0000805676-21-000066.txt : 20210412 0000805676-21-000066.hdr.sgml : 20210412 20210412170623 ACCESSION NUMBER: 0000805676-21-000066 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: Miller Matthew R CENTRAL INDEX KEY: 0001565840 FILING VALUES: FORM TYPE: 4/A SEC ACT: 1934 Act SEC FILE NUMBER: 001-13006 FILM NUMBER: 21821334 MAIL ADDRESS: STREET 1: 50 NORTH THIRD STREET CITY: NEWARK STATE: OH ZIP: 43055 FORMER NAME: FORMER CONFORMED NAME: Miller Matther R DATE OF NAME CHANGE: 20130103 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_161826156165315.xml FORM 4/A X0306 4/A 2021-03-27 2021-03-30 0 0000805676 PARK NATIONAL CORP /OH/ PRK 0001565840 Miller Matthew R 50 N. THIRD STREET NEWARK OH 43055 1 1 0 0 President Common Shares 2021-03-27 4 M 0 983.33 A 983.33 D Common Shares 2021-03-27 4 F 0 452.64 134.47 D 530.69 D Common Shares 3648.684 I KSOP Common Shares 2867.403 I Matthew R. Miller Managing Agency Account PBRSUs 2021-03-27 4 M 0 983.33 0 D Common Shares 983.33 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 which reported an estimated number of common shares as being 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 correct number of common shares withheld. /s/ Matthew R. Miller by Brady T. Burt, POA 2021-04-12