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FORM 5
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
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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CHECK THIS BOX IF NO LONGER SUBJECT TO
[ ] SECTION 16. FORM 4 OR FORM 5 OBLI-
GATIONS MAY CONTINUE. SEE INSTRUCTION 1(B).
[ ] FORM 3 HOLDINGS REPORTED
[X] FORM 4 TRANSACTIONS REPORTED
<TABLE>
<S> <C>
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1. Name and Address of 2. Issuer Name AND Ticker or Trading Symbol 6. Relationship of Reporting
Reporting Person* Person to Issuer
(Check all applicable)
X Director 10% Owner
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Gross Neal R. Century Bancshares, Inc (CTRY)
Officer (give Other (specify
--- title --- below)
below)
Director
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(Last) (First) (Middle) 3. IRS or Social Security 4. Statement for Month/Year
Number of Reporting
1323 Rhode Island Avenue, N.W. Person (Voluntary) December, 1998
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(Street) 5. If Amendment, Date of 7. Individual or Joint/
Original (Month/Year) Group Filing
(check applicable line)
Washington DC 20005 X Form Filed by One
--- Reporting Person
Form Filed by
--- More than One
Reporting Person
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(City) (State) (Zip)
TABLE I - NON-DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED
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1. Title of Security 2. Trans- 3. Trans- 4. Securities Acquired (A) 5. Amount of 6. Owner- 7. Nature
(Instr. 3) action action or Disposed of (D) Securities ship of In-
Date Code (Instr. 3, 4 and 5) Beneficially Form: direct
(Instr. Owned at Direct Bene-
(Month/ 8) End of (D) or ficial
Day/ Issuer's Indirect Owner-
Year) Fiscal Year (I) ship
(Instr. 3 (Instr. 4) (Instr. 4)
and 4)
(A) or
Amount (D) Price
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Common Stock 09/23/97 P 15,000 shares A $7.50 15,000 I By Trust
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104,899 D
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*If the form is filed by more than one reporting person, see instruction
4(b)(v).
Reminder: Report on a separate line for each class of securities beneficially
owned directly or indirectly.
(Over)
SEC 2270 (7-96)
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FORM 5 (continued)
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
<TABLE>
<S> <C>
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1. Title of Derivative 2. Conver- 3. Trans- 4. Transac- 5. Number of Deriv- 6. Date Exer- 7. Title and Amount of
Security sion or action tion ative Securities cisable and Ex- Underlying
(Instr. 3) Exercise Date (Instr. 8) Acquired (A) or piration Date Securities
Price of (Month/ Disposed of (D) (Month/Day/ (Instr. 3, and 4)
Deriv- Day/ Year)
ative Year)
Security
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Date Expira- Amount or
Exer- tion Title Number of
cisable Date Shares
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(A) (D)
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Warrant to Buy 11/15/96 11/16/98 (1) Common Stock 16,839
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Option to Buy 12/31/96 5/20/99 Common Stock 780
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Option to Buy 12/31/96 5/19/00 Common Stock 1,243
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Option to Buy 5/18/94 5/17/01 Common Stock 1,770
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Option to Buy 5/7/95 5/17/02 Common Stock 1,685
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Option to Buy 5/21/96 5/21/06 Common Stock 1,575
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Option to Buy 6/6/97 6/6/07 Common Stock 1,500
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8. Price 9. Number 10. 11. Na-
of of Deriv- Owner- ture
Deriv- ative ship of
ative Secur- De- In-
Secur- ities rivative direct
ity Bene- Secu- Bene-
(Instr. ficially rity: ficial
5) Owned Direct Own-
at End (D) or ership
of Indi-
Year rect
(Instr. (Instr.
4) 4)
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$5.12 16,839 D
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$2.11 780 D
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$2.69 1,243 D
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$4.03 1,770 D
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$5.12 1,685 D
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$5.71 1,575 D
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$6.88 1,500 D
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</TABLE>
Explanation of Responses:
(1) This issuer has the option, on and after November 14, 1997, to repurchase
the Warrants at a price equal to $.26 per Warrant.
**Intentional misstatements or omissions of facts constitute Federal Criminal
Violations.
See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
/S/ Neal R. Gross 2/17/98
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**Signature of Reporting Person Date
Note: File three copies of this Form, one of which must be manually signed.
If space provided is insufficient, see Instruction 6 for procedure.
Potential persons who are to respond to the collection of information contained
in this form are not required to respond unless the form displays a currently
valid OMB number.
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SEC 2270 (7-96)
