0001493152-23-016787.txt : 20230512 0001493152-23-016787.hdr.sgml : 20230512 20230512204424 ACCESSION NUMBER: 0001493152-23-016787 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230511 FILED AS OF DATE: 20230512 DATE AS OF CHANGE: 20230512 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: LEWIS JIM CENTRAL INDEX KEY: 0001260150 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-33203 FILM NUMBER: 23917956 MAIL ADDRESS: STREET 1: 800 POYNTZ AVE CITY: MANHATTAN STATE: KS ZIP: 66502 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: LANDMARK BANCORP INC CENTRAL INDEX KEY: 0001141688 STANDARD INDUSTRIAL CLASSIFICATION: NATIONAL COMMERCIAL BANKS [6021] IRS NUMBER: 431930755 STATE OF INCORPORATION: CA FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 701 POYNTZ AVENUE CITY: MANHATTAN STATE: KS ZIP: 66502 BUSINESS PHONE: 7855652000 MAIL ADDRESS: STREET 1: 701 POYNTZ AVENUE CITY: MANHATTAN STATE: KS ZIP: 66502 FORMER COMPANY: FORMER CONFORMED NAME: LANDMARK MERGER CO DATE OF NAME CHANGE: 20010530 4 1 ownership.xml X0407 4 2023-05-11 0 0001141688 LANDMARK BANCORP INC LARK 0001260150 LEWIS JIM 901 SOUTH SECOND DODGE CITY, KS 67801 1 0 0 0 0 Common Stock 2023-05-11 4 P 0 508 19.7427 A 124994 D Common Stock 2023-05-12 4 P 0 267 19.7725 A 125261 D /s/ Mark A. Herpich, as Attorney-in-Fact for Jim Lewis 2023-05-12