SEC Form 4 · accession 0000763563-17-000006
CHEMUNG FINANCIAL CORP · CHMG
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
John F Potter
Director
Period of report
Jan 3, 2017
Accepted (ET)
Jan 6, 2017 · 4:17 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000763563
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| COMMON STOCKF3 | holding | — | — | — | 46,636 | D | ||
| COMMON STOCKF3,F4 | holding | — | — | — | 9,448 | I | BY SPOUSE |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| PHANTOM STOCKF3,F1,F2 | — | Jan 3, 2017 | A | 403 | A | — | — | COMMON STOCK | 403 | 32,490 | D |
Explanation of responses
- F1Security converts to common stock on a one-for-one basis.
- F2Phantom Stock Units are to be settled 100% in Issuer's Common Stock in accordance with the term's of the Company's Deferred Directors' Fee Plan and at the director's election.
- F3Includes dividends issued periodically under issuer's dividend reinvestment plan.
- F4The reporting person disclaims beneficial ownership of these securities and the report shall not be deemed an admission that the reporting person is beneficial owner of such securities for the purpose of Section 16 or for any other purpose.