SEC Form 4 · accession 0001140361-16-083470

CHICOPEE BANCORP, INC. · CBNK

Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗

Reporting owner

Officer — Executive Vice President

Period of report

Oct 21, 2016

Accepted (ET)

Oct 25, 2016 · 11:40 am EDT

Rule 10b5-1 plan

unknown — predates the checkbox

Issuer CIK

0001355786

Table I — non-derivative securities

Security	Date	Code	Shares	Price	A/D	D/I	Nature of ownership
Common Stock^F1	Oct 21, 2016	J	11,459	—	D	D
Common Stock^F1	Oct 21, 2016	J	10,169	—	D	I	By 401(k)
Common Stock^F1	Oct 21, 2016	J	12,781	—	D	I	By ESOP
Common Stock^F1	Oct 21, 2016	J	1,961	—	D	I	By SERP

Security	Conv. / exercise price	Date	Code	Shares	A/D	Exercisable	Expires	Underlying	Underlying shares	D/I
Stock Options^F2	$16.55	Oct 21, 2016	J	10,000	D	Jan 22, 2014	Jan 22, 2023	Common Stock	10,000	D
Stock Options^F2	$14.21	Oct 21, 2016	J	10,000	D	Jan 25, 2013	Jan 25, 2022	Common Stock	10,000	D
Stock Options^F2	$14.29	Oct 21, 2016	J	66,954	D	Jul 26, 2008	Jul 26, 2017	Common Stock	66,954	D

F1Each share of common stock was converted into and became exchangeable for the right to receive 2.425 shares of Westfield Financial, Inc. common stock.
F2Each option was converted into an option to purchase a number of shares of Westfield Financial, Inc. common stock determined by multiplying the number of shares of Chicopee Bancorp, Inc. common stock subject to such stock option by 2.425, at a per share exercise price equal to the quotient obtained by dividing the per share exercise price for each share of Chicopee Bancorp, Inc. common stock subject to such option by 2.425.