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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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*
SJOGREN C STEVEN

(Last) (First) (Middle)
830 EAST KENSINGTON ROAD

(Street)
ARLINGTON HEIGHTS IL 60004

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
Ben Franklin Financial, Inc. [ BFFI ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
X Officer (give title below) Other (specify below)
Chairman, President and CEO
3. Date of Earliest Transaction (Month/Day/Year)
01/22/2015
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 01/22/2015 J 8,287 A $0.00 8,287(1) D
Common Stock 01/22/2015 P 10,000 A $10 18,287 D
Common Stock 01/22/2015 J 3,562 A $0.00 3,562(1) I By Trust
Common Stock 01/22/2015 J 3,562 A $0.00 3,562(1) I By Spouse's Trust
Common Stock 01/22/2015 J 676 A $0.00 676(1) I By IRA
Common Stock 01/22/2015 J 1,967 A $0.00 1,967(1) I By ESOP
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
Stock Options $26.28(2) 01/22/2015 J 8,548(2) 04/17/2009 04/17/2018 Common Stock 8,548(3) $0.00 8,548 D
Explanation of Responses:
1. Pursuant to the Plan of Conversion and Reorganization of Ben Franklin Financial, MHC, each share of common stock of Ben Franklin Financial, Inc. (Federal corporation) was exchanged for 0.3562 shares of common stock of Ben Franklin Financial, Inc. (Maryland corporation).
2. Pursuant to the Plan of Conversion and Reorganization of Ben Franklin Financial, MHC, each option to purchase shares of common stock of Ben Franklin Financial, Inc. (Federal corporation) was converted into an option to purchase shares of common stock of Ben Franklin Financial, Inc. (Maryland corporation) by multiplying the number of shares subject to each option by the 0.3562 exchange ratio. The exercise price per share of each converted option was determined by dividing the exercise price of the option by the 0.3562 exchange ratio. All such options continue to vest based on their original terms.
3. Stock options vest at a rate of 20% per year commencing on April 17, 2009.
Remarks:
/s/ Michael J. Brown, pursuant to power of attorney 01/26/2015
** 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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