Sec Form 4 Filing - CapGen Capital Group IV LP @ JACKSONVILLE BANCORP INC /FL/ - 2012-12-31

Insider filing report for Changes in Beneficial Ownership
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FORM 4
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
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
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1. Name and Address of Reporting Person
CapGen Capital Group IV LP
2. Issuer Name and Ticker or Trading Symbol
JACKSONVILLE BANCORP INC /FL/ [ JAXB]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X __ Director X __ 10% Owner
_____ Officer (give title below) X __ Other (specify below)
See Remarks
(Last) (First) (Middle)
1185 AVENUE OF THE AMERICAS, SUITE 2000
3. Date of Earliest Transaction (MM/DD/YY)
12/31/2012
(Street)
NEW YORK, NY10036
4. If Amendment, Date Original Filed (MM/DD/YY)
6. Individual or Joint/Group Filing (Check Applicable Line)
_____ Form filed by One Reporting Person
__ X __ Form filed by More than One Reporting Person
(City) (State) (Zip)
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1.Title of Security
(Instr. 3)
2. Transaction Date (MM/DD/YY) 2A. Deemed Execution Date, if any (MM/DD/YY) 3. Transaction Code
(Instr. 8)
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
6. Ownership Form: Direct (D) or Indirect (I)
(Instr. 4)
7. Nature of Indirect Beneficial Ownership
(Instr. 4)
Code V Amount (A) or (D) Price
Series B Preferred Stock 12/31/2012 S 5,000 D 0 I ( 1 ) ( 2 ) ( 3 ) Held by CapGen Capital Group IV LP
Series A Mandatorily Convertible Preferred Stock ( 6 ) 12/31/2012 P 5,000 A $ 5,000,000 ( 4 ) 5,000 I ( 1 ) ( 2 ) ( 3 ) Held by CapGen Capital Group IV LP
Series A Mandatorily Convertible Preferred Stock ( 6 ) 12/31/2012 P 22,530 A $ 22,530,000 22,530 I ( 1 ) ( 2 ) ( 3 ) Held by CapGen Capital Group IV LP
Series A Mandatorily Convertible Preferred Stock ( 6 ) 12/31/2012 P 830 A $ 830,000 830 D ( 5 )
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 or Exercise Price of Derivative Security 3. Transaction Date (MM/DD/YY) 3A. Deemed Execution Date, if any (MM/DD/YY) 4. Transaction Code
(Instr. 8)
5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4, and 5)
6. Date Exercisable and Expiration Date
(MM/DD/YY)
7. Title and Amount of Underlying Securities
(Instr. 3 and 4)
8. Price of Derivative Security
(Instr. 5)
9. Number of Derivative Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 4)
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
(Instr. 4)
11. Nature of Indirect Beneficial Ownership
(Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
CapGen Capital Group IV LP
1185 AVENUE OF THE AMERICAS
SUITE 2000
NEW YORK, NY10036
X X See Remarks
Ludwig Eugene
1185 AVENUE OF THE AMERICAS
SUITE 2000
NEW YORK, NY10036
X X See Remarks
CapGen Capital Group IV LLC
1185 AVENUE OF THE AMERICAS
SUITE 2000
NEW YORK, NY10036
X X See Remarks
Signatures
/s/ Eugene A. Ludwig as the managing member of CAPGEN CAPITAL GROUP IV LLC, the general partner of CAPGEN CAPITAL GROUP IV LP 01/03/2013
Signature of Reporting Person Date
/s/ Eugene A. Ludwig 01/03/2013
Signature of Reporting Person Date
Explanation of Responses:
( 1 )The shares reported in this row are owned directly by CapGen Capital Group IV LP ("CapGen LP"). CapGen Capital Group IV LLC ("CapGen LLC") is the sole general partner of CapGen LP. Mr. Eugene A. Ludwig is the managing member of CapGen LLC.
( 2 )As the sole general partner of CapGen LP, CapGen LLC may be deemed to be the indirect beneficial owner of the shares reported in this row under Rule 16a-1(a)(2) promulgated under the Securities Exchange Act of 1934, as amended (the "Exchange Act"). Pursuant to Rule 16a-1(a)(4) promulgated under the Exchange Act, CapGen LLC disclaims that it is the beneficial owner of such shares, except to the extent of its pecuniary interest.
( 3 )As the managing member of CapGen LLC, Mr. Ludwig may be deemed to be the indirect beneficial owner of the shares reported in this row under Rule 16a-1(a)(2) promulgated under the Exchange Act. Pursuant to Rule 16a-1(a)(4) promulgated under the Exchange Act, Mr. Ludwig disclaims that he is the beneficial owner of such shares, except to the extent of his pecuniary interest.
( 4 )Upon receipt of regulatory approval, the Noncumulative, Nonvoting Perpetual Preferred Stock, Series B (the "Series B Preferred Stock") of Jacksonville Bancorp, Inc. (the "Issuer") became exchangeable, on a one-for-one basis, into shares of Series A Mandatorily Convertible, Noncumulative, Nonvoting Perpetual Preferred Stock, Series A (the "Series A Preferred Stock"). On December 31, 2012, all 5,000 shares of Series B Preferred Stock held by the Reporting Persons were exchanged into 5,000 shares of Series A Preferred Stock.
( 5 )Mr. Ludwig directly owns the shares reported in this row.
( 6 )Upon receipt of requisite shareholder approvals, each share of Series A Preferred Stock will convert into 2,000 shares of common stock and/or nonvoting common stock (subject to adjustments), as more fully described in the Series A Preferred Stock Designation.

Remarks:
CapGen LP, CapGen LLC and Mr. Ludwig disclaim their status as directors by deputization by virtue of Messrs. John Rose's and John Sullivan's positions as members of the board of directors of the Issuer.

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