SEC Form 4/A · accession 0001412665-16-000129
MidWestOne Financial Group, Inc. · MOFG
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
This is an amendment (Form 4/A). It replaces an earlier filing for the same period.
Reporting owner
Susan R Evans
Officer — Chief Operating Officer
Period of report
Feb 15, 2016
Accepted (ET)
Feb 26, 2016 · 11:34 am EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001412665
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | Feb 15, 2016 | A | 2,500 | $0.00 | A | 18,413 | D | |
| Common Stock | Feb 15, 2016 | F | 609 | $26.45 | D | 17,804 | D | |
| Common StockF3 | holding | — | — | — | 2,683 | I | By ESOP |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Employee Stock Option (Right to Buy)F4 | $16.69 | holding | — | — | — | — | Apr 1, 2018 | Common Stock | 500 | 500 | D |
| Employee Stock Option (Right to Buy)F5 | $7.02 | holding | — | — | — | — | Jul 16, 2019 | Common Stock | 1,200 | 1,200 | D |
Explanation of responses
- F1Shares were acquired pursuant to a grant of restricted stock units which vest in four equal annual installments beginning February 15, 2017.
- F2Restricted Stock Units withheld to pay payroll taxes due upon vesting and issuance of Restricted Stock Units shares on February 15, 2016.
- F3Shares held in the MidWestOne Financial Group, Inc. Employee Stock Ownership Plan as of February 15, 2016. Shares increased by 18 shares since the date of the reporting person's last filing due to additional shares allocated to the reporting person's ESOP account.
- F4The option vests in four equal annual installments beginning on April 1, 2009.
- F5The option vests in four equal annual installments beginning on July 16, 2010.
Remarks
The purpose of this amended Form is to add Footnote 2, to reduce the number of forfeited shares by 117 shares, to 609 shares, and to add the market price per share forfeited.