Form 3 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION |
Expires: January 31, 2005 Estimated average burden hours per response. . . 0.5 |
(Print or type responses) |
1. Name and Address of Reporting Person*
Edward A. Mervine 214 West First Street Oswego, New York 13126 |
2. Date of Event Requiring Statement (Month/Day/Year) 01/01/2002 |
4. Issuer Name and Ticker or Trading Symbol
Pathfinder Bancorp, Inc. (pbhc) |
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3. I.R.S. Identification Number of Reporting Person, if an entity (voluntary) 186-46-0986 |
5. Relationship of Reporting Person(s) to Issuer (Check all applicable) ___ Director ___ 10% Owner _X_ Officer (give title below) ___ Other (specify below) |
6. If Amendment,
Date of Original (Month/Day/Year) |
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7. Individual or Joint/Group Filing (Check Applicable Line) _X_ Form filed by One Reporting Person ___ Form filed by More than One Reporting Person |
Table I - Non-Derivative Securities Beneficially Owned |
1. Title of Security (Instr. 4) |
2. Amount of Securities Beneficially Owned (Instr. 4) |
3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) |
4. Nature of Indirect Beneficial Ownership (Instr. 5) |
Pathfinder Bancorp, Inc. Common Stock | 150 | D |
Reminder: Report on a separate line for each class of securities beneficially owned directly
or indirectly. * If the form is filed by more than one reporting person, see Instructions 5(b)(v). |
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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. |
(Over) SEC 1474 (7-02) |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) |
1. Title of Derivative Security (Instr. 4) |
2. Date Exercisable and Expiration Date (Month/Day/Year) |
3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) |
4. Conversion or Exercise Price of Derivative Security |
5. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 5) |
6. Nature of Indirect Beneficial Ownership (Instr. 5) |
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Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
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Explanation of Responses: |
** | Intentional
misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
/s/ Eward A. Mervine
**Signature of Reporting Person |
03/24/2003
Date |
Note: | File three copies of this Form, one of which
must be manually signed. If space is insufficient, See Instruction 6 for procedure. |