UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
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(h) of the Investment Company Act of 1940
OMB Number: 3235-0362
1. Name and Address of Reporting Person*
2. Issuer Name and Ticker or Trading Symbol
6. Relationship of Reporting Person(s)
(Last) (First) (Middle)
3. I.R.S. Identification Number
4. Statement for
Hammonton, NJ 08037
5. If Amendment,
7. Individual or Joint/Group Filing (Check Applicable Line)
(City) (State) (Zip)
Table I Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security
4. Securities Acquired (A) or Disposed of (D)
5. Amount of
7. Nature of Indirect
Held by spouse
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
FORM 5 (continued)
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Derivative Security
5. Number of Derivative Securities Acquired (A) or Disposed of (D)
6. Date Exercisable
7. Title and Amount of Underlying Securities
8. Price of Derivative Security
9. Number of
11. Nature of Indirect Beneficial Ownership
Amount or Number of
By: /s/ William Hungerville
**Intentional misstatements or omissions of facts constitute Federal Criminal Violations.
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Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.