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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number. | SEC 2270 (9-02) |
1. Title of Derivative Security (Instr. 3) |
2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) |
5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4, and 5) |
6. Date Exercisable and Expiration Date (Month/Day/Year) |
7. Title and Amount of Underlying Securities (Instr. 3 and 4) |
8. Price of Derivative Security (Instr. 5) |
9. Number of Derivative Securities Beneficially Owned at End of Issuer's Fiscal Year (Instr. 4) |
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
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(A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
MILITELLO MARY CATHERINE ONE GRIMSBY DRIVE HAMBURG, NY 14075 |
 X |  |  |  |
Michelle A. Baumgarden, Attorney in Fact for Mary Catherine Militello | 02/13/2012 | |
**Signature of Reporting Person | Date |
* | If the form is filed by more than one reporting person, see Instruction 4(b)(v). |
** | Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
(1) | The terms of the Restricted Stock Award Agreement governing the grant to Mrs. Militello of 420 shares of restricted stock on February 15, 2011 provided that the award generally vests 100% on the one-year anniversary of the award but that upon a resignation from the board, a pro-rata portion of the award would be based upon the number of months served during that one-year period. Accordingly, upon Mrs. Militello's resignation from the board on October 31, 2011, 350 shares of restricted stock became vested and the remaining 70 shares were forfeited back to the Company. |
(2) | This number also reflects shares aquired under the Evans Bancorp, Inc. Dividend Reinvestment Plan as follows: 19.6959 shares on April 4, 2011 and 23.0549 shares on October 4, 2011. |