SEC FORM 3/A SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
 
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1. Name and Address of Reporting Person*
Golden Robert

(Last) (First) (Middle)
C/O HANOVER BANCORP, INC.
80 EAST JERICHO TURNPIKE

(Street)
MINEOLA NY 11501

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
05/10/2022
3. Issuer Name and Ticker or Trading Symbol
Hanover Bancorp, Inc. /NY [ HNVR ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
Officer (give title below) Other (specify below)
5. If Amendment, Date of Original Filed (Month/Day/Year)
05/10/2022
6. 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)
Common Stock 21,616 D
Common Stock 8,846 I See Footnote 1(1)
Common Stock 215,615 I See Footnote 2(2)
Common Stock 30,000 I See Footnote 3(3)
Common Stock 85,769 I See Footnote 4(4)
Common Stock 32,692 I See Footnote 5(5)
Common Stock 52,771 I See Footnote 6(6)
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: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Non-Qualified Stock Option 09/01/2019 09/01/2026 Common Stock 10,000 13 D
Explanation of Responses:
1. Shares held in various trusts for the benefit of the children of the Reporting Person, and of which the Reporting Person is a trustee
2. Shares held in a trusts for the benefit of the Reporting Person, and of which the spouse of the Reporting Person is a trustee
3. Shares held in various trusts for the benefit of the children of the Reporting Person, and of which the spouse of the Reporting Person is a trustee
4. Shares held in various trusts for the benefit of the sibling of the Reporting Person , and of which the Reporting Person is a trustee
5. Shares held by the spouse of the Reporting Person
6. Shares held by a limited liability company which is controlled by the Reporting Person
Remarks:
The Reporting Person's Form 3 filed on May 10, 2022 is amended hereby to (i) include 85,769 indirectly held shares owned by the trust for the benefit of the Mr. Golden's sibling and of which Mr. Golden is a trustee, which were excluded due to a clerical error, (ii) segregate shares held by Mr. Golden's spouse (which had been included in directly held shares, and (iii) provide further detail on the holdings of the various trusts of which Mr. Golden is associated.
/s/ Gregory Krauss, POA 01/26/2023
** Signature of Reporting Person Date
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 Instruction 5 (b)(v).
** 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 is insufficient, see Instruction 6 for procedure.
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