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

                                                                                  

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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 *

Bartholomew James R

2. Issuer Name and Ticker or Trading Symbol

Embassy Bancorp, Inc. [emyb]

5. Relationship of Reporting Person(s) to Issuer (Check all applicable)

_____ Director                      _____ 10% Owner
__ X __ Officer (give title below)      _____ Other (specify below)
Executive Vice President, SLO

(Last)          (First)          (Middle)

100 GATEWAY DRIVE, SUITE 100

3. Statement for Issuer's Fiscal Year Ended (MM/DD/YYYY)
12/31/2016 
(Street)

BETHLEHEM, PA 18017

(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                 4076.7453   (1) D    
Common Stock                 17578   I   By IRA  
Common Stock                 62.6505   (2) I   Footnote   (3)
Common Stock                 61.7179   (4) I   Footnote   (5)

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 33.0958 shares acquired on 9/30/2016 pursuant to a dividend reinvestment feature under the Embassy Bancorp, Inc. Dividend Reinvestment and Stock Purchase Plan.
( 2)  Includes 0.7538 shares acquired on 9/30/2016 pursuant to a dividend reinvestment feature under the Embassy Bancorp, Inc. Dividend Reinvestment and Stock Purchase Plan.
( 3)  By spouse as custodian for Grandson under UGMA PA.
( 4)  Includes 0.7426 shares acquired on 9/30/2016 pursuant to a dividend reinvestment feature under the Embassy Bancorp, Inc. Dividend Reinvestment and Stock Purchase Plan.
( 5)  By spouse as custodian for Granddaughter under UGMA PA.

Reporting Owners
Reporting Owner Name / Address
Relationships
Director 10% Owner Officer Other
Bartholomew James R
100 GATEWAY DRIVE, SUITE 100
BETHLEHEM, PA 18017


Executive Vice President, SLO

Signatures
Laura A. Suplee for James R. Bartholomew under Power of Attorney dated May 15, 2015 2/14/2017
** 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.
Embassy Bancorp (QX) (USOTC:EMYB)
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