3 1 form3-012402.txt DATE OF EVENT: 01/23/02 -------- ---------------------------- FORM 3 U.S. SECURITIES AND EXCHANGE COMMISSION OMB APPROVAL -------- Washington, D.C. 20549 ---------------------------- OMB Number: 3235-0104 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES Expires: December 31, 2001 Estimated average burden Filed pursuant to Section 16(a) of the Securities Exchange hours per response.......0.5 Act of 1934 Section 17(a) of the Public Utility Holding ---------------------------- Company Act of 1935 or Section 30(f) of the Investment Company Act of 1940
(Print or Type Responses) ________________________________________________________________________________ 1. Name and Address of Reporting Person* Johnson, Eugene B. -------------------------------------------------------------------------------- (Last) (First) (Middle) c/o FairPoint Communications, Inc. 521 East Morehead Street, Suite 250 -------------------------------------------------------------------------------- (Street) Charlotte NC 28202 -------------------------------------------------------------------------------- (City) (State) (Zip) ________________________________________________________________________________ 2. Date of Event Requiring Statement (Month/Day/Year) 01/23/02 ________________________________________________________________________________ 3. IRS Identification Number of Reporting Person, if an entity (voluntary) ________________________________________________________________________________ 4. Issuer Name and Ticker or Trading Symbol Choice One Communications Inc. (CWON) ________________________________________________________________________________ 5. Relationship of Reporting Person(s) to Issuer (Check all applicable) |X| Director |_| 10% Owner |_| Officer (give title below) |_| Other (specify below) ________________________________________________________________________________ 6. If Amendment, Date of Original (Month/Day/Year) ________________________________________________________________________________ 7. Individual or Joint/Group Filing (Check Applicable Line) |X| Form Filed by One Reporting Person |_| Form Filed by More Than One Reporting Person ________________________________________________________________________________
------------------------------------------------------------------------------------------------------------------------------------ Table I -- Non-Derivative Securities Beneficially Owned ------------------------------------------------------------------------------------------------------------------------------------ 1. Title of Security 2. Amount of Securities 3. Ownership Form: 4. Nature of Indirect Beneficial Ownership (Instr. 4) Beneficially Owned Direct (D) or (Instr. 5) (Instr. 4) Indirect (I) (Instr. 5) ------------------------------------------------------------------------------------------------------------------------------------ No securities owned. (1) ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. * If the Form is filed by more than one reporting person, see Instruction 5(b)(v).
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FORM 3 (continued) Table II -- Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) ------------------------------------------------------------------------------------------------------------------------------------ 1. Title of Derivative 2. Date Exercisable 3. Title and Amount of Securities 4. Conver- 5. Owner- 6. Nature of Security (Instr. 4) and Expiration Date Underlying Derivative Security sion or ship Indirect (Month/Day/Year) (Instr. 4) Exercise Form of Beneficial ---------------------- --------------------------------- Price of Derivative Ownership Date Expira- Amount Derivative Security: (Instr. 5) Exer- tion or Security Direct cisable Date Title Number (D) or of Indirect Shares (I) (Instr. 5) ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ Explanation of Responses: (1) Reporting Person is the Chief Executive Officer of FairPoint Communications, Inc. ("FairPoint") and FairPoint Communications Solutions Corp. ("FairPoint Solutions"), a wholly owned subsidiary of FairPoint. Reporting Person was appointed as a director pursuant to FairPoint Solutions' right to nominate a director to the Issuer's Board of Directors. Reporting Person disclaims beneficial ownership of all shares of common stock beneficially owned by FairPoint and FairPoint Solutions. ** Intentional misstatements or omissions of facts constitute /s/ Eugene B. Johnson January 24, 2002 Federal Criminal Violations. --------------------------- ------------------- See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). Name: Eugene B. Johnson Date Title: Chief Executive Officer Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, See Instruction 6 for this procedure.
Potential persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. Page 2 of 2