0001415889-21-006009.txt : 20211216
0001415889-21-006009.hdr.sgml : 20211216
20211216151753
ACCESSION NUMBER: 0001415889-21-006009
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20211215
FILED AS OF DATE: 20211216
DATE AS OF CHANGE: 20211216
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Bailey Larry R.
CENTRAL INDEX KEY: 0001740390
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38491
FILM NUMBER: 211497604
MAIL ADDRESS:
STREET 1: 300 NORTH WATER STREET
CITY: SALEM
STATE: IN
ZIP: 47167
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Mid-Southern Bancorp, Inc.
CENTRAL INDEX KEY: 0001734875
STANDARD INDUSTRIAL CLASSIFICATION: SAVINGS INSTITUTION, FEDERALLY CHARTERED [6035]
IRS NUMBER: 824821705
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 300 N. WATER STREET
CITY: SALEM
STATE: IN
ZIP: 47167
BUSINESS PHONE: (812)883-2639
MAIL ADDRESS:
STREET 1: 300 N. WATER STREET
CITY: SALEM
STATE: IN
ZIP: 47167
4
1
form4-12162021_121246.xml
X0306
4
2021-12-15
0001734875
Mid-Southern Bancorp, Inc.
MSVB
0001740390
Bailey Larry R.
300 NORTH WATER STREET
SALEM
IN
47167
true
false
false
false
Common Stock
2021-12-15
4
A
0
2000
15.39
A
10234
D
Represents award of restricted stock pursuant to the 2019 Equity Incentive Plan. 20% of the restricted stock award vests immediately, with the remaining 80% of the awarded stock vesting in four equal installments beginning on December 15, 2022 with the shares fully vested on December 15, 2025
/s/ Larry R. Bailey
2021-12-16