UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 3
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
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 Humphrey Peter G.
Reporting Person --------------------------------------
(Last) (First) (Middle)
220 Liberty Street
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(Street)
Warsaw New York 14569
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(City) (State) (Zip)
*If the form is filed by more than one reporting person, see Instruction
5(b)(v).
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2. Date of Event Requiring 11/2/00
Statement (Month/Day/Year)
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3. IRS or Social Security
Number of Reporting Person
(Voluntary)
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<PAGE>
-2-
FORM 3 (continued)
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4. Issuer Name and Ticker or Bath National Corporation.
Trading Symbol Bath
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5. Relationship of Reporting ___ Director ___ 10% Owner
Person(s) to Issuer ___ Officer (give __X_ Other (specify
(Check all applicable) title below) below)
Holder of Proxy to Vote _____% of shares
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6. If Amendment, Date of
Original (Month/Day/Year) ___/___/___
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7. Individual or Joint/Group _X_ Form filed by One Reporting Person
Filing (1) ____Form filed by More than One Reporting
(Check Applicable Line) Person
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<TABLE>
<CAPTION>
Table I - Non-Derivative Securities Beneficially Owned
<S> <C> <C> <C>
1. Title of Security 2. Amount of Securities 3. Ownership Form: 4. Nature of Indirect
(Instr. 4) Beneficially Owned Direct (D) or Beneficial
(Instr. 4) Indirect (I) Ownership
(Instr. 5) (Instr. 5)
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Common Stock 86,255 (1) I Right to vote shares
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Reminder: Report on a separate line for each class of securities
beneficially owned directly or indirectly.
</TABLE>
<PAGE>
-3-
FORM 3 (continued)
<TABLE>
<CAPTION>
Table II -- Derivative Securities Beneficially Owned (e.g., puts, calls,
warrants, options, convertible securities)
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<S> <C> <C>
1. Title of Derivative 2. Date Exercisable and 3. Title and Amount of Securities
Security (Instr. 4) Expiration Date Underlying Derivative Security
(Month/Day/Year) (Instr. 4)
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Date Expiration Title Amount or Number
Exercisable Date of Shares
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4. Conversion or Exercise 5. Ownership Form of Derivative 6. Nature of Indirect Beneficial
Price of Derivative Security: Direct (D) or Ownership
Security Indirect (I) (Instr. 5)
(Instr. 5)
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</TABLE>
Explanation of Responses:
(1) Financial Institutions Inc. and Peter G. Humphrey were each names as proxy
and attorney-in-fact to vote the reported shares of Bath National Corporation
("Bath") with respect to certain matters relating to the merger of Bath with and
into a wholly-owned subsidiary of Financial Institutions, Inc. (the "Merger").
The Bath shareholders granting the proxy are Theodore P. Capron, Robert H. Cole,
Herbert Fort, Edward C. Galpin, Lisle E. Hopkins, Lawrence C. Howell, Douglas L.
McCabe, Freeman H. Smith, III, Patrick Sullivan and Alan J. Wilcox Constance
Manikas, Laverne H. Billings and Joseph F. Meade, Jr.
Date: November 10, 2000
** International misstatements or
omissions of facts constitute
Federal Criminal Violations.
/s/Peter G. Humphrey
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See 18 U.S.C. 1001 and 15 U.S.C. 781(A) By: Peter G. Humphrey
**Signature of Reporting Person
