SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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X
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
Carmichael Stanley Clark

(Last) (First) (Middle)
1510 71ST ST.

(Street)
FENNVILLE MI 49408

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
1ST SOURCE CORP [ SRCE ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
Officer (give title below) X Other (specify below)
10% Group Member
3. Date of Earliest Transaction (Month/Day/Year)
12/10/2015
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 9,125 D
Common Stock 2,703 I See footnotes (1) (9)
Common Stock 30,618 I See footnotes (2) (9)
Common Stock 708,289 I See footnotes (3) (9)
Common Stock 12/10/2015 S 141,688 D $29.7375 5,567 I See footnotes (4) (9)
Common Stock 12/10/2015 S 229,930 D $29.7375 0 I See footnotes (5) (9)
Common Stock 1,598 I See footnotes (6) (9)
Common Stock 6,228 I See footnotes (7) (9)
Common Stock 12/10/2015 S 228,382 D $29.7375 0 I See footnotes (8) (9)
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Explanation of Responses:
1. Indirect through E.L. Morris fbo S.C. Carmichael Trust.
2. Indirect through S.C. Carmichael Charitable Annuity Trust.
3. Indirect through E.L. Morris Trust FBO S.C. Carmichael.
4. Indirect through Ernestine M. Raclin Charitable Irrev Trust FBO S.C. Carmichael Family.
5. Indirect through Ernestine M. Raclin Irrevocable Trust FBO S.C. Carmichael Family.
6. Indirect through Ella Morris Charitable Trust FBO S.C. Carmichael Family.
7. Indirect through E.L. Morris Charitable Living Trust FBO S.C. Carmichael Family.
8. Indirect through Ernestine M. Raclin Irrevocable Trust FBO S.C. Carmichael Family.
9. The reporting person has the power to direct the trustee with respect to the disposition of the reported securities. The reporting person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein, and the inclusion of these securities in this report shall not be deemed an admission of beneficial ownership of all of the reported securities for purposes of Section 16 or for any other purpose.
/s/ Stanley Clark Carmichael 12/14/2015
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 4 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
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