SEC FORM 5 SEC Form 5
FORM 5 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

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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 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.
1. Name and Address of Reporting Person*
Lesavoy Bernard M
(Last) (First) (Middle)
ONE WINDSOR PLAZA, SUITE 200
7535 WINDSOR DR.
(Street)
ALLENTOWN PA 18195-1014
(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
Embassy Bancorp, Inc. [ EMYB ] 		5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
Officer (give title below) Other (specify below)
3. Statement for Issuer's Fiscal Year Ended (Month/Day/Year)
12/31/2012
4. If Amendment, Date of Original Filed (Month/Day/Year)
 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 Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned at end of Issuer's Fiscal Year (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Amount (A) or (D) Price
Common Stock 09/28/2012 J(1) 569.0734 A $5.202 74,577.0734 D
Common Stock 09/28/2012 J(2) 65.7593 A $5.202 8,617.7593 I Footnote(5)
Common Stock 09/28/2012 J(3) 54.1792 A $5.202 7,100.1792 I Footnote(6)
Common Stock 09/28/2012 J(4) 48.9889 A $5.202 6,419.9889 I Footnote(7)
Common Stock 43,272 I By IRA
Common Stock 2,564 I By Spouse IRA
Common Stock 412 I By Red Bird Associates, LLC
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 (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 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 (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (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: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
(A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Explanation of Responses:
1. Includes 569.0734 shares acquired on 9/28/2012 pursuant to a dividend reinvestment feature under the Embassy Bancorp, Inc. Dividend Reinvestment and Stock Purchase Plan.
2. Includes 65.7593 shares acquired on 9/28/2012 pursuant to a dividend reinvestment feature under the Embassy Bancorp, Inc. Dividend Reinvestment and Stock Purchase Plan.
3. Includes 54.1792 shares acquired on 9/28/2012 pursuant to a dividend reinvestment feature under the Embassy Bancorp, Inc. Dividend Reinvestment and Stock Purchase Plan.
4. Includes 48.9889 shares acquired on 9/28/2012 pursuant to a dividend reinvestment feature under the Embassy Bancorp, Inc. Dividend Reinvestment and Stock Purchase Plan.
5. As PUGTMA for daughter.
6. As PUGTMA for son.
7. As PUGTMA for son.
Lynne M. Neel for Bernard M. Lesavoy under Power of Attorney dated May 20, 2011. 02/12/2013
** 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 4 (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.
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.