SEC Form 5 · accession 0001415889-18-000130
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, 2017
Accepted (ET)
Jan 26, 2018 · 8:45 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 | 230 | $30.00 | A | 4,829 | I | By ESOP |
| Common Stock | Jan 4, 2017 | P | 134 | $29.6518 | A | 39,949 | I | By 401k |
| Common Stock | Apr 11, 2017 | P | 128 | $31.2456 | A | 39,942 | I | By 401k |
| Common Stock | Jul 11, 2017 | P | 127 | $31.4429 | A | 40,196 | I | By 401k |
| Common Stock | Oct 11, 2017 | P | 128 | $31.2934 | A | 40,333 | I | By 401k |
| Common Stock | holding | — | — | — | 4,156 | I | By IRA | |
| Common Stock | holding | — | — | — | 45 | I | By Spouse | |
| Common Stock | holding | — | — | — | 28,453 | 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 | 7,200 | 7,200 | D |
Explanation of responses
- F1ESOP ALLOCATION
- F2401k DIVIDEND REINVESTMENT