SEC Form 4 · accession 0001437749-16-043621
CITIZENS & NORTHERN CORP · CZNC
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Shelley L D'Haene
Officer — EVP
Period of report
Dec 19, 2016
Accepted (ET)
Dec 21, 2016 · 11:17 am EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000810958
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock | Dec 19, 2016 | M | 420 | $22.325 | A | 4,777 | D | |
| Common Stock | Dec 19, 2016 | M | 745 | $17.50 | A | 5,522 | D | |
| Common Stock | Dec 19, 2016 | F | 874 | $25.635 | D | 4,648 | D | |
| Common Stock | holding | — | — | — | 3,175 | I | By ESOP |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Director Stock Options | $22.325 | Dec 19, 2016 | M | 420 | D | Jul 3, 2007 | Jan 3, 2017 | Common Stock | 420 | 0 | D |
| Director Stock Options | $17.50 | Dec 19, 2016 | M | 745 | D | Jul 3, 2008 | Jan 3, 2018 | Common Stock | 745 | 0 | D |
Remarks
Payment of Exercise Price by delivering securities incident to the exercise of a vested option in accordance with Rule 16b-3