SEC Form 4 · accession 0001415889-18-000892
Jacksonville Bancorp, Inc. · JXSB
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
John D Eilering
Officer — VP OF OPERATIONS
Period of report
Jun 4, 2018
Accepted (ET)
Jun 6, 2018 · 1:03 pm EDT
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, 2017 | A | 170 | $32.02 | A | 4,632 | I | By ESOP |
| Common StockF1 | Jun 4, 2018 | U | 1,048 | — | D | 0 | D | |
| Common StockF1 | Jun 4, 2018 | U | 9,603 | — | D | 0 | I | By 401k |
| Common StockF1 | Jun 4, 2018 | U | 4,632 | — | D | 0 | I | By ESOP |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Stock OptionF2 | $15.65 | Jun 4, 2018 | U | 1,652 | D | Apr 24, 2013 | Apr 24, 2022 | Common Stock | 1,652 | 0 | D |
Explanation of responses
- F1Each share of common stock was converted into and became exchangeable for the right to receive $33.70 in cash pursuant to an agreement and plan of merger between the Jacksonville Bancorp, Inc., CNB Bank Shares, Inc. and CNB Acquisition, Inc.
- F2The stock option was cancelled in connection with the merger and the holder received a cash payment upon such cancellation in an amount equal to $29,818.60, the product of (i) the number of shares of Issuer common stock provided for by such option and (ii) $33.70 minus $15.65, the exercise price of the option.