UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549INITIAL STATEMENT OF 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. | SEC 1473 (7-02) | ||
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. |
1. Title of Derivative Security (Instr. 4) |
2. Date Exercisable and Expiration Date (Month/Day/Year) |
3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) |
4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 5) |
6. Nature of Indirect Beneficial Ownership (Instr. 5) |
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Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
SMITH DOUGLAS WILLIAMS 3042 HAWKS GLEN TALLAHASSEE, FL 32312 |
X |
/s/ Douglas Williams Smith | 06/17/2013 | |
**Signature of Reporting Person | Date |
* | If the form is filed by more than one reporting person, see Instruction 5(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) | Robert H. Smith, the owner of 2,003,780 shares of Capital City Bank Group, Inc., common stock, died on May 28, 2013. On June 5, 2013, the Reporting Person was appointed as a co-personal representative to the decedent's estate, which is a 10% owner. Pursuant to SEC rules, the Reporting Person, as the co-personal representative of the decedent's estate, is deemed to be a 10% owner. As the Reporting Person does not have a pecuniary interest in the securities held by the decedent's estate, the shares held by the decedent's estate have not been reported as holdings of the Reporting Person. |