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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
SCHEDULE 13G
Under the Securities Exchange Act of 1934
(Amendment No. ___________)*
1st STATE BANCORP, INC.
(Name of Issuer)
COMMON STOCK
(Title of Class of Securities)
3365455 10 0
(CUSIP Number)
December 31, 2003
(Date of Event Which Requires Filing of this Statement)
Check the appropriate box to designate the rule pursuant to
which this Schedule is filed:
[ ] Rule 13d-1(b)
[ ] Rule 13d-1(c)
[ X ] Rule 13d-1(d)
*The remainder of this cover page shall be filled out for a
reporting person's initial filing on this form with respect
to the subject class of securities, and for any subsequent
amendment containing information which would alter the
disclosures provided in a prior cover page.
The information required in the remainder of this cover page
shall not be deemed to be "filed" for the purpose of Section
18 of the Securities Exchange Act of 1934 ("Act") or
otherwise subject to the liabilities of that section of the
Act but shall be subject to all other provisions of the Act
(however, see the Notes).
CUSIP No. 3365455 10 0
1. Names of Reporting Persons.
I.R.S. Identification Nos. of above persons (entities only).
MAURICE J. KOURY
2. Check the Appropriate Box if a Member of a Group (See
Instructions)
(a) ...........................................................
(b) ...........................................................
3. SEC Use Only ....................................................
4. Citizenship or Place of Organization
UNITED STATES OF AMERICA
Number of
Shares
Beneficially
Owned by
Each
Reporting
Person With
5. Sole Voting Power ............210,330 (1)
6. Shared Voting Power ........0
7. Sole Dispositive Power.......210,330 (1)
8. Shared Dispositive Power....0
9. Aggregate Amount Beneficially Owned by Each
Reporting Person...............210,330 (1)
10. Check if the Aggregate Amount in Row (9) Excludes
Certain Shares (See Instructions).............X.............
11. Percent of Class Represented by Amount in Row (9)......7.1 %
12. Type of Reporting Person (See Instructions)
IN
....(1) The aggregate number of shares does not include any of the
following: 17,500 shares held by the Maurice J. Koury Foundation,
Inc. ("Foundation"), 53,500 shares held by Carolina Hosiery Mills,
Inc. (the "Company"); and 19,000 shares held by the Carolina Hosiery
Mills, Inc. Employees Profit Sharing Trust ("Trust"). The person
listed on Item 1 above is: (a) one of four directors and president
of the Foundation; (b) a director, president and 23.6% shareholder
of the Company; and (c) a trustee of the Trust. In all such cases,
the person listed in Item 1 may have input into decisions concerning
the voting power over the shares held by the Foundation, the Company
and the Trust in certain limited circumstances.
INSTRUCTIONS FOR SCHEDULE 13G
Instructions for Cover Page
(l) Names and I.R.S. Identification Numbers of Reporting
Persons-Furnish the full legal name of each person for
whom the report is filed-i.e., each person required to
sign the schedule itself-including each member of a
group. Do not include the name of a person required to be
identified in the report but who is not a reporting
person. Reporting persons that are entities are also
requested to furnish their I.R.S. identification numbers,
although disclosure of such numbers is voluntary, not
mandatory (see "SPECIAL INSTRUCTIONS FOR COMPLYING WITH
SCHEDULE 13G" below).
(2) If any of the shares beneficially owned by a reporting
person are held as a member of a group and that
membership is expressly affirmed, please check row 2(a).
If the reporting person disclaims membership in a group
or describes a relationship with other persons but does
not affirm the existence of a group, please check row
2(b) [unless it is a joint filing pursuant to Rule
13d1(k)(1) in which case it may not be necessary to check
row 2(b)].
(3) The third row is for SEC internal use; please leave
blank.
(4) Citizenship or Place of Organization-Furnish citizenship
if the named reporting person is a natural person.
Otherwise, furnish place of organization.
(5)- Aggregate Amount Beneficially Owned By Each Reporting
(9), Person, Etc.-Rows (5) through (9) inclusive, and (11) are
(11) to be completed in accordance with the provisions of Item
4 of Schedule 13G. All percentages are to be rounded off
to the nearest tenth (one place after decimal point).
(10) Check if the aggregate amount reported as beneficially
owned in row (9) does not include shares as to which
beneficial ownership is disclaimed pursuant to Rule 13d-4
(17 CFR 240.13d-4] under the Securities Exchange Act of
1934.
(12) Type of Reporting Person-Please classify each "reporting
person" according to the following breakdown (see Item 3
of Schedule 13G) and place the appropriate symbol on the
form:
Category
Symbol
Broker Dealer
BD
Bank
BK
Insurance Company
IC
Investment Company
IV
Investment Adviser
IA
Employee Benefit Plan, Pension Fund, or Endowment Fund
EP
Parent Holding Company/Control Person
HC
Savings Association
SA
Church Plan
CP
Corporation
CO
Partnership
PN
Individual
IN
Other
OO
Notes: Attach as many copies of the second part of the cover
page as are needed, one reporting person per page.
Filing persons may, in order to avoid unnecessary
duplication, answer items on the schedules (Schedule 13D,
13G or 14D1) by appropriate cross references to an item
or items on the cover page(s). This approach may only be
used where the cover page item or items provide all the
disclosure required by the schedule item. Moreover, such
a use of a cover page item will result in the item
becoming a part of the schedule and accordingly being
considered as "filed" for purposes of Section 18 of the
Securities Exchange Act or otherwise subject to the
liabilities of that section of the Act.
Reporting persons may comply with their cover page filing
requirements by filing either completed copies of the
blank forms available from the Commission, printed or
typed facsimiles, or computer printed facsimiles,
provided the documents filed have identical formats to
the forms prescribed in the Commission's regulations and
meet existing Securities Exchange Act rules as to such
matters as clarity and size (Securities Exchange Act Rule
12b-12).
SPECIAL INSTRUCTIONS FOR COMPLYING WITH SCHEDULE 13G
Under Sections 13(d), 13(g), and 23 of the Securities
Exchange Act of 1934 and the rules and regulations
thereunder, the Commission is authorized to solicit the
information required to be supplied by this schedule by
certain security holders of certain issuers.
Disclosure of the information specified in this schedule is
mandatory, except for I.R.S. identification numbers,
disclosure of which is voluntary. The information will be
used for the primary purpose of determining and disclosing
the holdings of certain beneficial owners of certain equity
securities. This statement will be made a matter of public
record. Therefore, any information given will be available
for inspection by any member of the public.
Because of the public nature of the information, the
Commission can use it for a variety of purposes, including
referral to other governmental authorities or securities
self-regulatory organizations for investigatory purposes or
in connection with litigation involving the Federal
securities laws or other civil, criminal or regulatory
statutes or provisions. I.R.S. identification numbers, if
furnished, will assist the Commission in identifying
security holders and, therefore, in promptly processing
statements of beneficial ownership of securities.
Failure to disclose the information requested by this
schedule, except for I.R.S. identification numbers, may
result in civil or criminal action against the persons
involved for violation of the Federal securities laws and
rules promulgated thereunder.
GENERAL INSTRUCTIONS
A. Statements filed pursuant to Rule 13d-1(b) containing the
information required by this schedule shall be filed not
later than February 14 following the calendar year covered
by the statement or within the time specified in Rules 13d-
1(b)(2) and 13d2(c). Statements filed pursuant to Rule 13d-
1(c) shall be filed within the time specified in Rules 13d-
1(c), 13d-2(b) and 13d-2(d). Statements filed pursuant to
Rule 13d-1(d) shall be filed not later than February 14
following the calendar year covered by the statement
pursuant to Rules 13d-1(d) and 13d-2(b).
B. Information contained in a form which is required to be
filed by rules under section 13(f) (15 U.S.C. 78m(f)) for
the same calendar year as that covered by a statement on
this schedule may be incorporated by reference in response
to any of the items of this schedule. If such information is
incorporated by reference in this schedule, copies of the
relevant pages of such form shall be filed as an exhibit to
this schedule.
C. The item numbers and captions of the items shall be included
but the text of the items is to be omitted. The answers to
the items shall be so prepared as to indicate clearly the
coverage of the items without referring to the text of the
items. Answer every item. If an item is inapplicable or the
answer is in the negative, so state.
Item 1.
(a) Name of Issuer 1st STATE BANCORP, INC.
(b) Address of Issuer's Principal Executive Offices
445 S. MAIN STREET
BURLINGTON, NORTH CAROLINA 27215
Item 2.
(a) Name of Person Filing MAURICE J. KOURY
(b) Address of Principal Business Office or, if none,
Residence
PO DRAWER 850
BURLINGTON, NC 27216
(c) Citizenship UNITED STATES OF AMERICA
(d) Title of Class of Securities COMMON STOCK
(e) CUSIP Number 3365455 10 0
Item If this statement is filed pursuant to 240.13d-1(b) or
3. 240.13d-2(b) or (c), check whether the person filing is a:
NOT APPLICABLE
(a) [ ] Broker or dealer registered under section 15 of
the Act (15 U.S.C. 78o).
(b) [ ] Bank as defined in section 3(a)(6) of the Act (15
U.S.C. 78c).
(c) [ ] Insurance company as defined in section 3(a)(19)
of the Act (15 U.S.C. 78c).
(d) [ ] Investment company registered under section 8 of
the Investment Company Act of 1940 (15 U.S.C 80a-
8).
(e) [ ] An investment adviser in accordance with 240.13d-
1(b)(1)(ii)(E);
(f) [ ] An employee benefit plan or endowment fund in
accordance with 240.13d-1(b)(1)(ii)(F);
(g) [ ] A parent holding company or control person in
accordance with 240.13d-1(b)(1)(ii)(G);
(h) [ ] A savings associations as defined in Section 3(b)
of the Federal Deposit Insurance Act (12 U.S.C.
1813);
(i) [ ] A church plan that is excluded from the definition
of an investment company under section 3(c)(14) of
the Investment Company Act of 1940 (15 U.S.C. 80a-
3);
(j) [ ] Group, in accordance with 240.13d-1(b)(1)(ii)(J).
Item Ownership.
4.
Provide the following information regarding the aggregate number
and percentage of the class of securities of the issuer
identified in Item 1.
(a) Amount beneficially owned: SEE ROW 9 OF THE SECOND PART
OF THE COVER PAGE PROVIDED FOR THE REPORTING PERSON.
(b) Percent of class: SEE ROW 11 OF THE SECOND PART OF THE
COVER PAGE PROVIDED FOR THE REPORTING PERSON
(c) Number of shares as to which the person has: SEE ROW 5,
6, 7 AND 8 OF THE SECOND PART OF THE COVER PAGE FOR THE
REPORTING PERSON
(i) Sole power to vote or to direct the vote
210,330 (1).
(ii) Shared power to vote or to direct the vote
__________________.
(iii) Sole power to dispose or to direct the disposition
of 210,330 (1).
(iv) Shared power to dispose or to direct the
disposition of _______________.
Instruction. For computations regarding securities which
represent a right to acquire an underlying security see
240.13d3(d)(1).
Item Ownership of Five Percent or Less of a Class
5.
If this statement is being filed to report the fact that as of
the date hereof the reporting person has ceased to be the
beneficial owner of more than five percent of the class of
securities, check the following [ ].
Instruction: Dissolution of a group requires a response to this
item.
NOT APPLICABLE
Item Ownership of More than Five Percent on Behalf of Another
6. Person.
If any other person is known to have the right to receive or the
power to direct the receipt of dividends from, or the proceeds
from the sale of, such securities, a statement to that effect
should be included in response to this item and, if such interest
relates to more than five percent of the class, such person
should be identified. A listing of the shareholders of an
investment company registered under the Investment Company Act of
1940 or the beneficiaries of employee benefit plan, pension fund
or endowment fund is not required.
NOT APPLICABLE
Item Identification and Classification of the Subsidiary Which
7. Acquired the Security Being Reported on By the Parent
Holding Company or Control Person.
If a parent holding company or Control person has filed this
schedule, pursuant to Rule 13d-1(b)(1)(ii)(G), so indicate under
Item 3(g) and attach an exhibit stating the identity and the Item
3 classification of the relevant subsidiary. If a parent holding
company or control person has filed this schedule pursuant to
Rule 13d-1(c) or Rule 13d-1(d), attach an exhibit stating the
identification of the relevant subsidiary.
NOT APPLICABLE
Item Identification and Classification of Members of the Group
8.
If a group has filed this schedule pursuant to 240.13d-
1(b)(1)(ii)(J), so indicate under Item 3(j) and attach an exhibit
stating the identity and Item 3 classification of each member of
the group. If a group has filed this schedule pursuant to
240.13d-1(c) or 240.13d-1(d), attach an exhibit stating the
identity of each member of the group.
NOT APPLICABLE
Item Notice of Dissolution of Group
9.
Notice of dissolution of a group may be furnished as an exhibit
stating the date of the dissolution and that all further filings
with respect to transactions in the security reported on will be
filed, if required, by members of the group, in their individual
capacity. See Item 5.
NOT APPLICABLE
Item Certification
10.
The following certification shall be included if the
statement is filed pursuant to 240.13d-1(c):
By signing below I certify that, to the best of my
knowledge and belief, the securities referred to above
were not acquired and are not held for the purpose of or
with the effect of changing or influencing the control
of the issuer of the securities and were not acquired
and are not held in connection with or as a participant
in any transaction having that purpose or effect.
SIGNATURE
After reasonable inquiry and to the best of my knowledge and
belief, I certify that the information set forth in this
statement is true, complete and correct.
________________________________
Date
________________________________
Signature
________MAURICE J. KOURY_____
Name/Title
The original statement shall be signed by each person on
whose behalf the statement is filed or his authorized
representative. If the statement is signed on behalf of a
person by his authorized representative other than an
executive officer or general partner of the filing person,
evidence of the representative's authority to sign on behalf
of such person shall be filed with the statement, provided,
however, that a power of attorney for this purpose which is
already on file with the Commission may be incorporated by
reference. The name and any title of each person who signs
the statement shall be typed or printed beneath his
signature.
NOTE: Schedules filed in paper format shall include a signed
original and five copies of the schedule, including all
exhibits. See 240.13d-7 for other parties for whom copies
are to be sent.
Attention Intentional misstatements or omissions of fact
: constitute Federal criminal violations
(See 18 U.S.C. 1001)
http://www.sec.gov/divisions/corpfin/forms/13g.htm
Last update: 11/05/2002