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SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, DC 20549
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SCHEDULE 13G
(Rule 13d-102)
INFORMATION TO BE INCLUDED IN STATEMENTS FILED PURSUANT
TO RULES 13d-1 (b) (c), AND (d) AND AMENDMENTS THERETO FILED
PURSUANT TO RULE 13d-2 (b)
(Amendment No. 4)(1)
U.S.B. Holding Co., Inc.
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(Name of Issuer)
Common Stock, par value $0.01 per share
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(Title of Class of Securities)
902910108
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(CUSIP Number)
December 31, 1999
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(Date of Event Which Requires Filing of this Statement)
Check the appropriate box to designate the rule pursuant to which this
Schedule is filed:
[ ] Rule 13d-1 (b)
[ ] Rule 13d-1 (c)
[x] Rule 13d-1 (d)
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(1) 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 cover 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 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).
Page 1 of 8 Pages
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CUSIP NO. 902910108 13G PAGE 2 OF 8 PAGES
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NAME OF REPORTING PERSONS
I.R.S. IDENTIFICATION NO. OF ABOVE PERSONS (ENTITIES ONLY)
1
Thomas E. Hales
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CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* (a) [ ]
2 (b) [ ]
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SEC USE ONLY
3
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4 CITIZENSHIP OR PLACE OR ORGANIZATION
United States
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SOLE VOTING POWER
5 1,852,112 shares (inclusive of 865,503 shares issuable
upon the exercise of vested stock options)(see Item 4)
NUMBER OF ------------------------------------------------------------------
SHARES 6 SHARED VOTING POWER
BENEFICIALLY 879,597 shares (see Item 4)
OWNED BY ------------------------------------------------------------------
EACH SOLE DISPOSITIVE POWER
REPORTING 7 1,577,455 shares (inclusive of 865,503 shares
PERSON WITH issuable upon the exercise of
vested stock options)(see Item 4)
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8 SHARED DISPOSITIVE POWER
991,812 shares (see Item 4)
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9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
2,731,709 shares (see Item 4)
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CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES
10 CERTAIN SHARES* [ ]
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PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9
11
16.3% (see Item 4)
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TYPE OF REPORTING PERSON*
12
IN
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*SEE INSTRUCTIONS BEFORE FILLING OUT!
Page 2 of 8 Pages
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CUSIP NO. 902910108 13G PAGE 3 OF 8 PAGES
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NAME OF REPORTING PERSONS
I.R.S. IDENTIFICATION NO. OF ABOVE PERSONS (ENTITIES ONLY)
1
Alice Marie Hales
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CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* (a) [ ]
2 (b) [ ]
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SEC USE ONLY
3
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CITIZENSHIP OR PLACE OR ORGANIZATION
4 United States
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5 SOLE VOTING POWER
171,140 shares (see Item 4)
NUMBER OF ------------------------------------------------------------------
SHARES 6 SHARED VOTING POWER
BENEFICIALLY 708,457 shares (see Item 4)
OWNED BY ------------------------------------------------------------------
EACH 7 SOLE DISPOSITIVE POWER
REPORTING 171,140 shares (see Item 4)
PERSON WITH ------------------------------------------------------------------
8 SHARED DISPOSITIVE POWER
708,457 shares (see Item 4)
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9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
879,597 shares (see Item 4)
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CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES
10 CERTAIN SHARES* [ ]
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PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9
11
5.5%
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TYPE OF REPORTING PERSON*
12
IN
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*SEE INSTRUCTIONS BEFORE FILLING OUT!
Page 3 of 8 Pages
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ITEM 1(a). NAME OF ISSUER:
U.S.B. Holding Co., Inc.
ITEM 1(b). ADDRESS OF ISSUER'S PRINCIPAL EXECUTIVE OFFICES:
100 Dutch Hill Road, Orangeburg, NY 10962
ITEM 2(a). NAME OF PERSON FILING:
Thomas E. Hales and Alice Marie Hales
ITEM 2(b). ADDRESS OF PRINCIPAL BUSINESS OFFICE OR, IF NONE, RESIDENCE:
Thomas E. Hales: c/o Union State Bank, 100 Dutch Hill Road,
Orangeburg, NY10962
Alice Marie Hales: 66 Brookwood Drive, Briarcliff Manor,
NY 10510
ITEM 2(c). CITIZENSHIP:
Thomas E. Hales: United States
Alice Marie Hales: United States
ITEM 2(d). TITLE OF CLASS OF SECURITIES:
Common Stock
ITEM 2(e). CUSIP NUMBER:
902910108
ITEM 3. IF THIS STATEMENT IS FILED PURSUANT TO RULES 13d-1(b), OR
13D-2(b) OR (c), CHECK WHETHER THE PERSON FILING IS A:
Not applicable.
ITEM 4. OWNERSHIP.
(a) Amount Beneficially Owned:
Thomas E. Hales: 2,731,709 shares of Common Stock
This amount includes: (i) 711,952 shares of Common Stock owned
directly by Mr. Hales; (ii) 544,519 shares of Common Stock
owned jointly by Mr. Hales and Mrs.
Page 4 of 8 Pages
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Hales; (iii) 171,140 shares of Common Stock owned directly by
Mrs. Hales; (iv) 208,920 shares of Common Stock owned by the
U.S.B. Holding Co., Inc. Employee Stock Ownership Plan (with
401(k) provisions) (the "KSOP") and allocated to Mr. Hales;
(v) 65,737 shares of Common Stock owned by the Company's Key
Employees' Supplemental Investment Plan (the "KESIP") and
allocated to Mr. Hales; (vi) 163,938 shares of Common Stock
owned by the Hales Family Foundation, of which Mr. Hales is a
director; and (vii) vested stock options to purchase 865,503
shares of Common Stock held by Mr. Hales.
Alice Marie Hales: 879,597 shares of Common Stock
This amount includes: (i) 171,140 shares of Common Stock owned
directly by Mrs. Hales; (ii) 544,519 shares of Common Stock
owned jointly by Mr. Hales and Mrs. Hales; and (iii) 163,938
shares of Common Stock owned by the Hales Family Foundation,
of which Mrs. Hales is a director.
(b) Percent of Class:
Thomas E. Hales: 16.31%
This percentage is based upon 15,884,273 shares of Common
Stock issued and outstanding as of December 31, 1999, plus the
aggregate number of shares which the Reporting Person has the
right to acquire within 60 days pursuant to the exercise of
vested stock options.
Alice Marie Hales: 5.5%
This percentage is based upon 15,884,273 shares of Common
Stock issued and outstanding as of December 31, 1999.
(c) Number of shares as to which such person has:
(i) sole power to vote or to direct the vote:
Thomas E. Hales: 1,852,112 shares of Common Stock
This amount includes: (i) 711,952 shares of Common Stock owned
directly by Mr. Hales; (ii) 208,920 shares of Common Stock
owned by the KSOP and allocated to Mr. Hales; (iii) 65,737
shares of Common Stock owned by the KESIP and allocated to Mr.
Hales; and (iv) 865,503 shares of Common Stock issuable upon
the exercise of vested stock options held by Mr. Hales.
Alice Marie Hales: 171,140 shares of Common Stock
This amount refers to the shares of Common Stock owned
directly by Mrs. Hales.
Page 5 of 8 Pages
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(ii) shared power to vote or to direct the vote:
Thomas E. Hales: 879,597 shares of Common Stock
This amount includes: (i) 544,519 shares of Common Stock owned
jointly by Mr. Hales and Mrs. Hales; (ii) 163,938 shares of
Common Stock owned by the Hales Family Foundation, of which
Mr. Hales is a director; and (iii) 171,140 shares of Common
Stock owned directly by Mrs. Hales.
Alice Marie Hales: 708,457 shares of Common Stock
This amount includes: (i) 544,519 shares of Common Stock owned
jointly by Mr. and Mrs. Hales; and (ii) 163,938 shares of
Common Stock owned by the Hales Family Foundation, of which
Mrs. Hales is a director.
(iii) sole power to dispose or to direct the disposition of:
Thomas E. Hales: 1,577,455 shares of Common Stock
This amount includes: (i) 711,952 shares of Common Stock owned
directly by Mr. Hales; and (ii) 865,503 shares of Common Stock
issuable upon the exercise of vested stock options held by Mr.
Hales.
Alice Marie Hales: 171,140 shares of Common Stock
This amount refers to the shares of Common Stock owned
directly by Mrs. Hales.
(iv) shared power to dispose or to direct the disposition of:
Thomas E. Hales: 991,812 shares of Common Stock
This amount includes: (i) 544,519 shares of Common Stock owned
jointly by Mr. Hales and Mrs. Hales; (ii) 112,215 of the
shares of Common Stock held by the KSOP that are allocated to
Mr. Hales and that represent employee contributions and/or
matching employer contributions (collectively, the "401(k)
KSOP Shares"), as the trustees of the KSOP have shared power
(with the respective participants) to dispose or direct the
disposition of the 401(k) KSOP Shares; (iii) 163,938 shares of
Common Stock owned by the Hales Family Foundation, of which
Mr. Hales is one of the directors; and (iv) 171,140 shares of
Common Stock owned directly by Mrs. Hales.
Alice Marie Hales: 708,457 shares of Common Stock
This amount includes: (i) 544,519 shares of Common Stock owned
jointly by Mr. and Mrs. Hales; and (ii) 163,938 shares of
Common Stock owned by the Hales Family Foundation, of which
Mrs. Hales is a director.
Page 6 of 8 Pages
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ITEM 5. OWNERSHIP OF FIVE PERCENT OR LESS OF A CLASS.
Not applicable.
ITEM 6. OWNERSHIP OF MORE THAN FIVE PERCENT ON BEHALF OF ANOTHER
PERSON.
Not applicable.
ITEM 7. IDENTIFICATION AND CLASSIFICATION OF THE SUBSIDIARY WHICH
ACQUIRED THE SECURITY BEING REPORTED ON BY THE PARENT HOLDING
COMPANY.
Not applicable.
ITEM 8. IDENTIFICATION AND CLASSIFICATION OF MEMBERS OF THE GROUP.
Not applicable.
ITEM 9. NOTICE OF DISSOLUTION OF GROUP.
Not applicable.
ITEM 10. CERTIFICATIONS.
Not applicable.
Page 7 of 8 Pages
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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.
Date: February 14, 2000 Date: February 14, 2000
/s/ THOMAS E. HALES /s/ ALICE MARIE HALES
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THOMAS E. HALES ALICE MARIE HALES
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