SEC Form 4 · accession 0001311828-18-000007
Independence Bancshares, Inc. · IEBS
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Adam Gabriel Hurwich
Director
Period of report
Jan 23, 2018
Accepted (ET)
Jan 25, 2018 · 4:56 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.
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Series A Preferred StockF1,F2 | $1,000.00 | Jan 17, 2018 | J | 300 | D | — | — | Common Stock | 375,000 | 2,150 | I |
| Series A Preferred StockF1,F2 | $1,000.00 | Jan 17, 2018 | J | 2,150 | D | — | — | Common Stock | 2,687,500 | 0 | I |
Explanation of responses
- 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.
- F2Not Applicable