0001496877-18-000003.txt : 20180110 0001496877-18-000003.hdr.sgml : 20180110 20180110135359 ACCESSION NUMBER: 0001496877-18-000003 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20180104 FILED AS OF DATE: 20180110 DATE AS OF CHANGE: 20180110 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Michelotti Peter A CENTRAL INDEX KEY: 0001726952 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-12569 FILM NUMBER: 18521119 MAIL ADDRESS: STREET 1: 12 HOYT ST CITY: MADISON STATE: NJ ZIP: 07940 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: 1231 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 3 1 primary_doc.xml PRIMARY DOCUMENT X0206 3 2018-01-04 0 0001028954 SUSSEX BANCORP SBBX 0001726952 Michelotti Peter A C/O SUSSEX BANCORP 399 ROUTE 23 FRANKLIN NJ 07416 1 1 0 0 SEVP and Chief Operating Off. Common Stock 13675 D Common Stock 90 I by Wife Common Stock 2000 I by 401k Common Stock 21847 I by Corporation Shares held by a corporation of which the reporting person is a shareholder. The reporting person disclaims beneficial ownership of the reported securities except to the extent of his pecuniary interest therein. The inclusion of these shares in this report shall not be deemed an admission of beneficial ownership of all of the reported shares for the purposes of Section 16 or for any other purposes. Linda Kuipers, Attorney-in-Fact 2018-01-10