Statement of Changes in Beneficial Ownership (4)
October 27 2017 - 11:36AM
Edgar (US Regulatory)
FORM 4
[ ]
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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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0287
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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
*
NICHOLSON JOHN F JR
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2. Issuer Name
and
Ticker or Trading Symbol
FIRST SOUTH BANCORP INC /VA/
[
FSBK
]
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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)
EVP - Chief Credit Officer
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(Last)
(First)
(Middle)
103 S. DIMOCK ROAD
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3. Date of Earliest Transaction
(MM/DD/YYYY)
10/25/2017
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(Street)
WASHINGTON, NC 27889
(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)
_
X
_ Form filed by One Reporting Person
___ 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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Code
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V
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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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2000
(1)
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D
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Common Stock
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10/25/2017
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M
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3000
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A
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$10.91
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4000
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D
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Common Stock
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10/25/2017
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M
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6000
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A
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$5.40
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10000
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D
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Common Stock
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25262
(2)
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I
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By 401(k)
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Common Stock
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12000
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I
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By IRA
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Table II - Derivative Securities 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
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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 Following Reported Transaction(s) (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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Code
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V
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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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Right to Buy Options -ISO
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$10.91
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10/25/2017
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M
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3000
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(3)
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2/25/2020
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Common Stock
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3000
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$0
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0
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D
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Right to Buy Options -ISO
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$5.40
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10/25/2017
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M
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6000
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(4)
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2/28/2021
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Common Stock
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6000
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$0
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0
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D
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Explanation of Responses:
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(1)
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2,000 shares of Restricted Stock were granted on February 14, 2014. The shares vest and become earned in four equal annual installments of 500 shares each, beginning on February 14, 2015. The final vesting date of the last 500 share installment was accelerated to September 30, 2017, in connection with the pending merger of First South Bancorp, Inc., with and into Carolina Financial Corporation.
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(2)
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Between the date of Reporting Person's last Form 4 filing (2/14/14) and the date of the current filing, a total of 4,442 shares of the Issuer's common stock were acquired under the 401(k) plan.
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(3)
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The option vested and became exercisable in three equal annual installments beginning on February 25, 2011, as follows: 1,000 of the shares subject to the option vested on each of February 25, 2011, 2012, and 2013.
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(4)
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The option vested and became exercisable in three equal annual installments beginning on February 28, 2012, as follows: 2,000 of the shares subject to the option vested on each of February 28, 2012, 2013, and 2014.
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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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NICHOLSON JOHN F JR
103 S. DIMOCK ROAD
WASHINGTON, NC 27889
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EVP - Chief Credit Officer
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Signatures
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/s/ John F. Nicholson, Jr.
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10/27/2017
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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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