0001104659-22-023249.txt : 20220214
0001104659-22-023249.hdr.sgml : 20220214
20220214172717
ACCESSION NUMBER: 0001104659-22-023249
CONFORMED SUBMISSION TYPE: 5
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20211231
FILED AS OF DATE: 20220214
DATE AS OF CHANGE: 20220214
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: HYATT ALAN J
CENTRAL INDEX KEY: 0001218591
FILING VALUES:
FORM TYPE: 5
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-22345
FILM NUMBER: 22635165
MAIL ADDRESS:
STREET 1: SEVERN SAVINGS BANK FSB
STREET 2: 200 WESTGATE CIRCLE, SUITE 500
CITY: ANNAPOLIS
STATE: MD
ZIP: 21401
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: SHORE BANCSHARES INC
CENTRAL INDEX KEY: 0001035092
STANDARD INDUSTRIAL CLASSIFICATION: NATIONAL COMMERCIAL BANKS [6021]
IRS NUMBER: 521974638
STATE OF INCORPORATION: MD
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 18 EAST DOVER STREET
CITY: EASTON
STATE: MD
ZIP: 21601-3013
BUSINESS PHONE: 4108221400
MAIL ADDRESS:
STREET 1: 18 EAST DOVER STREET
CITY: EASTON
STATE: MD
ZIP: 21601-3013
5
1
tm226752d2_5.xml
OWNERSHIP DOCUMENT
X0306
5
2021-12-31
0
0
0
0001035092
SHORE BANCSHARES INC
SHBI
0001218591
HYATT ALAN J
18 EAST DOVER ST.
EASTON
MD
21601
1
0
0
0
Common Stock
2021-12-17
5
G
0
3000
0
D
1066128
D
Common Stock
2021-12-28
5
G
0
500
0
D
1065628
D
Common Stock
4802
I
Spouse
Common Stock
388306
I
By Trust
Common Stock
170692
I
By Trust
Common Stock
75333
I
By Trust
Common Stock
53749
I
By Trust
Common Stock
7603
I
By Partnership
Bonafide gift to a nonprofit organization.
Include 1,341 of unvested restricted stock that will vest on 2/1/2023.
Includes 94,819 shares held in the ESOP; 367 shares of which have been added since the last filing (shares have been rounded to the nearest whole share)
Includes 849,691 shares jointly owned by Alan J. Hyatt and his spouse Sharon G. Hyatt.
These shares erroneously excluded from the Form 4 filed February 2, 2022 due to a Scribner's error.
Shares are held in the Frances G. Hyatt State Exempt Marital Trust, of which the reporting person is a co-trustee and disclaims ownership except to the extent of his pecuniary interest.
Shares are held in the Frances G. Hyatt Residuary Trust, of which the reporting person is a co-trustee and disclaims ownership except to the extent of his pecuniary interest.
Shares are held in the Louis Hyatt Revocable Trust, of which the reporting person is a co-trustee and disclaims ownership except to the extent of his pecuniary interest.
Shares are held in the Frances G. Hyatt Fed GST EX MED Trust, of which the reporting person is a co-trustee and disclaims ownership except to the extent of his pecuniary interest.
Shares are held in the Crownsville Family Limited Partnership, of which the reporting person is the general partner and disclaims ownership except to the extent of his pecuniary interest.
/s/ Edward C. Allen/POA
2022-02-14