SEC Form 4 · accession 0001141688-17-000005
LANDMARK BANCORP INC · LARK
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Sarah Hill-Nelson
Director
Period of report
May 9, 2017
Accepted (ET)
May 11, 2017 · 5:09 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001141688
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | May 9, 2017 | M | 1,845 | $12.12 | A | 2,527 | D | |
| Common Stock | May 9, 2017 | F | 722 | $30.995 | D | 1,805 | D | |
| Common Stock | holding | — | — | — | 6,348 | I | IRA / Pension |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Options to Purchase Common StockF1,F2 | $12.12 | May 9, 2017 | M | 1,845 | D | — | Apr 20, 2021 | Common Stock | 1,845 | 0 | D |
Explanation of responses
- F1As adjusted for the Company's 5% stock dividends in December 2011, 2012, 2013, 2014, 2015, and 2016.
- F2The options vested in 4 equal installments on April 20, 2012, 2013, 2014, and 2015.