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OMB APPROVAL
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OMB Number 3235-0362
Expires: January 31, 2005
Estimated average burden
hours per response ....... 1.0
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U.S. SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 5
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
[ ] Check this box if no longer subject to Section 16. Form 4 or Form 5
obligations may continue. See Instruction 1(b).
[ ] Form 3 Holdings Reported
[ ] Form 4 Transactions Reported
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1. Name and Address of Reporting Person*
DAVIS, JR. WILLIAM W.
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(Last) (First) (Middle)
717 MAIN STREET
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(Street)
HONESDALE PA 18431
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(City) (State) (Zip)
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2. Issuer Name and Ticker or Trading Symbol
NORWOOD FINANCIAL CORP / NWFL
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3. I.R.S. Identification Number of Reporting Person, if an entity (Voluntary)
--
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4. Statement for Month/Year
DECEMBER 2002
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5. If Amendment, Date of Original (Month/Year)
--
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6. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
[ X ] Director [ ] 10% Owner
[ X ] Officer (give title below) [ ] Other (specify below)
PRESIDENT AND CHIEF EXECUTIVE OFFICER
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7. Individual or Joint/Group Reporting
(Check Applicable line)
[ X ] Form filed by One Reporting Person
[ ] Form filed by More than One Reporting Person
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Table I -- Non-Derivative Securities Acquired, Disposed of,
or Beneficially Owned
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5. 6.
4. Amount of Owner-
Securities Acquired (A) or Securities ship
2A. 3. Disposed of (D) Beneficially Form: 7.
Deemed Transaction (Instr. 3, 4 and 5) Owned at end Direct Nature of
2. Execution Code ------------------------------- of Issuer's (D) or Indirect
1. Transaction Date (Instr. 8) (A) Fiscal Year Indirect Beneficial
Title of Security Date if any Amount or Price (Instr. 3 (I) Ownership
(Instr. 3) (mm/dd/yy) (mm/dd/yy) (D) and 4) (Instr.4) (Instr. 4)
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COMMON 12/31/02 A 847 A $16.39 5,213 I ESOP
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12,026 D
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4,000 I IRA
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*If the form is filed by more than one reporting person, see Instruction 4(b)(v).
Persons who respond to the collection of information contained (Over)
in this form are not required to respond unless the form displays SEC 2270 (9-02)
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)
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9. 10.
Number Owner-
of ship
2. Deriv- of
Conver- 5. 7. ative Deriv- 11.
sion Number of Title and Amount Secur- ative Nature
or 3A. Derivative 6. of Underlying 8. ities Secur- of
Exer- Deemed 4. Securities Date Securities Price Bene- ity: In-
cise 3. Exe- Trans- Acquired (A) Exercisable and (Instr. 3 and 4) of ficially Direct direct
Price Trans- cution action or Disposed Expiration Date ---------------- Deriv- Owned (D) or Bene-
1. of action Date Code of(D) (Month/Day/Year) Amount ative at End In- ficial
Title of Deriv- Date if any (Instr. (Instr. 3, ---------------- or Secur- of direct Owner-
Derivative ative (Month/ Month/ 8) 4 and 5) Date Expira- Number ity Year (I) ship
Security Secur- Day/ Day/ ------------ Exer- tion of (Instr. (Instr. (Instr. (Instr.
(Instr. 3) ity Year) Year) (A) (D) cisable Date Title Shares 5) 4) 4) 4)
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OPTIONS -
RIGHT-TO-BUY COMMON 18,500 D
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Explanation of Responses:
BY: LEWIS J. CRITELLI
/S/WILLIAM W. DAVIS, JR. ATTORNEY-IN-FACT FEBRUARY 6, 2003
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**Signature of Reporting Person Date
** Intentional misstatements or omissions of facts constitute Federal Criminal
Violations.
See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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 collections of information contained
in this form are not required to respond unless the form displays a currently
valid OMB number.
Page 2 SEC 2270 (9-02)