0000805676-19-000022.txt : 20190208 0000805676-19-000022.hdr.sgml : 20190208 20190208123756 ACCESSION NUMBER: 0000805676-19-000022 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20181231 FILED AS OF DATE: 20190208 DATE AS OF CHANGE: 20190208 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Burt Brady T CENTRAL INDEX KEY: 0001330808 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 001-13006 FILM NUMBER: 19578884 MAIL ADDRESS: STREET 1: 0015 BENCHMARK ROAD, SUITE 300 STREET 2: P.O. BOX 6580 CITY: AVON STATE: CO ZIP: 81620 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: PARK NATIONAL CORP /OH/ CENTRAL INDEX KEY: 0000805676 STANDARD INDUSTRIAL CLASSIFICATION: NATIONAL COMMERCIAL BANKS [6021] IRS NUMBER: 311179518 STATE OF INCORPORATION: OH FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 50 NORTH THIRD ST CITY: NEWARK STATE: OH ZIP: 43055 BUSINESS PHONE: 6143498451 MAIL ADDRESS: STREET 1: P O BOX 3500 CITY: NEWARK STATE: OH ZIP: 43058-3500 5 1 wf-form5_154964746217612.xml FORM 5 X0306 5 2018-12-31 0 0 0 0000805676 PARK NATIONAL CORP /OH/ PRK 0001330808 Burt Brady T 50 N. THIRD STREET NEWARK OH 43055 0 1 0 0 Chief Financial Officer Common Shares 5132.885 I KSOP Common Shares 1180.389 I Brady T. Burt Managing Agency Account Common Shares 0 D PBRSUs Common Shares 669.44 669.44 D Includes an aggregate of 263.041 common shares of Park National Corporation ("Park") acquired by the reporting person within the Park National Corporation Employees Stock Ownership Plan (the "KSOP") since the most recent reportable transaction date of March 31, 2018 through the remainder of the fiscal year ended December 31, 2018. Correction from the number included in the reporting person's Form 4 dated April 2, 2018 of 1,180.369 common shares. The number shown in this Form 5 reflects the addition of 0.020 common share for the correct total of 1,180.389 common shares. These performance-based restricted stock units ("PBRSUs") convert into Park common shares on a one-for-one basis upon satisfaction of a service-based vesting requirement pursuant to which they are to vest on March 31, 2019. /s/ Brady T. Burt 2019-02-08