SEC Form 5 · accession 0001415889-17-000202
Jacksonville Bancorp, Inc. · JXSB
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Dean H Hess
Director
Period of report
Dec 31, 2016
Accepted (ET)
Feb 7, 2017 · 3:23 pm 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 | Jan 6, 2016 | P | 22 | $26.4772 | A | 24,332 | D | |
| Common Stock | Jul 8, 2016 | P | 15 | $29.01 | A | 24,348 | D | |
| Common Stock | Oct 12, 2016 | P | 15 | $29.973 | A | 24,363 | D | |
| Common StockF1 | Nov 30, 2016 | G | 910 | — | D | 23,453 | D | |
| Common StockF2 | Jan 4, 2017 | G | 2,730 | — | D | 20,723 | D | |
| Common Stock | holding | — | — | — | 39,408 | I | By SEP IRA | |
| Common Stock | holding | — | — | — | 3,251 | I | By Company | |
| Common Stock | holding | — | — | — | 10,113 | 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, 2016 | Apr 24, 2022 | Common Stock | 300 | — | D |
Explanation of responses
- F1Gift of 910 shares jointly held with spouse to family member
- F2Gift of 2730 shares jointly held with spouse to family member