SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

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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1. Name and Address of Reporting Person*
Cantrell James M

(Last) (First) (Middle)
102 S. CLINTON STREET
P.O. BOX 1700

(Street)
IOWA CITY IA 52244-1700

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
12/07/2017
3. Issuer Name and Ticker or Trading Symbol
MidWestOne Financial Group, Inc. [ MOFG ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Chief Financial Officer
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock 8,963(1) D
Common Stock 1,957(2) I By ESOP
Common Stock 500 I By IRA
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Explanation of Responses:
1. Includes 125 restricted stock units from February 15, 2014 award, 750 restricted stock units from February 15, 2015 award, 1,125 restricted stock units from February 15, 2016 award and 1,800 restricted stock units from February 15, 2017 award. The restricted stock units vest in equal annual installments over their respective four year vesting periods.
2. Shares held in the MidWestOne Financial Group, Inc. Employee Stock Ownership Plan as of December 7, 2017.
Remarks:
On November 14, 2017, Katie A. Lorenson announced her resignation from her positions as Senior Vice President, Chief Financial Officer, principal financial officer and principal accounting officer of MidWestOne Financial Group, Inc. (the "Company"). Her resignation became effective on December 7, 2017. On November 14, 2017, the Company appointed James M. Cantrell to serve as Chief Financial Officer, principal financial officer and principal accounting officer, on an interim basis beginning December 7, 2017, while the Company conducts an executive search for Ms. Lorenson's permanent replacement. Mr. Cantrell currently serves as Vice President, Chief Investment Officer and Treasurer of the Company and as Senior Vice President, Chief Investment Officer and Treasurer of MidWestOne Bank, the Company's wholly owned subsidiary. He has served in these positions since joining the Company in 2009.
Kenneth R. Urmie, Corporate Secretary, under Power of Attorney for James M. Cantrell, dated December 8, 2017 12/15/2017
** 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 5 (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.
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