-----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, Ggfyi2Y9n8jctNR7X0K3B8W6Oh1PB9Hb/y46f5Rwip2j9anP2xJhoxAOncH3vUhg T28z2AG74xw1/3wy6NN4fg== 0000950133-98-000479.txt : 19980218 0000950133-98-000479.hdr.sgml : 19980218 ACCESSION NUMBER: 0000950133-98-000479 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 19971231 FILED AS OF DATE: 19980217 SROS: NONE SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: CENTURY BANCSHARES INC CENTRAL INDEX KEY: 0000785813 STANDARD INDUSTRIAL CLASSIFICATION: NATIONAL COMMERCIAL BANKS [6021] IRS NUMBER: 521489098 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 5 SEC ACT: SEC FILE NUMBER: 000-16234 FILM NUMBER: 98541154 BUSINESS ADDRESS: STREET 1: 1275 PENNSYLVANIA AVE., N.W. CITY: WASHINGTON STATE: DC ZIP: 20004 BUSINESS PHONE: 202-496-40 MAIL ADDRESS: STREET 1: 1275 PENNSYLVANIA AVE NW CITY: WASHINGTON STATE: DC ZIP: 20004 COMPANY DATA: COMPANY CONFORMED NAME: GROSS NEAL R CENTRAL INDEX KEY: 0001055259 STANDARD INDUSTRIAL CLASSIFICATION: [] DIRECTOR FILING VALUES: FORM TYPE: 5 BUSINESS ADDRESS: STREET 1: NEAL R GROSS & CO INC STREET 2: 1232 RHODE ISLAND AVE NW CITY: WASHINGTON STATE: DC ZIP: 20005 MAIL ADDRESS: STREET 1: NEAL R GROSS & CO INC STREET 2: 1323 RHODE ISLAND AVE NW CITY: WASHINGTON STATE: DC ZIP: 20005 5 1 FORM 5 RE: CENTURY BANCSHARES/NEAL R. GROSS 1 - --------------------- FORM 5 - --------------------- UNITED STATES SECURITIES AND EXCHANGE COMMISSION WASHINGTON, D.C. 20549 ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(f) of the Investment Company Act of 1940 -------------------------------------- OMB APPROVAL OMB Number 3235-0362 Expires September 30, 1998 Estimated average burden hours per response...............1.0 -------------------------------------- CHECK THIS BOX IF NO LONGER SUBJECT TO [ ] SECTION 16. FORM 4 OR FORM 5 OBLI- GATIONS MAY CONTINUE. SEE INSTRUCTION 1(B). [ ] FORM 3 HOLDINGS REPORTED [X] FORM 4 TRANSACTIONS REPORTED - ------------------------------------------------------------------------------------------------------------------------------------ 1. Name and Address of 2. Issuer Name AND Ticker or Trading Symbol 6. Relationship of Reporting Reporting Person* Person to Issuer (Check all applicable) X Director 10% Owner --- --- Gross Neal R. Century Bancshares, Inc (CTRY) Officer (give Other (specify --- title --- below) below) Director ----------------------------------------------------- - ------------------------------------------------------------------------------------------------------------------------------------ (Last) (First) (Middle) 3. IRS or Social Security 4. Statement for Month/Year Number of Reporting 1323 Rhode Island Avenue, N.W. Person (Voluntary) December, 1998 - ------------------------------------------------------------------------------------------------------------------------------------ (Street) 5. If Amendment, Date of 7. Individual or Joint/ Original (Month/Year) Group Filing (check applicable line) Washington DC 20005 X Form Filed by One --- Reporting Person Form Filed by --- More than One Reporting Person - ------------------------------------------------------------------------------------------------------------------------------------ (City) (State) (Zip) 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. Owner- 7. Nature (Instr. 3) action action or Disposed of (D) Securities ship of In- Date Code (Instr. 3, 4 and 5) Beneficially Form: direct (Instr. Owned at Direct Bene- (Month/ 8) End of (D) or ficial Day/ Issuer's Indirect Owner- Year) Fiscal Year (I) ship (Instr. 3 (Instr. 4) (Instr. 4) and 4) (A) or Amount (D) Price - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 09/23/97 P 15,000 shares A $7.50 15,000 I By Trust - ------------------------------------------------------------------------------------------------------------------------------------ 104,899 D - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------
*If the form is filed by more than one reporting person, see instruction 4(b)(v). Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. (Over) SEC 2270 (7-96) 2 FORM 5 (continued) Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) - --------------------------------------------------------------------------------------------------------------------------------- 1. Title of Derivative 2. Conver- 3. Trans- 4. Transac- 5. Number of Deriv- 6. Date Exer- 7. Title and Amount of Security sion or action tion ative Securities cisable and Ex- Underlying (Instr. 3) Exercise Date (Instr. 8) Acquired (A) or piration Date Securities Price of (Month/ Disposed of (D) (Month/Day/ (Instr. 3, and 4) Deriv- Day/ Year) ative Year) Security ----------------------------------------------- Date Expira- Amount or Exer- tion Title Number of cisable Date Shares ------------------- (A) (D) - --------------------------------------------------------------------------------------------------------------------------------- Warrant to Buy 11/15/96 11/16/98 (1) Common Stock 16,839 - --------------------------------------------------------------------------------------------------------------------------------- Option to Buy 12/31/96 5/20/99 Common Stock 780 - --------------------------------------------------------------------------------------------------------------------------------- Option to Buy 12/31/96 5/19/00 Common Stock 1,243 - --------------------------------------------------------------------------------------------------------------------------------- Option to Buy 5/18/94 5/17/01 Common Stock 1,770 - --------------------------------------------------------------------------------------------------------------------------------- Option to Buy 5/7/95 5/17/02 Common Stock 1,685 - --------------------------------------------------------------------------------------------------------------------------------- Option to Buy 5/21/96 5/21/06 Common Stock 1,575 - --------------------------------------------------------------------------------------------------------------------------------- Option to Buy 6/6/97 6/6/07 Common Stock 1,500 - --------------------------------------------------------------------------------------------------------------------------------- 8. Price 9. Number 10. 11. Na- of of Deriv- Owner- ture Deriv- ative ship of ative Secur- De- In- Secur- ities rivative direct ity Bene- Secu- Bene- (Instr. ficially rity: ficial 5) Owned Direct Own- at End (D) or ership of Indi- Year rect (Instr. (Instr. 4) 4) - --------------------------------------------------------------------------------- $5.12 16,839 D - --------------------------------------------------------------------------------- $2.11 780 D - --------------------------------------------------------------------------------- $2.69 1,243 D - --------------------------------------------------------------------------------- $4.03 1,770 D - --------------------------------------------------------------------------------- $5.12 1,685 D - --------------------------------------------------------------------------------- $5.71 1,575 D - --------------------------------------------------------------------------------- $6.88 1,500 D - ---------------------------------------------------------------------------------
Explanation of Responses: (1) This issuer has the option, on and after November 14, 1997, to repurchase the Warrants at a price equal to $.26 per Warrant. **Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). /S/ Neal R. Gross 2/17/98 ------------------------------------------ **Signature of Reporting Person Date Note: File three copies of this Form, one of which must be manually signed. If space provided is insufficient, see Instruction 6 for procedure. Potential persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB number. Page 2 SEC 2270 (7-96) -----END PRIVACY-ENHANCED MESSAGE-----