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FORM 5 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION |
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[ ] Check this box if no longer subject to |
Washington, D.C. 20549 |
OMB Number 3235-0362 |
[ ] Form 3 Holdings Reported |
BENEFICIAL OWNERSHIP |
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[ ] Form 4 Transactions Reported |
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1. Name and Address of Reporting Person* Smith, Dan L. (Last) (First) (Middle) |
4. Statement for Month/Year Fiscal 1999 |
823 Riverview Drive (Street) |
5. If Amendment, Date of Original (Month/Year) |
Benton Harbor, Michigan 49022 (City) (State) (Zip) |
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2. Issuer Name and Ticker or Trading
Symbol Shoreline Financial Corporation ("SLFC") |
6. Relationship of Reporting Person(s) to Issuer |
3. IRS or Social Security Number of Reporting Person (Voluntary) |
7. Individual or Joint/Group
Reporting (check applicable line) X Form Filed by One Reporting Person Form Filed by More than One Reporting Person |
Table I -- Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned |
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1. Title of Security (Instr. 3) |
2. Transaction Date (Month/ Day/ Year) |
3. Transaction Code (Instr. 8) |
4. Securities
Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) |
5. Amount of Securities Beneficially Owned at end of Issuer's Fiscal Year (Instr. 3 and 4) |
6. Ownership Form: Di- rect (D) or Indirect (I) (Instr. 4) |
7. Nature of Indirect Beneficial Ownership (Instr. 4) |
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Amount | (A) or (D) | Price | ||||||
Common Stock |
75,808.5(1)
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D
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Common Stock |
18,250
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I
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By Spouse
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Common Stock |
7/15/99
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I
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3,057.067 | D | 25.5 |
8,753.7390
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I
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401(k)
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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 control number. |
Form 5 (continued) | Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) |
1. Title of Derivative Security (Instr. 3) |
2. Conversion of Exercise Price of Derivative Security |
3. Transaction Date (Month/ Day/ Year) |
4. Transaction Code (Instr. 8) |
5. Number of Deriva- tive Securities Ac- quired (A) or Dis- posed of (D) (Instr. 3, 4, and 5) |
6. Date Exercisable and Expiration Date (Month/Day/Year) |
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(A) |
(D) |
Date Exercisable |
Expiration Date |
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7. Title and Amount of Underlying Securities (Instr. 3 and 4) |
8. Price of Deriv- ative Security (Instr. 5) |
9. Number of Deriv- ative Securities Beneficially owned at End of Year (Instr. 4) |
10. Ownership of Derivative Sec- urity: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Bene- ficial Ownership (Instr. 4) |
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Title |
Amount or Number of Shares |
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**Intentional misstatements or omissions of facts constitute | /s/ Dan L. Smith | February 14, 2000 | ||
Federal Criminal Violations. | **Signature of Reporting Person | Date | ||
See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). | Dan L. Smith By Jeffrey A. Ott Attorney-in-Fact |
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