0000034782-16-000088.txt : 20160209 0000034782-16-000088.hdr.sgml : 20160209 20160209121454 ACCESSION NUMBER: 0000034782-16-000088 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20151231 FILED AS OF DATE: 20160209 DATE AS OF CHANGE: 20160209 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: 1ST SOURCE CORP CENTRAL INDEX KEY: 0000034782 STANDARD INDUSTRIAL CLASSIFICATION: STATE COMMERCIAL BANKS [6022] IRS NUMBER: 351068133 STATE OF INCORPORATION: IN FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 100 NORTH MICHIGAN STREET CITY: SOUTH BEND STATE: IN ZIP: 46601 BUSINESS PHONE: 5742352702 MAIL ADDRESS: STREET 1: P O BOX 1602 STREET 2: P O BOX 1602 CITY: SOUTH BEND STATE: IN ZIP: 46634 FORMER COMPANY: FORMER CONFORMED NAME: FBT BANCORP INC DATE OF NAME CHANGE: 19820818 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Seitz James R CENTRAL INDEX KEY: 0001524978 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 000-06233 FILM NUMBER: 161398176 MAIL ADDRESS: STREET 1: PO BOX 1602 CITY: SOUTH BEND STATE: IN ZIP: 46634 5 1 wf-form5_145503808289508.xml FORM 5 X0306 5 2015-12-31 0 0 0 0000034782 1ST SOURCE CORP SRCE 0001524978 Seitz James R P.O. BOX 1602 SOUTH BEND IN 46634 0 1 0 0 President Common Stock 40167 D Common Stock 21628 I By 401(k) On July 22, 2015, 1st Source Corporation declared a 10% stock dividend payable to all holders of record of common stock on August 15, 2015. As a result, the amount of shares of common stock held directly by Mr. Seitz increased by 3,651 shares. Between January 1, 2015 and December 31, 2015, Mr. Seitz acquired a total of 2,587 shares of 1st Source Corporation common stock under the 401(k) Plan through normal contributions and a 10% stock dividend declared by 1st Source Corporation on July 22, 2015, payable to all holders of common stock on August 15, 2015. The information in this report is based on a plan statement dated as of December 31, 2015. /s/ John B. Griffith, Attorney-in-Fact 2016-02-09