FORM 4 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP 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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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). |
1. Name and Address of Reporting Person*
(Street)
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2. Issuer Name and Ticker or Trading Symbol
MIDWEST BANC HOLDINGS INC [ MBHIP ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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3. Date of Earliest Transaction
(Month/Day/Year) 12/16/2009 | ||||||||||||||||||||||||||
4. If Amendment, Date of Original Filed
(Month/Day/Year) |
6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | ||||||||||
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1. Title of Security (Instr. 3) | 2. Transaction Date (Month/Day/Year) | 2A. Deemed Execution Date, if any (Month/Day/Year) | 3. Transaction Code (Instr. 8) | 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) | 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) | 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 7. Nature of Indirect Beneficial Ownership (Instr. 4) | |||
Code | V | Amount | (A) or (D) | Price | ||||||
Series A Preferred Convertible Stock(1) | 12/16/2009(1) | S | 52,800(1) | D | $2.0944(1) | 227,717(1) | D | |||
Series A Preferred Convertible Stock(1) | 12/17/2009(1) | S | 2,128(1) | D | $2.1(1) | 225,589(1) | D | |||
Series A Preferred Convertible Stock(1) | 12/18/2009(1) | S | 700(1) | D | $2.21(1) | 224,889(1) | D |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||||||||||
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1. Title of Derivative Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) | 6. Date Exercisable and Expiration Date (Month/Day/Year) | 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) | 8. Price of Derivative Security (Instr. 5) | 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) | 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) | ||||
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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Explanation of Responses: |
1. M3 Partners, L.P., a Delaware limited partnership (the "Fund") and M3 Funds, LLC, a Delaware limited liability company ("M3 Funds"), hereby make this filing with respect to certain depository shares of Series A Noncumulative Redeemable Convertible Perpetual Preferred Stock (the "Series A Convertible Preferred Stock") of Midwest Banc Holdings, Inc. (the "Issuer") deemed beneficially owned. The shares of Series A Convertible Preferred Stock are convertible into shares of common stock equal to the quotient achieved when $25.00 is divided by the initial conversion price of $15.00, which may be adjusted from time to time. |
Remarks: |
M3 Funds is the general partner of the Fund; M3 Funds may be deemed to have indirect beneficial ownership of shares of the Issuer directly owned by the Fund. As of the date of this filing, the Fund beneficially owned 224,889 depository shares the Issuer's Series A Convertible Preferred Stock. M3 Funds disclaims beneficial ownership of the shares of the Issuer held by the Fund, except to the extent of M3 Fund's pecuniary interest therein. Jason A. Stock and William C. Waller are the sole members of M3 Funds. Messrs. Stock and Waller also disclaim beneficial ownership of the shares of the Issuer held by the Fund, except to the extent of their respective pecuniary interest therein. |
/s/ Jason A. Stock, Manager of M3 Funds, LLC, General Partner of M3 Partners, LP | 12/18/2009 | |
** 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 4 (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. | ||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |