0000763563-12-000004.txt : 20120109 0000763563-12-000004.hdr.sgml : 20120109 20120109145417 ACCESSION NUMBER: 0000763563-12-000004 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20120103 FILED AS OF DATE: 20120109 DATE AS OF CHANGE: 20120109 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: POTTER JOHN F CENTRAL INDEX KEY: 0001183775 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-13888 FILM NUMBER: 12517308 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 X0304 4 2012-01-03 1 0000763563 CHEMUNG FINANCIAL CORP CHMG 0001183775 POTTER JOHN F 822 UPPER UNDERWOOD AVENUE ELMIRA NY 14905 1 0 0 0 Common Stock 33276 D Common Stock 7589 I By Spouse Phantom Stock 2012-01-03 2012-01-09 4 A 0 168.13 22.75 A Common Stock 168.13 24142.79 D Security converts to common stock on one-for-one basis. Phantom Stock Units are to be settled 100% in Issuer's Commons 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 the Issuer's Dividend Reinvestment Plan. Jane H. Adamy, Power of Attorney dated June 17, 2009. 2012-01-09