0001412665-21-000013.txt : 20210218
0001412665-21-000013.hdr.sgml : 20210218
20210218144111
ACCESSION NUMBER: 0001412665-21-000013
CONFORMED SUBMISSION TYPE: 4/A
PUBLIC DOCUMENT COUNT: 2
CONFORMED PERIOD OF REPORT: 20210215
FILED AS OF DATE: 20210218
DATE AS OF CHANGE: 20210218
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Ray Barry S
CENTRAL INDEX KEY: 0001632460
FILING VALUES:
FORM TYPE: 4/A
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35968
FILM NUMBER: 21649081
MAIL ADDRESS:
STREET 1: 102 S. CLINTON STREET
STREET 2: P.O. BOX 1700
CITY: IOWA CITY
STATE: IA
ZIP: 52244-1700
FORMER NAME:
FORMER CONFORMED NAME: Ray Barry
DATE OF NAME CHANGE: 20150202
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: MidWestOne Financial Group, Inc.
CENTRAL INDEX KEY: 0001412665
STANDARD INDUSTRIAL CLASSIFICATION: STATE COMMERCIAL BANKS [6022]
IRS NUMBER: 421206172
STATE OF INCORPORATION: IA
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 102 SOUTH CLINTON ST.
CITY: IOWA CITY
STATE: IA
ZIP: 52240
BUSINESS PHONE: 319-356-5800
MAIL ADDRESS:
STREET 1: 102 SOUTH CLINTON ST.
CITY: IOWA CITY
STATE: IA
ZIP: 52240
FORMER COMPANY:
FORMER CONFORMED NAME: ISB Financial Corp.
DATE OF NAME CHANGE: 20070918
4/A
1
wf-form4a_161367725815393.xml
FORM 4/A
X0306
4/A
2021-02-15
2021-02-17
0
0001412665
MidWestOne Financial Group, Inc.
MOFG
0001632460
Ray Barry S
102 S. CLINTON STREET
P.O. BOX 1700
IOWA CITY
IA
52244-1700
0
1
0
0
Senior EVP & CFO
Common Stock
2021-02-15
4
A
0
1808.973
0
A
10922.506
D
Common Stock
2021-02-15
4
F
0
342
27.64
D
10580.506
D
Common Stock
196
I
ESOP
Represents restricted stock units acquired pursuant to a grant of time-based restricted stock units which vest in three approximately equal annual installments beginning February 15, 2022.
Includes 11.748 Dividend Equivalents credited to unvested time-based RSUs in lieu of a cash dividend payment since the reporting person's last required Form filing, less 0.267 fractional Dividend Equivalent paid out in cash upon vesting on February 15, 2021. Each whole Dividend Equivalent is the economic equivalent of one share of MidWestOne Financial Group, Inc. common stock.
Restricted stock units withheld to pay payroll taxes due upon the vesting of restricted stock units from prior years' awards.
Shares allocated to the reporting person's account from within the MidWestOne Financial Group, Inc. Employee Stock Ownership Plan, as of February 12, 2021.
The number of vested units forfeited to pay payroll taxes was reduced from 343 to 342, as a result of final payroll calculations determined after the filing due date of the original Form 4 filed.
Kenneth R. Urmie, Corporate Secretary, for Barry S. Ray under Power of Attorney dated January 20, 2021
2021-02-18
EX-24
2
ex-24.txt
POWER OF ATTORNEY FOR BARRY S. RAY
MIDWESTONE FINANCIAL GROUP, INC.
POWER OF ATTORNEY
(SECTIONS 13(d) AND 16(a) MATTERS)
Know all by these present the undersigned hereby constitutes and
appoints each of Kenneth R. Urmie, John J. Ruppel, and Celeste M. Yoder,
signing singly, as the undersigned's true and lawful attorneys-in-fact to:
(1) execute for and on behalf of the undersigned, in the undersigned's
capacity as a more than five percent (5%) stockholder (if applicable)
of MidWestOne Financial Group, Inc. (the "Company"), any Schedule 13D
or Schedule 13G and any amendments thereto in accordance with Section 13(d)
of the Securities Exchange Act of 1934 (the "Exchange Act") and the rules
thereunder;
(2) execute for and on behalf of the undersigned, in the undersigned's
capacity as a director, officer or stockholder of the Company or a
subsidiary of the Company, Forms 3, 4 and 5 in accordance with
Section 16(a) of the Exchange Act and the rules thereunder;
(3) do and perform any and all acts for and on behalf of the
undersigned which may be necessary or desirable to complete and execute
any such Form 3, 4 or 5 and any such Schedule 13D or Schedule 13G and
any amendments thereto and timely file such form or schedule with the
United States Securities and Exchange Commission, the Nasdaq Stock
Market, the Company and any stock exchange or similar authority; and
(4) take any other action of any type whatsoever in connection with
the foregoing which, in the opinion of such attorney-in-fact, may be of
benefit to, in the best interest of, or legally required by, the
undersigned, it being understood that the documents executed by such
attorney-in-fact on behalf of the undersigned pursuant to this Power
of Attorney shall be in such form and shall contain such terms and
conditions as such attorney-in-fact may approve in such
attorney-in-fact's discretion.
The undersigned hereby grants to each such attorney-in-fact full power
and authority to do and perform any and every act and thing whatsoever
requisite, necessary or proper to be done in the exercise of any of
the rights and powers herein granted, as fully to all intents and
purposes as the undersigned might or could do if personally present,
with full power or substitution or revocation, hereby ratifying and
confirming all that such attorney-in-fact, or such attorney-in-fact's
substitute or substitutes, shall lawfully do or cause to be done by
virtue of this power of attorney and the rights and powers herein
granted. The undersigned acknowledges that the foregoing
attorneys-in-fact, in serving in such capacity at the request of the
undersigned, are not assuming, nor is the Company assuming, any of
the undersigned's responsibilities to comply with Section 13(d) or
Section 16 of the Exchange Act.
This Power of Attorney shall remain in full force and effect until
the undersigned is no longer required to file Forms 3, 4 and 5
and Schedule 13D or Schedule 13G (including any amendments thereto)
with respect to the undersigned's holdings of and transactions in
securities issued by the Company, unless earlier revoked by the
undersigned in a signed writing delivered to the foregoing
attorneys-in-fact.
For good and valuable consideration, the receipt and sufficiency
of which is hereby acknowledged, the undersigned, to the fullest
extent permitted by law: (i) agrees to hold the attorneys-in-fact
and the Company harmless from all liability, loss, cost, damage
or expense of any nature, including reasonable attorneys' fees
and expenses sustained or incurred by the attorneys-in-fact or
Company in connection with the performance, or non-performance,
of the actions described in paragraphs (1) - (4) above; and (ii)
irrevocably releases and waives any and all claims (in law or
equity) against the attorneys-in-fact and the Company, and all
of their respective heirs, estates, successors and assigns,
as the case may be, relating to the performance, or
non-performance, of the actions described in paragraphs
(1) - (4) above.
IN WITNESS WHEREOF, the undersigned has caused this Power
of Attorney to be executed as of the 20th day of January, 2021.
/s/ Barry S. Ray
Print Name: Barry S. Ray