SEC Form 5 · accession 0001415889-17-000188
Jacksonville Bancorp, Inc. · JXSB
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Richard A Foss
Officer — PRESIDENT AND CEO · Director
Period of report
Dec 31, 2016
Accepted (ET)
Feb 7, 2017 · 11:41 am EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001484949
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock | Dec 31, 2015 | A | 329 | $26.28 | A | 4,599 | I | By ESOP |
| Common Stock | Jan 6, 2016 | P | 119 | $26.4772 | A | 39,546 | I | By 401k |
| Common Stock | Jul 8, 2016 | P | 136 | $29.01 | A | 39,682 | I | By 401k |
| Common Stock | Oct 12, 2016 | P | 132 | $29.973 | A | 39,815 | I | By 401k |
| Common Stock | holding | — | — | — | 28,453 | D | ||
| Common Stock | holding | — | — | — | 4,156 | I | By IRA | |
| Common Stock | holding | — | — | — | 45 | I | By Spouse |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Stock Option | $15.65 | holding | — | — | — | Apr 24, 2013 | Apr 24, 2022 | Common Stock | 7,200 | — | D |