SEC Form 4 · accession 0001667682-16-000004
Embassy Bancorp, Inc. · EMYB
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Patti Gates Smith
Director
Period of report
May 27, 2016
Accepted (ET)
Jun 1, 2016 · 2:07 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001449794
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | May 27, 2016 | J | 1,577 | $0.00 | D | 0 | I | Footnote |
| Common StockF2 | holding | — | — | — | 237,866 | I | Footnote | |
| Common Stock | holding | — | — | — | 3,067 | I | By IRA |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1The reporting person is co-trustee of the Elmer D. Gates Revocable Trust, of which she is co-beneficiary. On May 27, 2016, the reporting person caused the trust to distribute 3,154 shares of Embassy Bancorp, Inc. common stock to beneficiaries of the trust, including 1,577 shares to the Patti G. Smith Living Trust, of which the reporting person is the trustee and beneficiary.
- F2By self as trustee of the Patti G. Smith Living Trust, which reflects shares acquired in the distribution described in Footnote 1.