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