-----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, LKtXAiIJNzG5ddQwdtmjQHf0SCYQtj5u90tSqElVKXg4tYRVEg3UFaHFhYInvK3i JZUMjbpxfhYLSPEUtM4Glw== 0001217555-05-000007.txt : 20050110 0001217555-05-000007.hdr.sgml : 20050110 20050110190525 ACCESSION NUMBER: 0001217555-05-000007 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 19990101 FILED AS OF DATE: 20050110 DATE AS OF CHANGE: 20050110 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: PAYNE DOYCE G MD CENTRAL INDEX KEY: 0001239618 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-30497 FILM NUMBER: 05521956 BUSINESS ADDRESS: STREET 1: C/O CORNERSTONE COMMUNITY BANK STREET 2: 6401 LEE HIGHWAY STE B CITY: CHATTANOOGA STATE: TN ZIP: 37421 BUSINESS PHONE: 4233853000 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: CORNERSTONE BANCSHARES INC CENTRAL INDEX KEY: 0001038773 STANDARD INDUSTRIAL CLASSIFICATION: NATIONAL COMMERCIAL BANKS [6021] IRS NUMBER: 621175427 STATE OF INCORPORATION: TN FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 4154 RINGGOLD RD CITY: CHATTANOOGA STATE: TN ZIP: 37412-416 BUSINESS PHONE: 4236982454 MAIL ADDRESS: STREET 1: 4154 RINGGOLD RD CITY: CHATTANOOGA STATE: TN ZIP: 37412-0416 FORMER COMPANY: FORMER CONFORMED NAME: EAST RIDGE BANCSHARES INC DATE OF NAME CHANGE: 19970507 4 1 primary_doc.xml PRIMARY DOCUMENT X0202 4 1999-01-01 0 0001038773 CORNERSTONE BANCSHARES INC csbq 0001239618 PAYNE DOYCE G MD 1 0 0 0 Common Stock 2005-01-10 2005-01-10 4 P 0 5000 15 A 56680 D Common Stock 6000 I Owned by Spouse Stock Option 5.28 2005-03-01 2006-03-01 Cornerstone Bancshares Inc 0 21000 D Exercise prices range from $5.00 to $10.88 The exercise date is determined by a two year vesting schedule, 50% the end of the 1st year, 50% the end of the 2nd year The expiration dates of the options range from 02/01/2006 to 03/01/2014 \s\ Doyce G Payne MD 2005-01-10 -----END PRIVACY-ENHANCED MESSAGE-----