0001415889-18-000878.txt : 20180606 0001415889-18-000878.hdr.sgml : 20180606 20180606125312 ACCESSION NUMBER: 0001415889-18-000878 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20180604 FILED AS OF DATE: 20180606 DATE AS OF CHANGE: 20180606 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Davidsmeyer Peggy CENTRAL INDEX KEY: 0001548335 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-34821 FILM NUMBER: 18883420 MAIL ADDRESS: STREET 1: 1211 WEST MORTON AVENUE CITY: JACKSONVILLE STATE: IL ZIP: 62650 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Jacksonville Bancorp, Inc. CENTRAL INDEX KEY: 0001484949 STANDARD INDUSTRIAL CLASSIFICATION: SAVINGS INSTITUTION, FEDERALLY CHARTERED [6035] IRS NUMBER: 000000000 STATE OF INCORPORATION: MD FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1211 WEST MORTON AVENUE CITY: JACKSONVILLE STATE: IL ZIP: 62650 BUSINESS PHONE: (217) 245-4111 MAIL ADDRESS: STREET 1: 1211 WEST MORTON AVENUE CITY: JACKSONVILLE STATE: IL ZIP: 62650 4 1 form4-06062018_090657.xml X0306 4 2018-06-04 1 0001484949 Jacksonville Bancorp, Inc. JXSB 0001548335 Davidsmeyer Peggy C/O JACKSONVILLE BANCORP, INC. 1211 W. MORTON AVE. JACKSONVILLE IL 62650 true false false false Common Stock 2018-06-04 4 D 0 600 D 0 D Stock Option 15.65 2018-06-04 4 D 0 900 D 2013-04-24 2022-04-24 Common Stock 900 0 D Each 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. The stock option was cancelled in connection with the merger and the holder received a cash payment upon such cancellation in an amount equal to $16,245.00, 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. /s/ Peggy S. Davidsmeyer 2018-06-05