-----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, PURBwLE6jI5ulpWVxxMH10Z5UcXJFbKPp8q+yRtx8tqAKbYGYQy8fQFZDdlq/q+Z opL0kC5YDJZNelWBsoIMMw== 0000763563-05-000012.txt : 20050111 0000763563-05-000012.hdr.sgml : 20050111 20050111172159 ACCESSION NUMBER: 0000763563-05-000012 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20050111 FILED AS OF DATE: 20050111 DATE AS OF CHANGE: 20050111 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: FALCK FREDERICK Q CENTRAL INDEX KEY: 0001183771 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-13888 FILM NUMBER: 05524144 MAIL ADDRESS: STREET 1: ONE CHEMUNG CANAL PLAZA STREET 2: PO BOX 1522 CITY: ELMIRA STATE: NY ZIP: 14902-1522 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: CHEMUNG FINANCIAL CORP CENTRAL INDEX KEY: 0000763563 STANDARD INDUSTRIAL CLASSIFICATION: STATE COMMERCIAL BANKS [6022] IRS NUMBER: 161237038 STATE OF INCORPORATION: NY FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: ONE CHEMUNG CANAL PLZ STREET 2: P O BOX 1522 CITY: ELMIRA STATE: NY ZIP: 14902 BUSINESS PHONE: 6077373711 MAIL ADDRESS: STREET 1: ONE CHEMUNG CANAL PLZ STREET 2: P O BOX 1522 CITY: ELMIRA STATE: NY ZIP: 14902 4 1 edgar.xml PRIMARY DOCUMENT X0202 4 2005-01-11 1 0000763563 CHEMUNG FINANCIAL CORP CHMG 0001183771 FALCK FREDERICK Q 111 THE PARKWAY ITHACA NY 14851 1 0 0 0 Common Stock 2005-01-11 4 M 0 4716 31.60 A 6516 D Common Stock 126342 I Various Trusts Phantom Stock 2005-01-11 4 M 0 4716 31.60 A 2005-01-11 2005-01-11 Common Stock 4716 9325.21 D Security converts to common stock on one-for-one basis. Phantom Stock Units are to be settled 100% in Issuer's Common Stock in accordance with the terms of the Company's Deferred Directors Fee Plan and at the director's election. Includes dividends reinvested periodically under Issuer's Dividend Reinvestment Plan. Includes shares held in various trusts of which the reporting person is a co-trustee or income beneficiary. Excludes 140,452 shares owned by The Rathbone Corporation of which Mr. Falck is an officer and director and a co-trustee of various trusts owning an interest in said corporation. Jane H. Adamy Power of Attorney dated November 8, 2000 2005-01-11 -----END PRIVACY-ENHANCED MESSAGE-----