SEC Form 4 · accession 0001311828-18-000005

Independence Bancshares, Inc. · IEBS

Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗

Reporting owner

Director

Period of report

Jan 23, 2018

Accepted (ET)

Jan 25, 2018 · 4:38 pm EST

Rule 10b5-1 plan

unknown — predates the checkbox

Issuer CIK

0001311828

Table I — non-derivative securities

No Table I lines on this filing.

Security	Conv. / exercise price	Date	Code	Shares	A/D	Exercisable	Expires	Underlying	Underlying shares	Owned after	D/I
Series A Preferred Stock^F1,F2,F3,F6	$1,000.00	Jan 23, 2018	J	1,910	D	—	—	Common Stock	2,387,500	540	I
Series A Preferred Stock^F1,F2,F4,F6	$1,000.00	Jan 23, 2018	J	290	D	—	—	Common Stock	362,500	250	I
Series A Preferred Stock^F1,F2,F5,F6	$1,000.00	Jan 23, 2018	J	250	D	—	—	Common Stock	312,500	0	I

F1Disposed of pursuant to that certain Agreement and Plan of Merger dated as of September 25, 2017, between First Reliance Bancshares, Inc. (First Reliance), FR Merger Subsidiary, Inc. (Merger Sub), and Independence Bancshares, Inc. (Independence), pursuant to which Independence was merged with and into First Reliance. Immediately prior to the effective time of the merger, each share of Independence Series A Preferred Stock was redeemed for its stated per share redemption price by the payment of cash in the amount of $1,000.
F2Mr. Echlov is an assistant portfolio manager at RMB Capital Management, LLC, which is the investment advisor for Iron Road Multi-Strategy Fund LP, Mendon Capital, QP, and Mendon Capital Master Fund, Ltd. Mr. Echlov has dispositive voting power over the securities of the Issuer held by Iron Road Multi-Strategy Fund LP, Mendon Capital, QP, and Mendon Capital Master Fund, Ltd.
F3These shares are owned directly by Mendon Capital Master Fund Ltd.
F4These shares are owned directly by Mendon Capital QP.
F5These shares are owned directly by Iron Road Multi-Strategy Fund, LP.
F6Not Applicable