0000908834-12-000352.txt : 20121203 0000908834-12-000352.hdr.sgml : 20121203 20121203103609 ACCESSION NUMBER: 0000908834-12-000352 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20121129 FILED AS OF DATE: 20121203 DATE AS OF CHANGE: 20121203 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: FITZPATRICK DANIEL B CENTRAL INDEX KEY: 0000939167 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-06233 FILM NUMBER: 121236382 MAIL ADDRESS: STREET 1: 4220 EDISON LAKES PKWY STREET 2: C/O QUALITY DINING INC CITY: MISHAWAKA STATE: IN ZIP: 46545 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 edgar.xml PRIMARY DOCUMENT X0306 4 2012-11-29 0000034782 1ST SOURCE CORP SRCE 0000939167 FITZPATRICK DANIEL B PO BOX 1602 SOUTH BEND IN 46634 1 0 0 0 Common Stock 2012-11-29 4 S 0 17274 21.12 D 25726 D Common Stock 5500 I By immediate family /s/ John B. Griffith, Attorney-in-Fact for Daniel B. Fitzpatrick 2012-11-29