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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 | |
BARRON THOMAS A PO BOX 900 TALLAHASSEE, FL 32302 |
X | Treasurer |
Thomas A. Barron | 02/17/2005 | |
**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 voluntatarily reported by the reporting person. |
(2) | These shares were issued under a performing share award granted under the 1996 Aoosiciate Incentive Plan of Capital City Bank Group, Inc. ("The Company") in a transaction exempt from the short-swing profit liability of Section 16 pursuant to Rule 16b-33(d) promuglated thereunder. |
(3) | The reporting person disclaims beneficial ownership of the securities and this report shall not be deemed an admission that the reporting person is beneficial owner of such surities for purpose of Section 16 or for any other purposes. |
(4) | Includes 34.7181 shares of common stock that were purchased under the Company's 1997 401(k) Profit Sharing Plan and were exempt from the reporting and short swing provisions of Section 16 pursuant to Rule 16b-3(c) promuglgated thereunder. |