SEC Form 5 · accession 0000911916-16-000447
1ST SOURCE CORP · SRCE
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Carmen C Murphy
10% Owner
Period of report
Dec 31, 2015
Accepted (ET)
Mar 10, 2016 · 11:53 am EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000034782
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock | Dec 29, 2015 | G | 15,375 | $0.00 | D | 135,742 | D | |
| Common StockF1 | holding | — | — | — | 1,642,535 | I | By Spouse | |
| Common StockF2 | holding | — | — | — | 584,600 | I | By LLC | |
| Common StockF3,F15 | holding | — | — | — | 283,897 | I | By Trust | |
| Common StockF4,F15 | holding | — | — | — | 646,582 | I | By Trust | |
| Common StockF5,F15 | holding | — | — | — | 17,246 | I | By Trust | |
| Common StockF6,F15 | holding | — | — | — | 43,132 | I | By Trust | |
| Common StockF7,F15 | holding | — | — | — | 41,640 | I | By Trust | |
| Common StockF8,F15 | holding | — | — | — | 115,684 | I | By Trust | |
| Common StockF9,F15 | holding | — | — | — | 708,289 | I | By Trust | |
| Common StockF10,F15 | holding | — | — | — | 147,255 | I | By Trust | |
| Common StockF11,F15 | holding | — | — | — | 229,930 | I | By Trust | |
| Common StockF12,F15 | holding | — | — | — | 1,598 | I | By Trust | |
| Common StockF13,F15 | holding | — | — | — | 6,228 | I | By Trust | |
| Common StockF14,F15 | holding | — | — | — | 228,382 | I | By Trust |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1Includes 530,343 shares of common stock held directly by Mr. Murphy, 51,279 shares of common stock held indirectly by Mr. Murphy under the 1st Source Corporation 401(k) Plan, 125,893 shares of common stock held indirectly by Mr. Murphy through a corporation and 935,020 shares of common stock held indirectly by Mr. Murphy through three limited partnerships. Mrs. Murphy disclaims beneficial ownership of these shares of common stock, and this report on Form 3 shall not be deemed an admission that Mrs. Murphy is the beneficial owner of these shares of common stock for purposes of Section 16 or for any other purpose.
- F10Indirect through the Ernestine M. Raclin Charitable Irrevocable Trust FBO Carmen C. Murphy.
- F11Indirect through the 1960 Ernestine M. Raclin Irrevocable Trust FBO Carmen C. Murphy.
- F12Indirect through the Ella Morris Charitable Trust FBO Carmen C. Murphy.
- F13Indirect through the Ella Morris Irrevocable Charitable Living Trust FBO Carmen C. Murphy.
- F14Indirect through the 1965 Ernestine M. Raclin Irrevocable Trust FBO Carmen C. Murphy.
- F15Mrs. Murphy has the power to direct the trustee with respect to the disposition of the reported shares of common stock. Mrs. Murphy disclaims beneficial ownership of these shares of common stock except to the extent of her pecuniary interest therein, and the inclusion of these shares of common stock in this Form 3 shall not be deemed an admission of beneficial ownership of all of the reported shares of common stock for purposes of Section 16 or for any other purpose.
- F2Mrs. Murphy is a voting member of the LLC. Mrs. Murphy disclaims beneficial ownership of those shares of common stock held by the LLC exceeding her pecuniary interest, and this report shall not be deemed an admission that Mrs. Murphy is the beneficial owner of such excess shares of common stock for purposes of Section 16 or for any other purpose.
- F3Indirect through the 1957 E. L. Morris FBO Carmen C. Murphy Trust.
- F4Indirect through the 1959 E. L. Morris FBO Carmen C. Murphy Trust.
- F5Indirect through the E. M. Raclin FBO Carmen C. Murphy Trust.
- F6Indirect through a 1965 E. L. Morris FBO E. M. Raclin and Carmen C. Murphy Trust.
- F7Indirect through a second 1965 E. L. Morris FBO E. M. Raclin and Carmen C. Murphy Trust.
- F8Indirect through the Carmen C. Murphy Charitable Annuity Trust.
- F9Indirect through the Ella Morris Trust FBO Carmen C. Murphy.