-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, PprTvfg2XpSN7gCGNDHUiserTPa3O14cPU52L8NFhv0hhaKxsXcbib0RCPaQReA3 ntjc1iih0RIFvJ/d8AfQPQ== 0000914317-04-003751.txt : 20041020 0000914317-04-003751.hdr.sgml : 20041020 20041020133550 ACCESSION NUMBER: 0000914317-04-003751 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20041019 FILED AS OF DATE: 20041020 DATE AS OF CHANGE: 20041020 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: CARNES J DAVID CENTRAL INDEX KEY: 0001069484 STATE OF INCORPORATION: IN FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-26012 FILM NUMBER: 041087112 BUSINESS ADDRESS: STREET 1: 5845 W 200 S CITY: HUNTINGTON STATE: IN ZIP: 46750 BUSINESS PHONE: 2193563311 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: NORTHEAST INDIANA BANCORP INC CENTRAL INDEX KEY: 0000942898 STANDARD INDUSTRIAL CLASSIFICATION: SAVINGS INSTITUTION, FEDERALLY CHARTERED [6035] IRS NUMBER: 371344113 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 648 N JEFFERSON ST CITY: HUNTINGTON STATE: IN ZIP: 46750 BUSINESS PHONE: 2193563311 MAIL ADDRESS: STREET 1: 648 N JEFFERSON ST STREET 2: PO BOX 70 CITY: HUNTINGTON STATE: IN ZIP: 46750-0070 4 1 form4-63574_dcex.xml X0202 4 2004-10-19 0 0000942898 NORTHEAST INDIANA BANCORP INC NEIB 0001069484 CARNES J DAVID 37 NORTHWAY DRIVE HUNTINGTON IN 46750 1 0 0 0 Common Stock 19382 D Non-Qualified Stock Options 9.710 2004-10-19 4 M 0 1000 9710 A 1997-01-15 2006-01-15 Common 8202 8202 D /s/ David Carnes 2004-10-19 -----END PRIVACY-ENHANCED MESSAGE-----