SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person*
KRATZ DOUGLAS M

(Last) (First) (Middle)
12700 PARK CENTRAL DRIVE
SUITE 1700

(Street)
DALLAS TX 75251

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
11/06/2014
3. Issuer Name and Ticker or Trading Symbol
Triumph Bancorp, Inc. [ TBK ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
Officer (give title below) Other (specify below)
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock 138,662 D
Common Stock 7,798(1) I By Wells Fargo Bank NA FBO reporting person
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Series B Preferred Stock(2) (2) (2) Common Stock 141,057 (2) D
Explanation of Responses:
1. These 7,798 shares of common stock of issuer are held for the benefit of reporting person by Wells Fargo Bank, National Association, pursuant to a holdback escrow agreement entered into in connection with issuer's acquisition of Triumph Community Bank in October 2013.
2. Reporting person has the right to acquire 141,057 shares of common stock of issuer through the conversion of 20,325 shares of Series B Convertible Preferred Stock at a conversion rate of 6.94008 shares of common stock for every one share of Series B Preferred Stock. Such conversion may be effected at any time while such preferred shares are outstanding.
Remarks:
/s/Adam D. Nelson Attorney-in-fact 11/06/2014
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
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