- Statement of Changes in Beneficial Ownership (4)
April 05 2011 - 10:25AM
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).
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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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
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1. Name and Address of Reporting Person
*
Bishop Brad
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2. Issuer Name
and
Ticker or Trading Symbol
FIRST COMMUNITY BANK CORP OF AMERICA
[
FCFL
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__
X
__ Director
_____ 10% Owner
_____ Officer (give title below)
_____ Other (specify below)
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(Last)
(First)
(Middle)
9001 BELCHER ROAD
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3. Date of Earliest Transaction
(MM/DD/YYYY)
3/31/2011
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(Street)
PINELLAS PARK, FL 33782
(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
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32814
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D
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Common Stock
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9398
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I
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Spouse
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Common Stock
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3/31/2011
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C
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60000
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A
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(3)
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92814
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D
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Common Stock
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3/31/2011
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C
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15000
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A
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(3)
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24398
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I
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Spouse
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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)
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2. Conversion or Exercise Price of Derivative Security
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3. Trans. Date
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3A. Deemed Execution Date, if any
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4. Trans. Code
(Instr. 8)
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5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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6. Date Exercisable and Expiration Date
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7. Title and Amount of Securities Underlying Derivative Security
(Instr. 3 and 4)
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8. Price of Derivative Security
(Instr. 5)
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9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4)
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10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4)
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11. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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(A)
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(D)
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Date Exercisable
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Expiration Date
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Title
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Amount or Number of Shares
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Convertible Preferred Stock, Series B
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(1)
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12/31/2009
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(2)
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Convertible Preferred Stock, Series B
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6000
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6000
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D
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Convertible Preferred Stock, Series B
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(1)
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12/31/2009
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(2)
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Convertible Preferred Stock, Series B
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1500
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1500
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I
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Spouse
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Convertible Preferred Stock, Series B
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(3)
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3/31/2011
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C
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6000
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12/31/2009
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(2)
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Convertible Preferred Stock, Series B
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6000
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(3)
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0
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D
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Convertible Preferred Stock, Series B
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(3)
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3/31/2011
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C
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1500
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12/31/2009
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(2)
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Convertible Preferred Stock, Series B
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1500
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(3)
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0
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I
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Spouse
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Explanation of Responses:
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(
1)
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Public Offering of units where each unit consists of one share of FCFL Convertible Preferred Stock, Series B, and 4.165 shares of FCFL Common Stock, rounded up to the nearest whole share. Each share of FCFL Convertible Preferred Stock, Series B, is convertible at any time into 10 shares of FCFL Common Stock, subject to adjustment pursuant to customery anti-dilution provisions set forth in FCFL's Articles of Amendment to the Amended and Restated Articles of Incorporation.
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(
2)
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FCFL Convertible Preferred Stock, Series B, has no expiration date.
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(
3)
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On March 31, 2011, each outstanding share of Convertible Preferred Stock, Series B, was mandatorily converted into ten (10)shares of common stock, pursuant to the terms of Section 4 of the Company's Amended and Restated Articles of Incorporation, as a result of the Company's inability to declare and pay dividends on the Series B Stock for the four consecutive quarters ending March 31, 2011.
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Reporting Owners
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Reporting Owner Name / Address
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Relationships
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Director
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10% Owner
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Officer
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Other
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Bishop Brad
9001 BELCHER ROAD
PINELLAS PARK, FL 33782
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X
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Signatures
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/s/ Brad Bishop
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4/4/2011
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**
Signature of Reporting Person
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Date
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
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*
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If the form is filed by more than one reporting person,
see
Instruction 4(b)(v).
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**
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Intentional misstatements or omissions of facts constitute Federal Criminal Violations.
See
18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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Note:
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File three copies of this Form, one of which must be manually signed. If space is insufficient,
see
Instruction 6 for procedure.
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Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number.
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