nature of Indirect Beneficial Ownership
(Instr. 4) |
(A) |
(D) |
Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
Explanation of
Responses: |
(1) |
Includes 245,202 shares
previously reported, including shares of restricted stock, some of
which remain unvested. |
(2) |
The reporting person
disclaims beneficial ownership of these securities except to the
extent of his pecuniary interest therein, and the inclusion of
these shares in this report shall not be deemed an admission of
beneficial ownership of all of the reported shares for purposes of
Section 16 or for any other purpose. |
Reporting
Owners
|
Reporting Owner Name / Address |
Relationships
|
Director |
10% Owner |
Officer |
Other |
Turner James S. Jr.
1201 DEMONBREUN ST
SUITE 700
NASHVILLE, TN 37203 |
X |
|
|
|
Signatures
|
/s/ Jeffrey L. Moody, as Attorney-in-Fact for
James S. Turner |
|
2/7/2023 |
**Signature of Reporting
Person |
Date |
Reminder: Report on a separate line for each class
of securities beneficially owned directly or
indirectly. |
* |
If the form is filed by more than one
reporting person, see Instruction 4(b)(v). |
** |
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 is insufficient, see
Instruction 6 for procedure. |
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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