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SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
SCHEDULE 13G
Under the Securities Exchange Act of 1934
(Amendment No. )*
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FIRST STATE CORPORATION
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(Name of Issuer)
Common Stock
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(Title of Class of Securities)
336907100
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(CUSIP Number)
Check the following box if a fee is being paid with this statement / /. (A
fee is not required only if the filing person: (1) has a previous statement on
file reporting beneficial ownership of more than five percent of the class of
securities described in Item 1; and (2) has filed no amendment subsequent
thereto reporting beneficial ownership of five percent or less of such class.)
(See Rule 13d-7.)
*The remainder of this cover page shall be filled out for a reporting
person's initial filing on this form with respect to the subject class of
securities, and for any subsequent amendment containing information which
would alter the disclosures provided in a prior page.
The information required in the remainder of this cover page shall not be
deemed to be "filed" for the purpose of Section 18 of the Securities Exchange
Act of 1934 ("Act") or otherwise subject to the liabilities of that section of
the Act but shall be subject to all other provisions of the Act (however, see
the Notes).
(Continued on following page(s))
Page 1 of 5 Pages
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CUSIP No. 336907100 13G Page 2 of 5 Pages
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(1) Names of Reporting Persons. S.S. or I.R.S. Identification Nos. of Above
Persons
Vernon Haley Warren SS # ###-##-####
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(2) Check the Appropriate Box if a Member (a) / /
of a Group* (b) / /
N/A
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(3) SEC Use Only
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(4) Citizenship or Place of Organization
United States of America
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Number of Shares (5) Sole Voting Power
Beneficially 379,801
Owned by --------------------------------------------------
Each Reporting (6) Shared Voting Power
Person With 4969
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(7) Sole Dispositive Power
-0-
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(8) Shared Dispositive Power
4969
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(9) Aggregate Amount Beneficially Owned by Each Reporting Person
583,440
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(10) Check Box if the Aggregate Amount in Row (9) Excludes Certain Shares*
N/A
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(11) Percent of Class Represented by Amount in Row (9)
12.82%
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(12) Type of Reporting Person*
Individual
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*SEE INSTRUCTION BEFORE FILLING OUT!
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Page 3 of 5 Pages
ITEM 1(a). NAME OF ISSUER
First State Corporation
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ITEM 1(b). ADDRESS OF ISSUER'S PRINCIPAL EXECUTIVE OFFICES
333 W. Broad Street
Albanyl, Georgia 31701
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ITEM 2(a). NAME OF PERSON(S) FILING
Vernon Haley Warren
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ITEM 2(b). ADDRESS OF PRINCIPAL BUSINESS OFFICE OR, IF NONE, RESIDENCE
108 Glenwood Road
Americus, Georgia 31709
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ITEM 2(c). CITIZENSHIP
United States of America
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ITEM 2(d). TITLE OF CLASS OF SECURITIES
Common Stock
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ITEM 2(e). CUSIP NUMBER
336907100
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ITEM 3. IF THIS STATEMENT IS FILED PURSUANT TO RULES 13D-1(b), OR 13D-2(b),
CHECK WHETHER THE PERSON FILING IS A
Not Applicable
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Page 4 of 5 Pages
ITEM 4. OWNERSHIP: As of December 31, 1996
(a) Amount Beneficially Owned: 583,440
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(b) Percent of Class: 12.82%
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(c) Number of shares as to which such person has:
(i) sole power to vote or to direct the vote: 378,801
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(ii) shared power to vote or to direct the vote: 4969
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(iii) sole power to dispose or to direct the disposition of: -0-
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(iv) shared power to dispose or to direct the disposition of: 4969
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* Includes presently exercisable option to purchase 990 shares.
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ITEM 5. OWNERSHIP OF FIVE PERCENT OR LESS OF A CLASS
Not Applicable
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ITEM 6. OWNERSHIP OF MORE THAN FIVE PERCENT ON BEHALF OF ANOTHER PERSON
Not Applicable
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ITEM 7. IDENTIFICATION AND CLASSIFICATION OF THE SUBSIDIARY WHICH ACQUIRED
THE SECURITY BEING REPORTED ON BY THE PARENT HOLDING COMPANY
Not Applicable
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ITEM 8. IDENTIFICATION AND CLASSIFICATION OF MEMBERS OF THE GROUP
Not Applicable
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ITEM 9. NOTICE OF DISSOLUTION OF GROUP
Not Applicable
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ITEM 10. CERTIFICATION
Not Applicable
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Page 5 of 5 Pages
SIGNATURE
After reasonable inquiry and to the best of my knowledge and belief, I
certify that the information set forth in this statement is true, complete and
correct.
January 31, 1997
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(Date)
/s/ Vernon Haley Warren
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(Signature)
Vernon Haley Warren
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(Name/Title)
