0001562463-21-000108.txt : 20211228
0001562463-21-000108.hdr.sgml : 20211228
20211228111236
ACCESSION NUMBER: 0001562463-21-000108
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20200115
FILED AS OF DATE: 20211228
DATE AS OF CHANGE: 20211228
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Williams Jerry L.
CENTRAL INDEX KEY: 0001569215
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35750
FILM NUMBER: 211523145
MAIL ADDRESS:
STREET 1: 8888 KEYSTONE CROSSING, SUITE 1700
CITY: INDIANAPOLIS
STATE: IN
ZIP: 46240
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: First Internet Bancorp
CENTRAL INDEX KEY: 0001562463
STANDARD INDUSTRIAL CLASSIFICATION: STATE COMMERCIAL BANKS [6022]
IRS NUMBER: 203489991
STATE OF INCORPORATION: IN
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 8701 E. 116TH STREET
CITY: FISHERS
STATE: IN
ZIP: 46038
BUSINESS PHONE: 317-532-7900
MAIL ADDRESS:
STREET 1: 8701 E. 116TH STREET
CITY: FISHERS
STATE: IN
ZIP: 46038
4
1
wf-form4_164070794452273.xml
FORM 4
X0306
4
2020-01-15
0
0001562463
First Internet Bancorp
INBK
0001569215
Williams Jerry L.
8701 EAST 116TH STREET
FISHERS
IN
46038
1
0
0
0
Common Stock
2020-01-15
4
P
0
57
23.90
A
45903
D
Common Stock
2020-04-15
4
P
0
142
16.69
A
46045
D
Common Stock
2020-07-15
4
P
0
151
15.75
A
46196
D
Common Stock
2020-10-15
4
P
0
150
17.13
A
46346
D
Common Stock
42500
I
shares held in an IRA
Common Stock
1702
I
shares held by a limited liability company of which Mr. Williams holds voting and investment power
Represents automatic reinvestment of dividends pursuant to the terms of a brokerage account.
Reports on Form 4 filed after the transaction date incorrectly underreported total ownership by the amount purchased.
/s/ Kenneth J. Lovik, Attorney-in-Fact for Jerry L. Williams (power of attorney previously filed)
2021-12-28