0001104659-23-000403.txt : 20230103 0001104659-23-000403.hdr.sgml : 20230103 20230103170707 ACCESSION NUMBER: 0001104659-23-000403 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20221231 FILED AS OF DATE: 20230103 DATE AS OF CHANGE: 20230103 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: 23503117 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 tm231386-1_5seq1.xml OWNERSHIP DOCUMENT X0306 5 2022-12-31 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 2022-12-09 5 G 0 300 0 D 1068494 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 Gift to a nonprofit organization. Includes 849,691 shares jointly owned by Alan J. Hyatt and his spouse Sharon G. Hyatt. Includes 32.5816 shares acquired through the Company's Dividend Reinvestment Plan. 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/ Vance W. Adkins/POA 2023-01-03