-----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, GO/3PEdQk/3OWP+xYkPJnuPQlpNoYjw3AWYJ9U/YJgP8+fH0n5C/VS+4tRDr/Pw2 tX5kbpeTa6uCOAL7mDUPSg== 0000905729-05-000075.txt : 20050210 0000905729-05-000075.hdr.sgml : 20050210 20050210115042 ACCESSION NUMBER: 0000905729-05-000075 CONFORMED SUBMISSION TYPE: SC 13G/A PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20050210 DATE AS OF CHANGE: 20050210 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: SOUTHERN MICHIGAN BANCORP INC CENTRAL INDEX KEY: 0000703699 STANDARD INDUSTRIAL CLASSIFICATION: STATE COMMERCIAL BANKS [6022] IRS NUMBER: 382407501 STATE OF INCORPORATION: MI FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G/A SEC ACT: 1934 Act SEC FILE NUMBER: 005-78842 FILM NUMBER: 05591476 BUSINESS ADDRESS: STREET 1: 51 W PEARL ST CITY: COLDWATER STATE: MI ZIP: 49036 BUSINESS PHONE: 5172795500 MAIL ADDRESS: STREET 1: 51 W PEARL ST CITY: COLDWATER STATE: MI ZIP: 49036 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: RANDALL HARVEY B CENTRAL INDEX KEY: 0001218316 FILING VALUES: FORM TYPE: SC 13G/A BUSINESS ADDRESS: STREET 1: 8391 OLD 27 SOUTH CITY: MARSHALL STATE: MI ZIP: 49068 BUSINESS PHONE: 6167814330 SC 13G/A 1 smbrandall13ga2_021005.htm SMB-HARVEY RANDALL SC 13G/A#2 Southern Michigan - Harvey Randall SC 13G/A2 - 02/10/05

SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

SCHEDULE 13G
(Rule 13d-102)

INFORMATION TO BE INCLUDED IN STATEMENTS FILED PURSUANT TO
RULES 13d-1(b), (c) and (d) AND AMENDMENTS THERETO FILED PURSUANT TO RULE 13d-2(b)

(Amendment No. 2)1

SOUTHERN MICHIGAN BANCORP, INC.


(Name of Issuer)

 

Common Stock, par value $2.50


(Title of Class of Securities)

 

84336P103


(CUSIP Number)

 

December 31, 2004


(Date of Event Which Requires Filing of this Statement)





Check the appropriate box to designate the rule pursuant to which this Schedule is filed:

 

[   ]

Rule 13d-1(b)

 

[   ]

Rule 13d-1(c)

 

[X]

Rule 13d-1(d)




1 The remainder of this cover page shall be filled out for a reporting person's initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter the disclosures provided in a prior cover page.

The information required in the remainder of this cover page shall not be deemed to be "filed" for the purpose of Section 18 of the Securities Exchange Act of 1934 ("Act") or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act.





Page 1 of 4





CUSIP No. 84336P103
Schedule 13G
Page 2 of 4

(1)

Names of Reporting Persons
I.R.S. Identification No. of Above Persons (Entities Only)

Harvey B. Randall

 

 

 

 

(2)

Check the Appropriate Box if a Member of a Group
(a)     [   ]
(b)     [   ]

 

 

(3)

SEC Use Only

 

 

(4)

Citizenship or Place of Organization

United States of America

 

 

Number of Shares Beneficially Owned by Each Reporting Person With

 

 

(5)

Sole Voting Power

146,184* shares

 

 

 

(6)

Shared Voting Power

0 shares

 

 

 

(7)

Sole Dispositive Power

146,184* shares

 

 

 

(8)

Shared Dispositive Power

0 shares

 

 

(9)

Aggregate Amount Beneficially Owned by Each Reporting Person

 

 

146,184* shares

 

 

 

(10)

Check Box if the Aggregate Amount in Row (9) Excludes Certain Shares

[   ]


(11)

Percent of Class Represented by Amount in Row 9

 

 

8.0%


(12)

Type of Reporting Person

 

 

IN









*          Includes 146,122 shares held by Mr. Randall as trustee and 62 shares held by Mr. Randall directly.




CUSIP No. 84336P103
Schedule 13G
Page 3 of 4

Item 1(a).

Name of Issuer:

Southern Michigan Bancorp, Inc.

 

 

Item 1(b).

Address of Issuer's Principal Executive Offices:

51 West Pearl Street
Coldwater, Michigan 49036

 

 

Item 2(a).

Name of Person Filing:

Harvey B. Randall

 

 

Item 2(b).

Address of Principal Business Office or, if None, Residence:

8391 Old 27 South
Marshall, Michigan 49068

 

 

Item 2(c).

Citizenship:

United States of America

 

 

Item 2(d).

Title of Class of Securities:

Common Stock, par value $2.50

 

 

Item 2(e).

CUSIP Number:

84336P103

 

 

Item 3.

If this statement is filed pursuant to Rule 13d-1(b), or 13d-2(b) or (c), check whether the person filing is a:


 

(a)

[   ]

Broker or dealer registered under Section 15 of the Act;

 

 

 

 

 

(b)

[   ]

Bank as defined in Section 3(a)(6) of the Act;

 

 

 

 

 

(c)

[   ]

Insurance company as defined in Section 3(a)(19) of the Act;

 

 

 

 

 

(d)

[   ]

Investment company registered under Section 8 of the Investment Company Act;

 

 

 

 

 

(e)

[   ]

Investment adviser in accordance with Rule 13d-1(b)(1)(ii)(E);

 

 

 

 

 

(f)

[   ]

Employee benefit plan or endowment fund in accordance with Rule 13d-1(b)(1)(ii)(F);

 

 

 

 

 

(g)

[   ]

Parent holding company or control person in accordance with Rule 13d-1(b)(1)(ii)(G);

 

 

 

 

 

(h)

[   ]

Savings association as defined in Section 3(b) of the Federal Deposit Insurance Act;

 

 

 

 

 

(i)

[   ]

Church plan that is excluded from the definition of an investment company under Section 3(c)(14) of the Investment Company Act;

 

 

 

 

 

(j)

[   ]

Group, in accordance with Rule 13d-1(b)(1)(ii)(J).



CUSIP No. 84336P103
Schedule 13G
Page 4 of 4

Item 4.

Ownership.

 

 

 

(a)

Amount Beneficially Owned:

146,184* shares

 

 

 

 

 

(b)

Percent of Class:

8.0%*

 

 

 

 

 

(c)

Number of shares as to which such person has:

 

 

 

 

 

 

 

(i)

Sole power to vote or to direct the vote

146,184* shares

 

 

 

 

 

 

 

(ii)

Shared power to vote or to direct the vote

0 shares

 

 

 

 

 

 

 

(iii)

Sole power to dispose or to direct the disposition of

146,184* shares

 

 

 

 

 

 

 

(iv)

Shared power to dispose or to direct the disposition of

0 shares

 

 

* Includes 146,122 shares held by Mr. Randall as trustee and 62 shares held by Mr. Randall directly.

 

 

Item 5.

Ownership of Five Percent or Less of a Class.

Not applicable.

 

 

Item 6.

Ownership of More than Five Percent on Behalf of Another Person.

 

 

 

Not applicable.

 

 

Item 7.

Identification and Classification of the Subsidiary Which Acquired the Security Being Reported on by the Parent Holding Company or Control Person.

Not applicable.

 

 

Item 8.

Identification and Classification of Members of the Group.

Not applicable.

 

 

Item 9.

Notice of Dissolution of Group.

Not applicable.

 

 

Item 10.

Certifications.

 

 

 

Not applicable.

 

 

 

SIGNATURE

 

 

 

After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct.


 

February 9, 2005


/s/ Harvey B. Randall


Harvey B. Randall
(Signature)
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