-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, SeVnFuM688KdXMmCBTIQkpgACa0siabgWVDyMSkE4jk7PZR64EY2ROAq/rsZjqG6 2p6KhjtSC2loQlsCQ4wgyg== 0000946275-03-000087.txt : 20030210 0000946275-03-000087.hdr.sgml : 20030210 20030210145329 ACCESSION NUMBER: 0000946275-03-000087 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20021231 FILED AS OF DATE: 20030210 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: NORWOOD FINANCIAL CORP CENTRAL INDEX KEY: 0001013272 STANDARD INDUSTRIAL CLASSIFICATION: STATE COMMERCIAL BANKS [6022] IRS NUMBER: 232828306 STATE OF INCORPORATION: PA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 000-28364 FILM NUMBER: 03547019 BUSINESS ADDRESS: STREET 1: 717 MAIN ST STREET 2: PO BOX 269 CITY: HONESDALE STATE: PA ZIP: 18431 BUSINESS PHONE: 7172531455 REPORTING-OWNER: COMPANY DATA: COMPANY CONFORMED NAME: DAVIS WILLIAM W JR CENTRAL INDEX KEY: 0001192350 RELATIONSHIP: OFFICER FILING VALUES: FORM TYPE: 5 BUSINESS ADDRESS: STREET 1: P O BOX 269 STREET 2: 717 MAIN ST CITY: HONESDALE STATE: PA ZIP: 18431 BUSINESS PHONE: 6702531455 MAIL ADDRESS: STREET 1: P O BOX 269 STREET 2: 717 MAIN ST CITY: HONESDALE STATE: PA ZIP: 18431 5 1 f5_123102-0160davis.txt FORM 5 WILLIAM W. DAVIS, JR. ------------------------------ OMB APPROVAL ------------------------------ OMB Number 3235-0362 Expires: January 31, 2005 Estimated average burden hours per response ....... 1.0 ------------------------------ U.S. SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 FORM 5 ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP 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 [ ] Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). [ ] Form 3 Holdings Reported [ ] Form 4 Transactions Reported ================================================================================ 1. Name and Address of Reporting Person* DAVIS, JR. WILLIAM W. - -------------------------------------------------------------------------------- (Last) (First) (Middle) 717 MAIN STREET - -------------------------------------------------------------------------------- (Street) HONESDALE PA 18431 - -------------------------------------------------------------------------------- (City) (State) (Zip) ================================================================================ 2. Issuer Name and Ticker or Trading Symbol NORWOOD FINANCIAL CORP / NWFL ================================================================================ 3. I.R.S. Identification Number of Reporting Person, if an entity (Voluntary) -- ================================================================================ 4. Statement for Month/Year DECEMBER 2002 ================================================================================ 5. If Amendment, Date of Original (Month/Year) -- ================================================================================ 6. Relationship of Reporting Person(s) to Issuer (Check all applicable) [ X ] Director [ ] 10% Owner [ X ] Officer (give title below) [ ] Other (specify below) PRESIDENT AND CHIEF EXECUTIVE OFFICER ================================================================================ 7. Individual or Joint/Group Reporting (Check Applicable line) [ X ] Form filed by One Reporting Person [ ] Form filed by More than One Reporting Person ================================================================================ Table I -- Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned ================================================================================
5. 6. 4. Amount of Owner- Securities Acquired (A) or Securities ship 2A. 3. Disposed of (D) Beneficially Form: 7. Deemed Transaction (Instr. 3, 4 and 5) Owned at end Direct Nature of 2. Execution Code ------------------------------- of Issuer's (D) or Indirect 1. Transaction Date (Instr. 8) (A) Fiscal Year Indirect Beneficial Title of Security Date if any Amount or Price (Instr. 3 (I) Ownership (Instr. 3) (mm/dd/yy) (mm/dd/yy) (D) and 4) (Instr.4) (Instr. 4) - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ COMMON 12/31/02 A 847 A $16.39 5,213 I ESOP - ------------------------------------------------------------------------------------------------------------------------------------ 12,026 D - ------------------------------------------------------------------------------------------------------------------------------------ 4,000 I IRA - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ ==================================================================================================================================== *If the form is filed by more than one reporting person, see Instruction 4(b)(v). Persons who respond to the collection of information contained (Over) in this form are not required to respond unless the form displays SEC 2270 (9-02) a currently valid OMB control number.
FORM 5 (continued) Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) ================================================================================
9. 10. Number Owner- of ship 2. Deriv- of Conver- 5. 7. ative Deriv- 11. sion Number of Title and Amount Secur- ative Nature or 3A. Derivative 6. of Underlying 8. ities Secur- of Exer- Deemed 4. Securities Date Securities Price Bene- ity: In- cise 3. Exe- Trans- Acquired (A) Exercisable and (Instr. 3 and 4) of ficially Direct direct Price Trans- cution action or Disposed Expiration Date ---------------- Deriv- Owned (D) or Bene- 1. of action Date Code of(D) (Month/Day/Year) Amount ative at End In- ficial Title of Deriv- Date if any (Instr. (Instr. 3, ---------------- or Secur- of direct Owner- Derivative ative (Month/ Month/ 8) 4 and 5) Date Expira- Number ity Year (I) ship Security Secur- Day/ Day/ ------------ Exer- tion of (Instr. (Instr. (Instr. (Instr. (Instr. 3) ity Year) Year) (A) (D) cisable Date Title Shares 5) 4) 4) 4) - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ OPTIONS - RIGHT-TO-BUY COMMON 18,500 D - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ ====================================================================================================================================
Explanation of Responses: BY: LEWIS J. CRITELLI /S/WILLIAM W. DAVIS, JR. ATTORNEY-IN-FACT FEBRUARY 6, 2003 - ------------------------------------------------ --------------------- **Signature of Reporting Person Date ** 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 provided is insufficient, see Instruction 6 for procedure. Potential persons who are to respond to the collections of information contained in this form are not required to respond unless the form displays a currently valid OMB number. Page 2 SEC 2270 (9-02) -----END PRIVACY-ENHANCED MESSAGE-----