-----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, QdFzRUFgxr490/i6QnxrwtV9AkEtaf1flLRgFlCwHuAs/f7w5/SUZZw5/1HzTeiD QbDYeKlwfHxMUuTfzXzgfA== 0001223482-04-000037.txt : 20040603 0001223482-04-000037.hdr.sgml : 20040603 20040603145653 ACCESSION NUMBER: 0001223482-04-000037 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040601 FILED AS OF DATE: 20040603 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: CARVER BANCORP INC CENTRAL INDEX KEY: 0001016178 STANDARD INDUSTRIAL CLASSIFICATION: SAVINGS INSTITUTION, FEDERALLY CHARTERED [6035] IRS NUMBER: 133904174 STATE OF INCORPORATION: DE FISCAL YEAR END: 0331 BUSINESS ADDRESS: STREET 1: 75 W 125TH ST CITY: NEW YORK STATE: NY ZIP: 10027-4512 BUSINESS PHONE: 2128764747 MAIL ADDRESS: STREET 1: 75 W 125TH ST CITY: NEW YORK STATE: NY ZIP: 10027-4512 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: TERRELL FREDERICK CENTRAL INDEX KEY: 0001203688 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-13007 FILM NUMBER: 04846974 BUSINESS ADDRESS: STREET 1: 17 STATE STREET CITY: NEW YORK STATE: NY ZIP: 10004 BUSINESS PHONE: 2122718878 MAIL ADDRESS: STREET 1: 17 STATE STREET CITY: NEW YORK STATE: NY ZIP: 10004 4 1 ter51.xml X0202 4 2004-06-01 0 0001016178 CARVER BANCORP INC CNY 0001203688 TERRELL FREDERICK 75 WEST 125TH STREET NEW YORK NY 100274512 1 0 0 0 Series B Convertible 0.00 2004-06-01 4 S 0 125000 20.00 D Common Stock 125000.00 0.00 I By Ltd Partnership Each shere can be converted into 2.083 shares of common stock (125,000) at any time. Mr. Terrell disclaims beneficial ownership of such securities. Because this is a convertible security it has no expiration date. By: Linda J. Dunn, Attorney-In-Fact 2004-06-03 -----END PRIVACY-ENHANCED MESSAGE-----