0000034782-20-000019.txt : 20200213
0000034782-20-000019.hdr.sgml : 20200213
20200213095842
ACCESSION NUMBER: 0000034782-20-000019
CONFORMED SUBMISSION TYPE: 5
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20191231
FILED AS OF DATE: 20200213
DATE AS OF CHANGE: 20200213
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Seitz James R
CENTRAL INDEX KEY: 0001524978
FILING VALUES:
FORM TYPE: 5
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-06233
FILM NUMBER: 20607402
MAIL ADDRESS:
STREET 1: PO BOX 1602
CITY: SOUTH BEND
STATE: IN
ZIP: 46634
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: 1ST SOURCE CORP
CENTRAL INDEX KEY: 0000034782
STANDARD INDUSTRIAL CLASSIFICATION: STATE COMMERCIAL BANKS [6022]
IRS NUMBER: 351068133
STATE OF INCORPORATION: IN
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 100 NORTH MICHIGAN STREET
CITY: SOUTH BEND
STATE: IN
ZIP: 46601
BUSINESS PHONE: 5742352702
MAIL ADDRESS:
STREET 1: P O BOX 1602
STREET 2: P O BOX 1602
CITY: SOUTH BEND
STATE: IN
ZIP: 46634
FORMER COMPANY:
FORMER CONFORMED NAME: FBT BANCORP INC
DATE OF NAME CHANGE: 19820818
5
1
wf-form5_158160590460886.xml
FORM 5
X0306
5
2019-12-31
0
0
0
0000034782
1ST SOURCE CORP
SRCE
0001524978
Seitz James R
P.O. BOX 1602
SOUTH BEND
IN
46634
0
1
0
0
President
Common Stock
2019-11-08
5
G
0
479
0
D
51040
D
Common Stock
24163
I
By 401(k)
On July 22, 2015, 1st Source Corporation declared a 10% stock dividend payable to all holders of common stock on August 15, 2015. As a result, the 180 shares of common stock held directly by Mr. Seitz that he reported on an amended Form 3 filed on November 22, 2019 increased by 17 shares.
Between January 1, 2019 and December 31, 2019, Mr. Seitz acquired a total of 670 shares of 1st Source Corporation common stock under the 401(k) Plan. The information in this report is based on a plan statement dated as of December 31, 2019.
/s/ John B. Griffith, Attorney-in-Fact
2020-02-13