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