SEC Form 5 · accession 0001415889-18-000128
Jacksonville Bancorp, Inc. · JXSB
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Andrew F Applebee
Officer — CHAIRMAN OF THE BOARD · Director
Period of report
Dec 31, 2017
Accepted (ET)
Jan 26, 2018 · 8:18 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, 2016 | A | 62 | $30.00 | A | 3,981 | I | By ESOP |
| Common Stock | holding | — | — | — | 9,014 | I | By IRA | |
| Common Stock | holding | — | — | — | 25,959 | I | By 401k | |
| Common Stock | holding | — | — | — | 10,572 | I | By Trust | |
| Common Stock | holding | — | — | — | 24,201 | I | By Spouse Trust | |
| cCommon Stock | holding | — | — | — | 4,500 | D |
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 | 3,000 | 3,000 | D |