0001562463-21-000023.txt : 20210120
0001562463-21-000023.hdr.sgml : 20210120
20210120160914
ACCESSION NUMBER: 0001562463-21-000023
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210118
FILED AS OF DATE: 20210120
DATE AS OF CHANGE: 20210120
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: SMITH MICHAEL L
CENTRAL INDEX KEY: 0001194201
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35750
FILM NUMBER: 21538848
MAIL ADDRESS:
STREET 1: ANTHEM INC
STREET 2: 120 MONUMENT CIRCLE
CITY: INDIANAPOLIS
STATE: IN
ZIP: 46204
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: First Internet Bancorp
CENTRAL INDEX KEY: 0001562463
STANDARD INDUSTRIAL CLASSIFICATION: STATE COMMERCIAL BANKS [6022]
IRS NUMBER: 203489991
STATE OF INCORPORATION: IN
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 11201 USA PARKWAY
CITY: FISHERS
STATE: IN
ZIP: 46037
BUSINESS PHONE: 317-532-7900
MAIL ADDRESS:
STREET 1: 11201 USA PARKWAY
CITY: FISHERS
STATE: IN
ZIP: 46037
4
1
wf-form4_161117694205235.xml
FORM 4
X0306
4
2021-01-18
0
0001562463
First Internet Bancorp
INBK
0001194201
SMITH MICHAEL L
11201 USA PARKWAY
FISHERS
IN
46037
1
0
0
0
Common Stock
2021-01-18
4
A
0
1810
0
A
3273
D
Restricted stock award scheduled to vest as follows: 149 shares were fully vested on the date of grant and 151 shares will vest on the fifteenth day of each month beginning February 15, 2021 and ending on December 15, 2021.
/s/ Kenneth J. Lovik, Attorney-in-Fact for Michael L. Smith (power of attorney previously filed)
2021-01-20