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 |
|
1. Name and Address of Reporting Person*
(Street)
|
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)
|
5. If Amendment, Date of Original Filed
(Month/Day/Year) |
||||||||||||||
6. Individual or Joint/Group Filing (Check Applicable Line)
|
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. | ||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |