SEC Form 4 · accession 0001140361-16-048681
SURREY BANCORP · SYRB
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Edward C Ashby III
Officer — President & CEO · Director
Period of report
Dec 7, 2015
Accepted (ET)
Jan 26, 2016 · 3:46 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001229146
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock | Dec 7, 2015 | P | 312 | $12.50 | A | 451 | I | Trustee for granddaughter |
| Common Stock | holding | — | — | — | 81,505 | D | ||
| Common Stock | holding | — | — | — | 55,748 | I | Held in an IRA for Mr. Ashby | |
| Common Stock | holding | — | — | — | 5,016 | I | Held by Wife | |
| Common Stock | holding | — | — | — | 939 | I | Trustee for grandson |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Series A 4.5% Convertible Cumulative Perpetural PreferredF3,F1,F2 | — | holding | — | — | — | — | — | Common Stock | 11,684 | 5,090 | D |
| Series D 5.0% Convertible Non-cumulative Perpetual PreferredF4,F1,F2 | — | holding | — | — | — | — | — | Common Stock | 19,420 | 17,655 | D |
Explanation of responses
- F1Convertible into common stock
- F2Perpetual Preferred Stock
- F3Series A 4.5% Convertible Non-cumulative Perpetual Preferred Stock is convertible into 2.2955 shares of common stock per share
- F4Series A 5.0% Convertible Non-cumulative Perpetual Preferred Stock is convertible into 1.1000 shares of common stock per share