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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 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 1474 (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 Following Reported Transaction(s) (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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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
SMITH WILLIAM G JR P.O. BOX 900 TALLAHASSEE, FL 32302 |
X | X | Chairman, President and CEO |
William G. Smith, Jr. | 01/29/2004 | |
**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) | This transaction is exempt from Section 16 reporting and is being voluntarily reported by the reporting person. |
(2) | These shares were issued under a performance share award granted under the 1996 Associate Incentive Plan of Capital City Bank Group, Inc. ("the Company") in a transaction exempt from the short-swing profit liability provisions of Section 16 pursuant to Rule 16b-3(d) promulgated thereunder. |
(3) | These shares are adjusted for the 5 for 4 stock split in the form of a stock dividend effective June 13, 2003. |
(4) | Includes 275.57 of common stock acquired during the fiscal year 2003 pursuant to the Company's 1996 Dividenf Reinvestment Plan. These acquisitions were exempt from the reporting and short-swing profit liabilty provisions of Section 16 pursuant to Rule 16a-11 promulgated thereunder. |
(5) | The rporting person disclaims beneficial ownership of these shares and this report shall not be deemed an admission that the reporting person is beneficial owner of such securities. |
(6) | Includes 4.892 of coomon stock acquired during the fiscal year 2003 pursuant to the Company's 1996 Dividend Reinvestment Plan. These acquisitions were exempt from the reporting and short-swing profit liabilty provisions of Section 16 pursuant to Rule 16a-11 promulgated thereunder. |
(7) | Includes 49.507 of common stock acquired during the fiscal year 2003 pursuant to the Company's 1996 Dividend Reinvestment Plan. These shares were exempt from the reporting and short-swing profit liabliity provisions of Section 16 pursuant to Rule 16a-11 promulgated thereunder. |
(8) | Includes 46.519 of common stock acquired during the fiscal year 2003 to the Company's 1995 Dividend Reinvestment Plan. These acquisitions wew exempt from the reporting and short-swing profit liability provisions of Section 16 pursuant to Rule 16a-11 promulgated thereunder. |
(9) | Includes 466.26 of common stock acquired during the fiscal year 2003 pursuant to the Company's 1996 Dividend Reinvestment Plan. These acquisitions were exempt from the reporting and short-swing liability provisions of Section 16 pursuant 16a-11 promulgated thereunder. |
(10) | Includes 16.817 of common stock acquired during the fiscal year 2003 pursuant to the Company's 1996 Dividend Reinvestment Plan. These acquisitions were exempt from the reporting and short-swing profit liability provisions of Section 16 pursuant Rule 16a-11 promulgated thereunder. |
(11) | Includes 49.168 of common stock acquired during the fiscal year 2003 pursuant to the Company's 1996 Dividend Reinvestment Plan. These acquisitions were exempt from the reporting and short-swing profit liability provisions of Section 16 pursuant to Rule 16a-11 promulgated thereunder. |