0001562463-23-000041.txt : 20230330
0001562463-23-000041.hdr.sgml : 20230330
20230330094026
ACCESSION NUMBER: 0001562463-23-000041
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20230329
FILED AS OF DATE: 20230330
DATE AS OF CHANGE: 20230330
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Dee Ann C.
CENTRAL INDEX KEY: 0001665618
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35750
FILM NUMBER: 23777502
MAIL ADDRESS:
STREET 1: 600 E 96TH ST, #100
CITY: INDIANAPOLIS
STATE: IN
ZIP: 46240
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: 8701 E. 116TH STREET
CITY: FISHERS
STATE: IN
ZIP: 46038
BUSINESS PHONE: 317-532-7900
MAIL ADDRESS:
STREET 1: 8701 E. 116TH STREET
CITY: FISHERS
STATE: IN
ZIP: 46038
4
1
wf-form4_168018361421342.xml
FORM 4
X0407
4
2023-03-29
0
0001562463
First Internet Bancorp
INBK
0001665618
Dee Ann C.
8701 E. 116TH STREET
FISHERS
IN
46038
1
0
0
0
0
Common Stock
2023-03-29
4
P
0
2000
17.26
A
4850
D
/s/ Kenneth J. Lovik, Attorney-in-Fact for Ann Colussi Dee (power of attorney previously filed)
2023-03-30