0001311828-18-000005.txt : 20180125 0001311828-18-000005.hdr.sgml : 20180125 20180125163859 ACCESSION NUMBER: 0001311828-18-000005 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20180123 FILED AS OF DATE: 20180125 DATE AS OF CHANGE: 20180125 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: ECHLOV RUSSELL CENTRAL INDEX KEY: 0001643131 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-51907 FILM NUMBER: 18548729 MAIL ADDRESS: STREET 1: 500 E WASHINGTON ST CITY: GREENVILLE STATE: SC ZIP: 29601 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Independence Bancshares, Inc. CENTRAL INDEX KEY: 0001311828 STANDARD INDUSTRIAL CLASSIFICATION: NATIONAL COMMERCIAL BANKS [6021] IRS NUMBER: 201734180 STATE OF INCORPORATION: SC FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 500 E. WASHINGTON STREET STREET 2: P.O. BOX 1776 CITY: GREENVILLE STATE: SC ZIP: 29602 BUSINESS PHONE: 864-672-1776 MAIL ADDRESS: STREET 1: 500 E. WASHINGTON STREET STREET 2: P.O. BOX 1776 CITY: GREENVILLE STATE: SC ZIP: 29602 4 1 primary_doc.xml PRIMARY DOCUMENT X0306 4 2018-01-23 0 0001311828 Independence Bancshares, Inc. IEBS 0001643131 ECHLOV RUSSELL 500 E WASHINGTON ST GREENVILLE SC 29601 1 0 0 0 Series A Preferred Stock 1000 2018-01-23 4 J 0 1910 1000 D Common Stock 2387500 540 I By Mendon Capital Master Fund Ltd. Series A Preferred Stock 1000 2018-01-23 4 J 0 290 1000 D Common Stock 362500 250 I By Mendon Capital QP LP Series A Preferred Stock 1000 2018-01-23 4 J 0 250 1000 D Common Stock 312500 0 I By Iron Road Multi-Strategy Fund LP, Disposed of pursuant to that certain Agreement and Plan of Merger dated as of September 25, 2017, between First Reliance Bancshares, Inc. (First Reliance), FR Merger Subsidiary, Inc. (Merger Sub), and Independence Bancshares, Inc. (Independence), pursuant to which Independence was merged with and into First Reliance. Immediately prior to the effective time of the merger, each share of Independence Series A Preferred Stock was redeemed for its stated per share redemption price by the payment of cash in the amount of $1,000. Mr. Echlov is an assistant portfolio manager at RMB Capital Management, LLC, which is the investment advisor for Iron Road Multi-Strategy Fund LP, Mendon Capital, QP, and Mendon Capital Master Fund, Ltd. Mr. Echlov has dispositive voting power over the securities of the Issuer held by Iron Road Multi-Strategy Fund LP, Mendon Capital, QP, and Mendon Capital Master Fund, Ltd. These shares are owned directly by Mendon Capital Master Fund Ltd. These shares are owned directly by Mendon Capital QP. These shares are owned directly by Iron Road Multi-Strategy Fund, LP. Not Applicable /s/Russell Echlov 2018-01-25