5 1 leh5_01.txt FORM 5 UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 FORM 5 ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP [ ] Check box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. [ ] Form 3 Holdings Reported [ ] Form 4 Transactions Reported 1. Name and Address of Reporting Person(s) Holdren, Larry E. 138 Putnam Street P.O. Box 738 Marietta, OH 45750-0738 2. Issuer Name and Ticker or Trading Symbol Peoples Bancorp Inc. (PEBO) 3. I.R.S. Identification Number of Reporting Person, if an entity (Voluntary) 4. Statement for Month/Year 12/00 5. If Amendment, Date of Original (Month/Year) 6. Relationship of Reporting Person(s) to Issuer (Check all applicable) [ ] Director [ ] 10% Owner [X] Officer (give title below) [ ] Other (specify below) Executive Vice President . 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 2)Trans- 3.Trans- 4.Securities Acquired(A) 5)Amount of 6) 7)Nature of action action or Disposed of (D) Securities Indirect Date Code A Beneficially D Beneficial (Month/ or Owned at or Ownership Day/Year) Code Amount D Price End of Year I ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 12/23/99 P 5 110 A $20.45 (1) 1,923 D Direct Common Stock 10,921 I 401(k) Plan Table II (PART 1) Derivative Securitites Acquired, Disposed of, or Beneficially Owned (Columns 1 through 6) ------------------------------------------------------------------------------------------------------------------------------------ 1)Title of Derivative 2)Conversion 3)Trans- 4)Trans- 5)Number of Derivative 6)Date Exercisable and Security or Exercise action action Securities Acquired (A) Expiration Date Price of Date Code or Disposed of (D) Derivative Security Code A D Exercisable Expiration ------------------------------------------------------------------------------------------------------------------------------------ Incentive Stock Option (right $10.65 11/10/04 to buy) Incentive Stock Option (right $7.97 11/20/93 05/20/03 to buy) Incentive Stock Option (right $17.25 04/27/00 A 3,000 04/27/10 to buy) Incentive Stock Option (right $18.95 04/01/09 to buy) Incentive Stock Option (right $23.76 07/23/08 to buy) Incentive Stock Option (right $24.11 12/03/07 to buy) Table II (PART 2) Derivative Securitites Acquired, Disposed of, or Beneficially Owned (Columns 1,3 and 7 through 11) ------------------------------------------------------------------------------------------------------------------------------------ 1)Title of Derivative 3)Trans- 7)Title and Amount 8)Price 9)Number of 10) 11)Nature of Security action of Underlying of Deri- Derivative Indirect Date Securities vative Securities D Beneficial Amount or Security Beneficially or Ownership Number of Owned at I - Title Shares End of Year ------------------------------------------------------------------------------------------------------------------------------------ Incentive Stock Option (right Common Stock 15,373 15,373 D Direct to buy) Incentive Stock Option (right Common Stock 4,392 4,392 D Direct to buy) Incentive Stock Option (right 04/27/00 Common Stock 3,000 3,000 D Direct to buy) Incentive Stock Option (right Common Stock 6,050 6,050 D Direct to buy) Incentive Stock Option (right Common Stock 643 643 D Direct to buy) Incentive Stock Option (right Common Stock 6,262 6,262 D Direct to buy) Explanation of Responses: (1) Price and number of shares adjusted for 10% stock dividend paid 3/14/00.
SIGNATURE OF REPORTING PERSON /S/ Holdren, Larry E. DATE 02/09/01