0001496877-12-000075.txt : 20121130 0001496877-12-000075.hdr.sgml : 20121130 20121130110824 ACCESSION NUMBER: 0001496877-12-000075 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20121128 FILED AS OF DATE: 20121130 DATE AS OF CHANGE: 20121130 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Ursin John E CENTRAL INDEX KEY: 0001555311 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-12569 FILM NUMBER: 121233551 MAIL ADDRESS: STREET 1: C/O SUSSEX BANCORP STREET 2: 399 ROUTE 23 CITY: FRANKLIN STATE: NJ ZIP: 07416 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: SUSSEX BANCORP CENTRAL INDEX KEY: 0001028954 STANDARD INDUSTRIAL CLASSIFICATION: STATE COMMERCIAL BANKS [6022] IRS NUMBER: 223475473 STATE OF INCORPORATION: NJ FISCAL YEAR END: 0427 BUSINESS ADDRESS: STREET 1: 399 RTE 23 CITY: FRANKLIN STATE: NJ ZIP: 07416 BUSINESS PHONE: 9738272914 MAIL ADDRESS: STREET 1: 399 RTE 23 CITY: FRANKLIN STATE: NJ ZIP: 07416 4 1 primary_doc.xml PRIMARY DOCUMENT X0306 4 2012-11-28 0 0001028954 SUSSEX BANCORP SBBX 0001555311 Ursin John E C/O SUSSEX BANCORP 399 ROUTE 23 FRANKLIN NJ 07416 1 0 0 0 Common Stock 2012-11-28 4 P 0 272.73 5.5 A 1498.65 I by Director Deferred Compensation Agreement Common Stock 10000 I By IRA Common Stock 300 I By IRA - Spouse These shares represent phantom stock units issued pursuant to the Company's Amended and Restated Directors Deferred Comepnsation Agreement due to the deferral of director's fees earned by the reporting person. Each share of phantom stock is payable in one share of common stock upon the reporting person's termination of service as a director. Linda Kuipers, Attorney-in-Fact 2012-11-30