SEC Form 4 · accession 0000939057-18-000360
Mid-Southern Bancorp, Inc. · MSVB
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Erica B. Schmidt
Officer — Executive VP and CFO
Period of report
Jul 11, 2018
Accepted (ET)
Jul 12, 2018 · 5:47 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001734875
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock, par value $0.01 per shareF1 | Jul 11, 2018 | P | 1,000 | $10.00 | A | 1,234 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Employee stock option (right to buy)F2 | $5.16 | Jul 11, 2018 | A | 234 | A | Jul 11, 2018 | Apr 26, 2021 | Common Stock | 234 | 234 | D |
Explanation of responses
- F1Includes 234 shares which were converted from shares of common stock of Mid-Southern Savings Bank, FSB ("Bank") to shares of common stock of Mid-Southern Bancorp, Inc. ("Company") in connection with the mutual-to-stock conversion of Mid-Southern, M.H.C. and Mid-Southern Savings Bank, FSB which was completed on July 11, 2018. As part of the conversion, each existing share of Bank common stock held by public stockholders was converted into 2.3462 shares of Company common stock.
- F2Represents an award of stock options originally made to the employee on April 26, 2011 to purchase shares of Mid-Southern Savings Bank, FSB. Pursuant to the mutual-to-stock conversion of Mid-Southern, M.H.C. and Mid-Southern Savings Bank, FSB these options were converted into options to purchase shares of common stock of Mid-Southern Bancorp, Inc.