0000805676-21-000065.txt : 20210412
0000805676-21-000065.hdr.sgml : 20210412
20210412170558
ACCESSION NUMBER: 0000805676-21-000065
CONFORMED SUBMISSION TYPE: 4/A
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210327
FILED AS OF DATE: 20210412
DATE AS OF CHANGE: 20210412
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Herreman Kelly A
CENTRAL INDEX KEY: 0001702544
FILING VALUES:
FORM TYPE: 4/A
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-13006
FILM NUMBER: 21821330
MAIL ADDRESS:
STREET 1: 50 N THIRD STREET
CITY: NEWARK
STATE: OH
ZIP: 43055
FORMER NAME:
FORMER CONFORMED NAME: Edds Kelly A
DATE OF NAME CHANGE: 20170330
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
4/A
1
wf-form4a_161826154291834.xml
FORM 4/A
X0306
4/A
2021-03-27
2021-03-30
0
0000805676
PARK NATIONAL CORP /OH/
PRK
0001702544
Herreman Kelly A
50 N. THIRD STREET
NEWARK
OH
43055
0
1
0
0
Chief Accounting Officer
Common Shares
2021-03-27
4
M
0
163.89
A
163.89
D
Common Shares
2021-03-27
4
F
0
54.56
134.47
D
109.33
D
Common Shares
1454.175
I
KSOP
Common Shares
282.06
I
Kelly Herreman Managing Agency Account
PBRSUs
2021-03-27
4
M
0
163.89
0
D
Common Shares
163.89
0
D
These performance-based restricted stock units ("PBRSUs") converted into common shares of Park National Corporation on a one-for-one basis upon satisfaction of a service-based vesting requirement on March 27, 2021.
On March 30, 2021, the reporting person filed a Form 4 but did not have available the number of common shares withheld by Park National Corporation in order to satisfy the tax withholding obligations that arose upon the vesting of the PBRSUs. This amendment reports the number of common shares withheld.
/s/ Kelly A. Herreman by Brady T. Burt, POA
2021-04-12