0001562463-23-000052.txt : 20230505
0001562463-23-000052.hdr.sgml : 20230505
20230505160217
ACCESSION NUMBER: 0001562463-23-000052
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20230503
FILED AS OF DATE: 20230505
DATE AS OF CHANGE: 20230505
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Dee Ann C.
CENTRAL INDEX KEY: 0001665618
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35750
FILM NUMBER: 23893670
MAIL ADDRESS:
STREET 1: 600 E 96TH ST, #100
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_168331692306343.xml
FORM 4
X0407
4
2023-05-03
0
0001562463
First Internet Bancorp
INBK
0001665618
Dee Ann C.
8701 E. 116TH STREET
FISHERS
IN
46038
1
0
0
0
0
Common Stock
2023-05-03
4
P
0
2000
12.52
A
6850
D
/s/ Kenneth J. Lovik, Attorney-in-Fact for Ann Colussi Dee (power of attorney previously filed)
2023-05-05