SEC Form 5 · accession 0001415889-18-000145
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, 2017
Accepted (ET)
Jan 29, 2018 · 3:06 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 StockF1 | Jun 21, 2017 | G | 440 | — | D | 4,435 | I | By Trust |
| Common StockF2 | Jul 17, 2017 | G | 430 | — | D | 4,005 | I | By Trust |
| Common StockF3 | Jan 4, 2018 | G | 400 | — | D | 3,605 | I | By Trust |
| Common StockF4 | Jan 4, 2018 | G | 400 | — | D | 3,205 | I | By Trust |
| Common StockF5 | Jan 4, 2018 | G | 400 | — | D | 2,805 | I | By Trust |
| Common StockF6 | Jul 19, 2017 | G | 430 | — | D | 25,613 | I | By Spouse Trust |
| Common StockF7 | Jul 17, 2017 | G | 430 | — | D | 26,043 | I | By Spouse Trust |
| Common Stock | holding | — | — | — | 300 | D | ||
| Common Stock | holding | — | — | — | 39,408 | I | By SEP IRA | |
| Common Stock | holding | — | — | — | 4,253 | I | By Company |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Stock Options | $15.65 | holding | — | — | — | Apr 24, 2017 | Apr 24, 2022 | Common Stock | 0 | 0 | D |
Explanation of responses
- F1Gift of shares to son-in-law, Kevin M. Leahr
- F2Gift of shares to grandson, Luke Hill
- F3Gift of shares to daughter, Rebecca Leahr
- F4Gift of shares to son-in-law, Kevin M. Leahr
- F5Gift of shares to grandson, Jacob Leahr
- F6Gift of shares to son-in-law, Kevin M. Leahr
- F7Gift of shares to grandson, Luke Hill