-----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, QVuZbsYvF0g8E6ioh068O6b//LXRAYIUqLBvlFe5ibnUtaGFt4SGHFwh02etY3h7 be7TqBLFtbFuesnoxiC0WA== 0000905729-01-500228.txt : 20020412 0000905729-01-500228.hdr.sgml : 20020412 ACCESSION NUMBER: 0000905729-01-500228 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20011130 FILED AS OF DATE: 20011210 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: CHEMICAL FINANCIAL CORP CENTRAL INDEX KEY: 0000019612 STANDARD INDUSTRIAL CLASSIFICATION: STATE COMMERCIAL BANKS [6022] IRS NUMBER: 382022454 STATE OF INCORPORATION: MI FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-08185 FILM NUMBER: 1810016 BUSINESS ADDRESS: STREET 1: 333 E MAIN ST CITY: MIDLAND STATE: MI ZIP: 48640 BUSINESS PHONE: 5176313310 COMPANY DATA: COMPANY CONFORMED NAME: SMITH DAN L CENTRAL INDEX KEY: 0001015757 STANDARD INDUSTRIAL CLASSIFICATION: NATIONAL COMMERCIAL BANKS [6021] DIRECTOR STATE OF INCORPORATION: MI FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 BUSINESS ADDRESS: STREET 1: 823 RIVERVIEW DR CITY: BENTON HARBOR STATE: MI ZIP: 49022 BUSINESS PHONE: 6169272251 MAIL ADDRESS: STREET 1: 823 RIVERVIEW DR STREET 2: C/O SHORELINE BANK P O BOX 1248 CITY: BENTON HARBOR STATE: MI ZIP: 49022 4 1 smithform4121001.htm FORM 4 FORM 4

FORM 4

UNITED STATES SECURITIES AND EXCHANGE COMMISSION

 
OMB APPROVAL

[   ] Check this box if no longer
       subject to Section 16. Form 4 or
       Form 5 obligations may continue.
       See Instruction 1(b).

Washington, D.C. 20549
 
STATEMENT OF CHANGES IN

OMB Number                  3235-0287
Expires:             December 31, 2001
Estimated average burden
hours per response                      0.5

(Print or Type Responses)

BENEFICIAL OWNERSHIP

 

Filed pursuant to Section 16(a) of the Securities Exchange 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

1.    Name and Address of Reporting Person*
 
Smith                        Dan                          L.
        (Last)                                        (First)                                   (Middle)
4.    Statement for Month/Year
 
    11/01
 
 
 
823 Riverview Drive
                                                        (Street)

5.    If Amendment, Date of Original (Month/Year)

    12/01

 
 
Benton Harbor             Michigan              49022
        (City)                                        (State)                                   (Zip)
 
2.    Issuer Name and Ticker or Trading Symbol  
 
     Chemical Financial Corporation (CHFC)
6.    Relationship of Reporting Person(s) to Issuer
                                    (Check all applicable)
   X       Director                                          10% Owner
            Officer (give title                  X          Other (specify below)
                           below)
                     
 Officer of Principal Business Unit
3.    I.R.S. or Social Security Number of Reporting Person (Voluntary)
 
 
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 Acquired, Disposed of, or Beneficially Owned
 
1. Title of Security
    (Instr. 3)
2. Transaction
    Date
    (Month/
    Day/
    Year)
3. Transaction
    Code
    (Instr. 8)
4. Securities Acquired (A)
    or Disposed of (D)
    (Instr. 3, 4 and 5)
5. Amount of
    Securities
    Beneficially
    Owned at
    End of
    Month
    (Instr. 3
    and 4)
6. Ownership
    Form: Di-
    rect (D) or
    Indirect (I)
    (Instr. 4)
7. Nature of
    Indirect
    Beneficial
    Ownership
    (Instr. 4)
    Code V Amount (A) or (D) Price      
Common Stock
11/09/01
J(1)
 
1,096
D
n/a
See below
I
By wife Trust  
Common Stock
11/27/01
G
 V
100 
D
n/a 
10,900 (2)
I
By wife Trust 
Common Stock
 11/09/01
J(1)  
 1,096
A
 n/a
See below
I
By Family Limited Partnership
Common Stock
11/21/01
S  
1,096
D
$29.00
0 (2)
I
By Family Limited Partnership
Common Stock            
49,643
D
 
Common Stock            
6,572.332
I
401(k) Plan


(1) Change in form of beneficial ownership exempt from Section 16.

(2) The reporting person disclaims beneficial ownership of all shares owned by his wife.





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 4(b)(v).

  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 control number.



Form 4 (continued) Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
 
1. Title of Derivative Security
    (Instr. 3)
2. Conversion
    or Exercise
    Price of
    Derivative
    Security
3. Transaction
    Date
    (Month/
    Day/
    Year)
4. Transaction
    Code
    (Instr. 8)
5. Number of Deriva-
    tive Securities Ac-
    quired (A) or Dis-
    posed of (D)
    (Instr. 3, 4, and 5)
6. Date Exercisable
    and Expiration Date
    (Month/Day/Year)
       
Code
 
V
 
(A)
 
(D)
Date
Exercisable
Expiration
Date
                 
                 
                 
                 
                 
                 
                 
7. Title and Amount of
Underlying Securities (Instr. 3 and 4)
8. Price of Derivative Securitie(Instr. 5) 9. Number of derivative Securities Beneficially Owned at End of Month (Instr. 4) 10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
 Title
Amount of Number of Shares
     
 
           
           
           
           
           
           
           

Explanation of Responses:


**Intentional misstatements or omissions of facts constitute  

Dan L. Smith

By:  /s/ Dan L. Smith*

 

December 10, 2001
    Federal Criminal Violations.  
**Signature of Reporting Person
  Date
    See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).  
*Jeffrey A. Ott
    Attorney-in-Fact  
   

Note: File three copies of this Form, one of which must be manually signed.
          If space provided is insufficient, see Instruction 6 for 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.


POWER OF ATTORNEY

                    The undersigned, a director and/or officer of Chemical Financial Corporation, a Michigan corporation (the "Company"), does hereby nominate, constitute and appoint Aloysius J. Oliver, David B. Ramaker, Lori A. Gwizdala and Jeffrey A. Ott, or any one or more of them, his or her true and lawful attorneys and agents to do any and all acts and things and to execute and file any and all instruments that such attorneys and agents, or any of them, may deem necessary or advisable to enable the undersigned (in his or her individual capacity or in a fiduciary or other capacity) to comply with the Securities Exchange Act of 1934, as amended (the "Act"), and any requirements of the Securities and Exchange commission in respect thereof, in connection with the preparation, execution and filing of any report or statement of beneficial ownership or changes in beneficial ownership of securities of the Company that the undersigned (in his or her individual capacity or in a fiduciary or other capacity) may be required to file pursuant to Section 16(a) of the Act including, without limitation, full power and authority to sign the undersigned's name, in his or her individual capacity or in a fiduciary or other capacity, to any report or statement on Form 3, 4 or 5, or to any amendments or any successor forms thereto, or any form or forms adopted by the Securities and Exchange Commission in lieu thereof or in addition thereto, hereby ratifying and confirming all that such attorneys and agents, or any of them, shall do or cause to be done by virtue hereof.

                    The undersigned agrees that the attorneys-in-fact named herein may rely entirely on information furnished orally or in writing by the undersigned to such attorneys-in-fact.

                    This authorization shall supersede all prior authorizations to act for the undersigned with respect to securities of the Company in these matters, which prior authorizations are hereby revoked, and shall survive the termination of the undersigned's status as a director and/or officer of the Company and remain in effect thereafter for so long as the undersigned (in his or her individual capacity or in a fiduciary or other capacity) has any obligation under Section 16 of the Act with respect to securities of the Company.



Date: January 18th, 2001

 

/s/ Dan L. Smith


   

Dan L. Smith

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