-----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, REaVYem4rX6ThEiJJI1bu9/xIZ8RauA8Yu1WPN46ilrMn9Sp8n9SxcayKlluAxa5 +b66HLzRbO6HYDTv1b3BSw== 0001021408-98-000131.txt : 19980302 0001021408-98-000131.hdr.sgml : 19980302 ACCESSION NUMBER: 0001021408-98-000131 CONFORMED SUBMISSION TYPE: SC 13G PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 19980227 SROS: AMEX SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: COLONY BANKCORP INC CENTRAL INDEX KEY: 0000711669 STANDARD INDUSTRIAL CLASSIFICATION: STATE COMMERCIAL BANKS [6022] IRS NUMBER: 581492391 STATE OF INCORPORATION: GA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G SEC ACT: SEC FILE NUMBER: 005-41513 FILM NUMBER: 98552768 BUSINESS ADDRESS: STREET 1: 302 S MAIN ST STREET 2: PO BOX 989 CITY: FITZGERALD STATE: GA ZIP: 31750 BUSINESS PHONE: 9124235446 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: ROSS ROBERT SIDNEY CENTRAL INDEX KEY: 0000898362 STANDARD INDUSTRIAL CLASSIFICATION: [] FILING VALUES: FORM TYPE: SC 13G BUSINESS ADDRESS: STREET 1: 115 SOUTH GANT ST CITY: FITZGERALD STATE: GA ZIP: 31750 BUSINESS PHONE: 9124266000 MAIL ADDRESS: STREET 1: 115 SOUTH GANT ST CITY: FITZGERALD STATE: GA ZIP: 31750 SC 13G 1 ROBERT SIDNEY ROSS SCHEDULE 13G ---------------------------- OMB APPROVAL ---------------------------- OMB Number: 3235-0145 Expires: August 31, 1991 Estimated average burden hours per response . . 14.90 ---------------------------- UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 SCHEDULE 13G Under the Securities Exchange Act of 1934 (Amendment No. ________)* Colony Bankcorp, Inc. - -------------------------------------------------------------------------------- (Name of Issuer) Common Stock - -------------------------------------------------------------------------------- (Title of Class of Securities) N/A - -------------------------------------------------------------------------------- (CUSIP Number) Check the following box if a fee is being paid with this statement [_]. (A fee is not required only if the filing person: (1) has a previous statement on file reporting beneficial ownership of more than five percent of the class of securities described in Item 1; and (2) has filed no amendment subsequent thereto reporting beneficial ownership of five percent or less of such class.) (See Rule 13d-7). *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 (however, see the Notes). Page 1 of 8 pages - ----------------------- --------------------- CUSIP NO. N/A 13G PAGE 2 OF 4 PAGES - ----------------------- --------------------- - ------------------------------------------------------------------------------ NAME OF REPORTING PERSON 1 S.S. OR I.R.S. IDENTIFICATION NO. OF ABOVE PERSON Robert Sidney Ross SSN ###-##-#### - ------------------------------------------------------------------------------ CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* 2 (a) [_] N/A (b) [_] - ------------------------------------------------------------------------------ SEC USE ONLY 3 - ------------------------------------------------------------------------------ CITIZENSHIP OR PLACE OF ORGANIZATION 4 United States - ------------------------------------------------------------------------------ SOLE VOTING POWER 5 NUMBER OF 263,841.50 SHARES ----------------------------------------------------------- SHARED VOTING POWER BENEFICIALLY 6 N/A OWNED BY ----------------------------------------------------------- EACH SOLE DISPOSITIVE POWER 7 REPORTING 263,841.50 PERSON ----------------------------------------------------------- SHARED DISPOSITIVE POWER WITH 8 N/A - ------------------------------------------------------------------------------ AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 9 263,841.50 - ------------------------------------------------------------------------------ CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES 10 CERTAIN SHARES* [_] N/A - ------------------------------------------------------------------------------ PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9 11 12.14% - ------------------------------------------------------------------------------ TYPE OF REPORTING PERSON* 12 IN. - ------------------------------------------------------------------------------ *SEE INSTRUCTIONS BEFORE FILLING OUT! Page 2 of 8 pages SECURITIES AND EXCHANGE COMMISSION SCHEDULE 13G Item 1. a. Colony Bankcorp, Inc. b. 115 South Grant Street P.O. Box 989 Fitzgerald, Georgia 31750 Item 2. a. Robert Sidney Ross b. P.O. Box 666 Ocilla, Georgia 31774 c. United States Citizen d. Colony Bankcorp, Inc. Common Stock e. Not Applicable Item 3. Not Applicable Item 4. a. 263,841.50 b. 12.14% c. (i) 263,841.50 c. (ii) Not Applicable c. (iii) 263,841.50 c. (iv) Not Applicable Item 5. Not Applicable Item 6. Not Applicable Item 7. Not Applicable Item 8. Not Applicable Item 9. Not Applicable Item 10. 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. 2-9-98 ------------------------- /s/ Robert Sidney Ross ------------------------- Signature Robert Sidney Ross ------------------------- Name/Title -----END PRIVACY-ENHANCED MESSAGE-----