0001493152-23-020053.txt : 20230602 0001493152-23-020053.hdr.sgml : 20230602 20230602214728 ACCESSION NUMBER: 0001493152-23-020053 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230601 FILED AS OF DATE: 20230602 DATE AS OF CHANGE: 20230602 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: LEWIS JIM CENTRAL INDEX KEY: 0001260150 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-33203 FILM NUMBER: 23991087 MAIL ADDRESS: STREET 1: 800 POYNTZ AVE CITY: MANHATTAN STATE: KS ZIP: 66502 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: LANDMARK BANCORP INC CENTRAL INDEX KEY: 0001141688 STANDARD INDUSTRIAL CLASSIFICATION: NATIONAL COMMERCIAL BANKS [6021] IRS NUMBER: 431930755 STATE OF INCORPORATION: CA FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 701 POYNTZ AVENUE CITY: MANHATTAN STATE: KS ZIP: 66502 BUSINESS PHONE: 7855652000 MAIL ADDRESS: STREET 1: 701 POYNTZ AVENUE CITY: MANHATTAN STATE: KS ZIP: 66502 FORMER COMPANY: FORMER CONFORMED NAME: LANDMARK MERGER CO DATE OF NAME CHANGE: 20010530 4 1 ownership.xml X0407 4 2023-06-01 0 0001141688 LANDMARK BANCORP INC LARK 0001260150 LEWIS JIM 901 SOUTH SECOND DODGE CITY, KS 67801 1 0 0 0 0 Common Stock 2023-06-01 4 P 0 133 20.7899 A 127795 D /s/ Mark A. Herpich, as Attorney-in-Fact for Jim Lewis 2023-06-02