SEC Form 4 · accession 0001127602-16-065768
FIRST MIDWEST BANCORP INC · FMBI
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Michelle Y Hoskins
Officer — EVP, Chief HR Officer
Period of report
Oct 28, 2016
Accepted (ET)
Nov 1, 2016 · 6:48 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000702325
Table I — non-derivative securities
No Table I lines on this filing.
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Phantom Stock Under NQ Retirement PlanF2,F1 | — | Oct 28, 2016 | A | 29 | A | — | — | Common Stock | 29 | 1,190 | D |
Explanation of responses
- F1Shares of phantom stock acquired under the Nonqualified Retirement Plan have a 1-for-1 conversion ratio and are payable in cash upon distribution to the Participant in accordance with the terms of the Plan.
- F2Between October 18, 2016 and November 1, 2016, the Reporting Person acquired 29 shares of First Midwest Bancorp, Inc. Common Stock under the First Midwest Bancorp, Inc. Non-Qualified Retirement Plan through the bi-weekly employee contribution feature of the Plan. The information in this report is based on a Plan statement dated October 28, 2016.