-----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, HsTBtD7nt+OnDIo1iBJGE0Zll4nJfz/b1Nc0g7+XLuZECXmhSDXUgE6MCH/agXhz rQmUCZyixg+sWIMnHEZp4Q== 0001179110-04-001572.txt : 20040122 0001179110-04-001572.hdr.sgml : 20040122 20040122140503 ACCESSION NUMBER: 0001179110-04-001572 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040122 FILED AS OF DATE: 20040122 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: FULLER LYNN B CENTRAL INDEX KEY: 0001184324 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-15393 FILM NUMBER: 04537169 MAIL ADDRESS: STREET 1: 1398 CENTRAL AVE CITY: DUBUQUE STATE: IA ZIP: 52001 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: HEARTLAND FINANCIAL USA INC CENTRAL INDEX KEY: 0000920112 STANDARD INDUSTRIAL CLASSIFICATION: STATE COMMERCIAL BANKS [6022] IRS NUMBER: 421405748 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1398 CENTRAL AVE CITY: DUBUQUE STATE: IA ZIP: 52001 BUSINESS PHONE: 5635892000 MAIL ADDRESS: STREET 1: 1398 CENTRAL AVE CITY: DUBUQUE STATE: IA ZIP: 52001 4 1 edgar.xml FORM 4 - X0201 4 2004-01-22 0 0000920112 HEARTLAND FINANCIAL USA INC htlf 0001184324 FULLER LYNN B 1398 CENTRAL AVE DUBUQUE IA 52001 1 1 0 0 President & CEO Common Stock 445792 I As Trustee Common Stock 21000 I Partnership Common Stock 6000 I By Spouse Common Stock 1549.002 I By Son Common Stock 116772 I As Trustee Common Stock 251.200 I Minor Son Common Stock 832 I IRA Non-Qualified Stock Option (Right to Buy) 12.00 2009-01-02 Common Stock 36000 36000 D Non-Qualified Stock Option (Right to Buy) 12.00 2010-01-17 Common Stock 13500 13500 D Non-Qualified Stock Option (Right to Buy) 8.67 2011-06-01 Common Stock 15000 15000 D Non-Qualified Stock Option (Right to Buy) 8.80 2012-01-15 Common Stock 8250 8250 D Non-Qualified Stock Option (Right to Buy) 11.84 2013-01-21 Common Stock 15000 15000 D Non-Qualified Stock Option (Right To Buy) 19.48 2004-01-20 4 A 0 15000 0 A 2014-01-20 Common Stock 15000 15000 D The reporting person disclaims beneficial ownership of these securities,and this report shall not be deemed to be an admission that the reporting person is the beneficial owner of such securities for purposes of Section 16 or any other purpose. Shares held by Lynn B. Fuller Trust Under Agreement dated 5-7-96, Lynn B. Fuller Trustee Shares held by the Emma O. Fuller Trust dated 9-3-85 Dubuque Bank & Trust, L.S. Fuller & L.B. Fuller, co-trustees Represents options to buy granted under the Company's 1993 Stock Option Plan, a Rule 16(b)(3) plan, which options vest one-third per year beginning on the 3rd anniversary of date of grant. These shares participate in a Dividend Reinvestment Plan. This figure reflects the 3 for 2 stock split declared by the Company on December 29, 2003 These shares reflect 1,500 shares issued December 31, 2003, pursuant to the Employee Stock Purchase Plan. /s/ Lynn B. Fuller 2004-01-22 -----END PRIVACY-ENHANCED MESSAGE-----