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