X0306 4 2018-01-23 0 0001311828 Independence Bancshares, Inc. IESB 0001351590 Miller Lawrence R 500 E. WASHINGTON ST. GREENVILLE SC 29601 1 1 0 0 INTERIM CHIEF EXECUTIVE OFFICE Common Stock 2018-01-23 4 D 0 93750 0.125 D 0 D Options 0.01 2018-01-23 4 D 0 14385 0 D 2018-01-23 Common Stock 14385 0 D Options 0.01 2018-01-23 4 D 0 50000 0 D 2023-07-16 Common Stock 50000 0 D Disposed of pursuant to that certain Agreement and Plan of Merger dated as of September 25, 2017, between First Reliance Bancshares, Inc. (First Reliance), FR Merger Subsidiary, Inc. (Merger Sub), and Independence Bancshares, Inc. (Independence), pursuant to which Independence was merged with and into First Reliance (the Merger). At the effective time of the merger, each share of Independence common stock was converted into the right to receive $0.125 in cash. On January 23, 2008, the reporting person was granted an option to purchase 14,385 shares of common stock at $10.50 per share. The option was to vest ratably 20% every 12 months. Prior to the effective time of the Merger, all holders of options granted by Independence surrendered their rights under the options for a cash payment of $0.01 per share of common stock underlying the options. On July 16, 2013, the reporting person was granted an option to purchase 50,000 shares of common stock at $0.80 per share. The option immediately vested for 5,000 shares, or 10% of the shares. The option for the remaining 45,000 shares, or 90% of the shares, was to vest ratably every 12 months provided that a performance condition with respect to Independence had been satisfied. Prior to the effective time of the Merger, all holders of options granted by Independence surrendered their rights under the options for a cash payment of $0.01 per share of common stock underlying the options. /s/Lawrence R. Miller 2018-01-25