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