0001181431-13-008046.txt : 20130208 0001181431-13-008046.hdr.sgml : 20130208 20130208173525 ACCESSION NUMBER: 0001181431-13-008046 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20121231 FILED AS OF DATE: 20130208 DATE AS OF CHANGE: 20130208 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: MEDINA DANIEL A CENTRAL INDEX KEY: 0001208200 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 000-27464 FILM NUMBER: 13587981 MAIL ADDRESS: STREET 1: C/O BROADWAY FEDERAL BANK STREET 2: 4800 WILSHIRE BLVD. CITY: LOS ANGELES STATE: CA ZIP: 90010 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: BROADWAY FINANCIAL CORP \DE\ CENTRAL INDEX KEY: 0001001171 STANDARD INDUSTRIAL CLASSIFICATION: SAVINGS INSTITUTION, FEDERALLY CHARTERED [6035] IRS NUMBER: 954547287 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 4800 WILSHIRE BLVD CITY: LOS ANGELES STATE: CA ZIP: 90010 BUSINESS PHONE: 2136341700 MAIL ADDRESS: STREET 1: 4800 WILSHIRE BLVD CITY: LOS ANGELES STATE: CA ZIP: 90010 5 1 rrd368643.xml ANNUAL STATEMENT OF BENEFICIAL OWNERSHIP X0306 5 2012-12-31 0 0 0 0001001171 BROADWAY FINANCIAL CORP \DE\ BYFC 0001208200 MEDINA DANIEL A 4800 WILSHIRE BOULEVARD LOS ANGELES CA 90010 1 0 0 0 Common Stock 806 D Common Stock 6110 D Common Stock 19231 D Stock Option (Right to Buy) 6.00 2010-01-21 2020-01-21 Common Stock 1250 1250 D Stock Option (Right to Buy) 4.00 2009-01-21 2019-01-21 Common Stock 1875 1875 D Held directly in the name of Daniel Medina. Held in the trust of Daniel Medina and Laura Martin. The Board of Directors granted this Stock Option on January 21, 2009 and January 21, 2010. It will renew each year on January 21 or until the Board discontinues the annual grant. This is a stock option grant that vests upon granting. On July 2, 2012, an investment of Capital was made in exchange for common stock. The shares are held in the name of "Martin Medina Family Trust UTD 6/30/94." \s\ Daniele C. Johnson, Attorney-as-in-fact 2013-02-04