4 1 form4fbi2001.txt FORM 4 FORM 4 U.S. SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 STATEMENT OF CHANGES IN 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 First Banks, Inc. 135 N. Meramec Clayton, Missouri 63105 2. Issuer Name and Ticker or Trading Symbol First Banks America, Inc. FBA 3. IRS or Social Security Number of Reporting Person (Voluntary) 4. Statement for Month/Year October 2001 5. If Amendment, Date of Original (Month/Year) 6. Relationship of Reporting Person to Issuer (Check all applicable) Director X 10% Owner ----- --------- Officer (give title below) Other (Specify below) ----- 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: (a) Common Stock (b) Class B Common Stock 2. Transaction Date (Month/Day/Year): 10/31/01 3. Transaction Code V: (a) P (b) N/A 4. Securities Acquired (A) or disposed of (D): --- (a) A Amount 803,757 (b) N/A - ------- (a) Price $32.50 (b) N/A ------ 5. Amount of Securities Beneficially Owned at End of Month: (a) 9,545,107 (b) 2,500,000 6. Ownership Form Direct (D) or Indirect (I): (a) D (b) D 7. Nature of Indirect Beneficial Ownership: N/A Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned -------------------------------------------------------------------------------- (e.g., puts calls, warrants, options, convertible securities) ------------------------------------------------------------- 1. Title of Derivative Security N/A 2. Conversion or Exercise Price of Derivative Security N/A 3. Transaction Date (Month/Day/Year): N/A 4. Transaction Code Code____ V_____ N/A 5. Number of Derivative Securities Acquired (A)____ or Disposed of (D)____ N/A 6. Date Exercisable and Expiration Date (Month/Day/Year) N/A Date Exercisable ____________ Expiration Date ____________ N/A 7. Title and Amount of Underlying Securities: N/A Title ___________________ Amount or Number of Shares _______: N/A 8. Price of Derivative Security: N/A 9. Number of Derivative Securities Beneficially Owned at End of Month: N/A 10.Ownership Form of Derivative Security Direct (D) or Indirect (i) N/A 11.Nature of Indirect Beneficial Ownership: N/A Explanation of Responses: /s/Allen H. Blake ------------------------------------ Signature of Reporting Person