0001415889-22-011541.txt : 20221118
0001415889-22-011541.hdr.sgml : 20221118
20221118103805
ACCESSION NUMBER: 0001415889-22-011541
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20221116
FILED AS OF DATE: 20221118
DATE AS OF CHANGE: 20221118
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: 221400937
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
form4-11182022_031158.xml
X0306
4
2022-11-16
0001734875
Mid-Southern Bancorp, Inc.
MSVB
0001740390
Bailey Larry R.
300 NORTH WATER STREET
SALEM
IN
47167
true
false
false
false
Common Stock
2022-11-16
4
A
0
1080
13
A
11314
D
Stock Options
13
2022-11-16
4
A
0
1500
0
A
2032-11-16
Common Stock
1500
11225
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 November 16, 2023, with the shares fully vested on November 16, 2026.
The options were granted under the 2019 Equity Incentive Plan. 20% of the options granted were exercisable immediately with the remaining 80% of the awarded options first becoming exercisable in four equal installments beginning on November 16, 2023, with the options fully exercisable on November 16, 2026.
/s/ Larry R. Bailey
2022-11-18