0000034782-21-000147.txt : 20211108 0000034782-21-000147.hdr.sgml : 20211108 20211108161609 ACCESSION NUMBER: 0000034782-21-000147 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211105 FILED AS OF DATE: 20211108 DATE AS OF CHANGE: 20211108 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: OZARK TIMOTHY K CENTRAL INDEX KEY: 0001217074 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-06233 FILM NUMBER: 211388159 MAIL ADDRESS: STREET 1: P O BOX 1602 CITY: SOUTH BEND STATE: IN ZIP: 46634 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 4 1 wf-form4_163640614374738.xml FORM 4 X0306 4 2021-11-05 0 0000034782 1ST SOURCE CORP SRCE 0001217074 OZARK TIMOTHY K 333 N. CANAL ST UNIT 3605 CHICAGO IL 60606 1 0 0 0 Common Stock 2021-11-05 4 A 0 311 48.20 A 38674 D /s/ John B. Griffith, Attorney-in-Fact 2021-11-08