-----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, TTGAxqsYAPz10bYI09TMJp33yqMitvZamaX7YzYhkn/LS8yW7o6ZH2msXLSLKn60 kVeVthjcrhFayauUQLEp8A== 0001104659-02-005419.txt : 20021108 0001104659-02-005419.hdr.sgml : 20021108 20021108161425 ACCESSION NUMBER: 0001104659-02-005419 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20021104 FILED AS OF DATE: 20021108 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: MID-STATE BANCSHARES CENTRAL INDEX KEY: 0001027324 STANDARD INDUSTRIAL CLASSIFICATION: STATE COMMERCIAL BANKS [6022] IRS NUMBER: 770442667 STATE OF INCORPORATION: CA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-23925 FILM NUMBER: 02814374 BUSINESS ADDRESS: STREET 1: 1026 GRAND AVE CITY: ARROYO GRANDE STATE: CA ZIP: 93420 BUSINESS PHONE: 8054737700 MAIL ADDRESS: STREET 1: 1026 GRAND AVE CITY: ARROYO GRANDE STATE: CA ZIP: 93420 FORMER COMPANY: FORMER CONFORMED NAME: BSM BANCORP DATE OF NAME CHANGE: 19961121 FORMER COMPANY: FORMER CONFORMED NAME: MID STATE BANCSHARES DATE OF NAME CHANGE: 19980820 REPORTING-OWNER: COMPANY DATA: COMPANY CONFORMED NAME: DIANI A J CENTRAL INDEX KEY: 0001198902 RELATIONSHIP: DIRECTOR FILING VALUES: FORM TYPE: 4 BUSINESS ADDRESS: STREET 1: MID-STATE BANCSHARES STREET 2: POST OFFICE BOX 580 CITY: ARROYO GRANDE STATE: CA ZIP: 93421-0580 BUSINESS PHONE: 8054736829 MAIL ADDRESS: STREET 1: MID-STATE BANCSHARES STREET 2: POST OFFICE BOX 580 CITY: ARROYO GRANDE STATE: CA ZIP: 93421-0580 4 1 j5882_4.htm 4

FORM 4

  X  Check this box if no longer subject to Section 16.  Form 4 or Form 5 obligations may continue.
See Instruction 1(b).

(Print or Type Responses)

UNITED STATES SECURITIES AND EXCHANGE COMMISSION

Washington, D.C.  20549


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

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 1. Name and Address of Reporting Person *



Diani       A.       J.

(Last)            (First)              (Middle)


1026 Grand Avenue

(Street)


Arroyo Grande       CA       93420

(City)       (State)          (Zip)

 

 2. Issuer Name and Ticker
    or Trading Symbol

Mid State Bancshares

MDST

 

 

 3. I.R.S. Identification
    Number of Reporting
    Person, if an entity
    (voluntary)

###-##-####

 4. Statement for
 (Month/Day/Year)

November 4, 2002

 



 5. If Amendment, Date of
   Original (Month/Day/Year)



 6. Relationship of Reporting Person(s) to Issuer

(Check all applicable)

  X  Director

 

      10% Owner

 

      Officer (give title below)

 

      Other (specify below)

 

 


 7. Individual or Joint/Group
     Filing (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

 

1. Title of Security
(Instr. 3)

2. Transaction Date (Month/Day/
Year)

2A. Deemed Execution Date, if any (Month/Day/
Year)

3. Transaction Code
(Instr. 8)

4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)

5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)

6. Ownership Form: Direct (D) or Indirect (I)
(Instr. 4)

7. Nature of Indirect Beneficial Ownership
(Instr. 4)

Code

V

Amount

(A) or (D)

Price

A. J. Diani TR UA Dtd Sep 10, 1979/A. J. Diani Trust

N/A

 

 

 

 

 

 

155,175 Shrs

D

 

A. J. Diani & Gayle Diani

JT TEN

N/A

 

 

 

 

 

 

20,000 Shrs

D

 

TOTAL SHARES HELD:

 

 

 

 

 

 

 

175,175 Shrs

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


 

Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)

 

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 Securities: Direct (D) or Indirect (I)
(Instr. 4)

11. Nature of Indirect Beneficial Ownership
(Instr. 4)

Code

V

(A)

(D)

Date
Exercisable

Expiration
Date

Title

Amount or Number of Shares

Common Stock Option

 

None Excercised

 

 

 

 

 

8/12/99

8/12/08

Mid-State Bancshares

20,000 Shrs

$15.50 per Shr

16,000 Shrs Vested at 10/31/02

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Explanation of Responses:

 Final Report - Mr. A. J. Diani, Vice Chairman/Director, passed away on October 31, 2002

 

 

 

 

/s/ Marlene Weeks for A. J. Diani

** Signature of Reporting Person

11/7/02

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

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