-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, MHZdXPcUgjs4sEDWICWHLkCVE/BQCJ2F9+/F+ZxXDbIrlDFNcJIUUTvN+lgx6Oze H6bIvxBtgossDQeRKFxuSw== 0000712534-96-000028.txt : 19960805 0000712534-96-000028.hdr.sgml : 19960805 ACCESSION NUMBER: 0000712534-96-000028 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 19960802 SROS: NASD SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: FIRST MERCHANTS CORP CENTRAL INDEX KEY: 0000712534 STANDARD INDUSTRIAL CLASSIFICATION: NATIONAL COMMERCIAL BANKS [6021] IRS NUMBER: 351544218 STATE OF INCORPORATION: IN FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-17071 FILM NUMBER: 96603148 BUSINESS ADDRESS: STREET 1: 200 E JACKSON ST STREET 2: PO BOX 792 CITY: MUNCIE STATE: IN ZIP: 47308-0792 BUSINESS PHONE: 3177471500 MAIL ADDRESS: STREET 1: 200 EAST JACKSON STREET CITY: MUNCIE STATE: IN ZIP: 47305 COMPANY DATA: COMPANY CONFORMED NAME: MEDLER RODNEY A CENTRAL INDEX KEY: 0001012950 STANDARD INDUSTRIAL CLASSIFICATION: STATE COMMERCIAL BANKS [6022] OFFICER STATE OF INCORPORATION: IN FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 BUSINESS ADDRESS: STREET 1: 200 E JACKSON ST STREET 2: PO BOX 792 CITY: MUNCIE STATE: IN ZIP: 47308-0792 BUSINESS PHONE: 3177471500 MAIL ADDRESS: STREET 1: 200 EAST JACKSON STREET CITY: MUNCIE STATE: IN ZIP: 47305 4 1 FORM 4 - JULY 1996 U.S. SECURITIES AND EXCHANGE COMMISSION WASHINGTON, D.C. FORM 4 ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP ( ) Check box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instructions 1(b). 1. Name and Address of Reporting Person MEDLER, RODNEY A. RURAL ROUTE #1 BOX 67 FARMLAND, IN 47340 2. Issuer Name and Ticker or Trading Symbol FIRST MERCHANTS CORPORATION FRME 3. IRS or Social Security Number of Reporting Person (Voluntary) ###-##-#### 4. Statement for Month/Year JULY 1996 5. If Amendment, Date of Original (Month/Year) 6. Relationship of Reporting Person to Issuer (Check all applicable) ( ) Director ( ) 10% Owner (X) Officer (give title below) ( ) Other (specify below) SECRETARY-FIRST MERCHANTS CORPORATION, FIRST VICE PRESIDENT--FIRST MERCHANTS BANK, N.A.
___________________________________________________________________________________________________________________________________ Table I -- Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | ___________________________________________________________________________________________________________________________________| 1. Title of Security |2. |3. |4.Securities Acquired (A) |5.Amount of |6.Dir |7.Nature of Indirect | | Transaction | or Disposed of (D) | Securities |ect | Beneficial Ownership | | | | | Beneficially |(D)or | | | | | | | A/| | Owned at |Indir | | | Date |Code|V| Amount | D | Price | End of Year |ect(I)| | ___________________________________________________________________________________________________________________________________| Common Stock | | | | | | |2,700 |D | | - -----------------------------------------------------------------------------------------------------------------------------------| ___________________________________________________________________________________________________________________________________| ___________________________________________________________________________________________________________________________________ Table II -- Derivative Securitites Acquired, Disposed of, or Beneficially Owned | ___________________________________________________________________________________________________________________________________| 1.Title of Derivative |2.Con- |3. |4. |5.Number of De |6.Date Exer|7.Title and Amount |8.Price|9.Number |10.|11.Nature of| Security |version |Transaction | rivative Secu |cisable and| of Underlying |of Deri|of Deriva |Dir|Indirect | |or Exer | | | rities Acqui |Expiration | Securities |vative |tive |ect|Beneficial | |cise | | | red(A) or Dis |Date(Month/| |Secu |Securities |(D)|Ownership | |Price of| | | posed of(D) |Day/Year) | |rity |Benefi |or | | |Deriva- | | | |Date |Expir| | |ficially |Ind| | |tive | | | | A/|Exer-|ation| Title and Number | |Owned at |ire| | |Secu- | | | | | D |cisa-|Date | of Shares | |End of |ct | | |rity |Date |Code|V| Amount | |ble | | | |Year |(I)| | ___________________________________________________________________________________________________________________________________| Employee Stock Option |24.125 |07-31|A |V|1,700 |A |01-31|07-31|Common |1,700 | |7,567 |D | | (Right to Buy) | |-96 | | | | |-97 |-06 | | | | | | | - -----------------------------------------------------------------------------------------------------------------------------------| | | | | | | | | | | | | | | | ___________________________________________________________________________________________________________________________________|
Explanation of Responses: SIGNATURE OF REPORTING PERSON RODNEY A MEDLER (Confirming Statement on File) DATE August 1, 1996 -----END PRIVACY-ENHANCED MESSAGE-----