SEC Form 4 · accession 0001437749-17-000116
FIRST US BANCSHARES, INC. · FUSB
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Sheri S Cook
Director
Period of report
Dec 30, 2016
Accepted (ET)
Jan 4, 2017 · 2:07 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000717806
Table I — non-derivative securities
No Table I lines on this filing.
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Phantom Stock UnitsF2,F1,F3 | — | Dec 30, 2016 | A | 99 | A | — | — | Common Stock | 99 | 947 | D |
Explanation of responses
- F1The units convert to common stock on a 1-for-1 basis.
- F2Includes 1.34 shares attributable to quarterly dividends accrued under the United Security Bancshares, Inc. Non-Employee Directors' Deferred Compensation Plan.
- F3The phantom stock units were accrued under the United Security Bancshares, Inc. Non-Employee Directors' Deferred Compensation Plan and are to be settled in common stock at the end of the deferral period.