Statement of Changes in Beneficial Ownership (4)
November 18 2021 - 1:42PM
Edgar (US Regulatory)
FORM 4
[ ]
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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3235-0287
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Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
*
NASCA DAVID J |
2. Issuer Name and Ticker or Trading Symbol
EVANS BANCORP INC
[
EVBN
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__X__ Director _____ 10% Owner __X__ Officer (give title below) _____ Other (specify below) President and CEO |
(Last)
(First)
(Middle)
6460 MAIN STREET |
3. Date of Earliest Transaction
(MM/DD/YYYY)
3/9/2021 |
(Street)
WILLIAMSVILLE, NY 14221
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
_X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1.Title of Security (Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code (Instr. 8)
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4. Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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Common Stock | 11/16/2021 | | A | | 3170 | A | $39.06 | 86040.73 (1) | D | |
Common Stock | 3/9/2021 | | G |
V
| 1300 | D | $34.48 | 84740.73 | D | |
Common Stock | | | | | | | | 210 | I | by son |
Common Stock | | | | | | | | 198 | I | by son |
Common Stock | | | | | | | | 144 | I | by daughter |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Trans. Date | 3A. Deemed Execution Date, if any | 4. Trans. Code (Instr. 8) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) | 6. Date Exercisable and Expiration Date | 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) | 8. Price of Derivative Security (Instr. 5) | 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) | 10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) |
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Option (right to buy) | $39.06 | 11/16/2021 | | A | | 1959 | | 11/16/2022 | 11/16/2031 | Common Stock | 1959 | $0 | 1959 | D | |
Option (right to buy) | $39.06 | 11/16/2021 | | A | | 3331 | | 11/16/2022 | 11/16/2031 | Common Stock | 3331 | $0 | 3331 | D | |
Explanation of Responses: |
(1) | Balance includes 160.35 shares acquired under the Evans Bancorp, Inc. Dividend Reinvestment Plan on October 6, 2021, and 348 shares acquired under the Evans Bancorp Inc. Employee Stock Purchase Plan on June 30, 2021. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
NASCA DAVID J 6460 MAIN STREET WILLIAMSVILLE, NY 14221 | X |
| President and CEO |
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Signatures
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/s/Jessica L. Brosius, Attorney in Fact for David J. Nasca | | 11/18/2021 |
**Signature of Reporting Person | Date |
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