FORM 4 o
Check
this box if no longer subject to Section 16.
Form 4 or Form 5 obligations may continue. |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549
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OMB APPROVAL |
OMB
Number: 3235-0287 |
1. Name and Address of Reporting Person *
(Last)
(First)
(Middle)
(Street)
(City)
(State) (Zip)
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2. Issuer Name and Ticker Mid-State
Bancshares
3. I.R.S.
Identification N/A
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4. Statement for March 5, 2003
N/A |
6. Relationship of Reporting Person(s) to Issuer (Check all applicable) Director
10% Owner
X Officer (give title below)
Other (specify below) Executive Vice President/Chief Credit Officer
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned |
1. Title of Security |
2. Transaction Date
(Month/Day/ |
2A. Deemed Execution Date,
if any (Month/Day/ |
3. Transaction Code |
4. Securities Acquired (A)
or Disposed of (D) |
5. Amount of Securities
Beneficially Owned Following Reported Transaction(s) |
6. Ownership Form: Direct
(D) or Indirect (I) |
7. Nature of Indirect
Beneficial Ownership |
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Code |
V |
Amount |
(A) or (D) |
Price |
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Common Stock |
03/04/2003 |
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P |
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11.2545 |
A |
$16.620018 |
3,269.522234 Shrs |
D/401(k) Plan |
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Common Stock |
03/04/2003 |
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P |
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22.50901 |
A |
$16.620011 |
3,292.031244 Shrs |
D/401(k) Plan |
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Table II - Derivative Securities Acquired, Disposed of, or Beneficially
Owned |
1. Title of Derivative Security (Instr. 3) |
2. Conversion or Exercise Price of Derivative Security |
3. Transaction Date |
3A. Deemed Execution Date,
if any (Month/Day/ |
4. Transaction Code (Instr. 8) |
5. Number of Derivative
Securities Acquired (A) or Disposed of (D) |
6. Date Exercisable and
Expiration Date |
7. Title and Amount of
Underlying Securities |
8. Price of Derivative
Security |
9. Number of Derivative
Securities Beneficially Owned Following Reported Transaction(s) |
10. Ownership Form of
Derivative Securities: Direct (D) or Indirect (I) |
11. Nature of Indirect
Beneficial Ownership |
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Code |
V |
(A) |
(D) |
Date |
Expiration |
Title |
Amount or Number of Shares |
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Incentive |
$17.40 |
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03/13/2003 |
03/13/2012 |
Common |
5,000 |
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1,000 Shrs |
I |
By |
Non- |
$17.10 |
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02/19/2003 |
02/19/2013 |
Common |
10,322 |
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0 Shrs |
I |
By |
Incentive |
$17.10 |
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02/19/2003 |
02/19/2013 |
Common Stock |
7,663 |
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0 Shrs |
I |
By |
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Explanation
of Responses: (1) Options vest 20% per year on the anniversary date of the grant for five (5) years at which time the option is 100% vested. Optionee has another five (5) years from the five (5) year 100% vesting anniversary date to exercise the shares in accordance with the terms and conditions of the 1996 Stock Option Plan. (2) 1,000 shares will vest on March 13, 2003 bringing the total number of vested shares available for exercise to 1,000 shares. (3) 17,985 shares granted as an ISO under the 1996 Stock Option Plan. Due to the $100K limitation, 10,322 shares were issued and treated as a non-qualified option, the remaining 7,663 shares were issued and treated as an ISO. |
/s/ Harry H. Sackrider ** Signature of Reporting Person |
03/05/2003 Date |
Reminder: Report on a separate
line for each class of securities beneficially owned directly or indirectly.
* 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).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
http://www.sec.gov/divisions/corpfin/forms/form4.htm
Last update: 09/05/2002