0000805676-22-000022.txt : 20220210 0000805676-22-000022.hdr.sgml : 20220210 20220210170618 ACCESSION NUMBER: 0000805676-22-000022 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211231 FILED AS OF DATE: 20220210 DATE AS OF CHANGE: 20220210 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: DELAWDER DAN CENTRAL INDEX KEY: 0001201379 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 001-13006 FILM NUMBER: 22615160 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_164453073269430.xml FORM 5 X0306 5 2021-12-31 0 0 0 0000805676 PARK NATIONAL CORP /OH/ PRK 0001201379 DELAWDER DAN 50 N. THIRD STREET NEWARK OH 43055 1 0 0 0 Common Shares 56507 D Common Shares 27347.804 I KSOP Common Shares 8199.962 I C. Daniel DeLawder Managing Agency Account Common Shares 50232 I Diane S., spouse PBRSUs Common Shares 1062.5 1062.50 D Reflects the transfer of 777 common shares of Park National Corporation ("Park") from being held and beneficially owned indirectly through the reporting person's account under the Park National Corporation Employees Stock Ownership Plan (the "KSOP") to being held and beneficially owned directly by the reporting person as a result of the reporting person receiving a required minimum distribution from the KSOP on Nov. 30, 2021. Includes 255.045 common shares of Park acquired by the reporting person within the KSOP since the most recent reportable transaction date of October 25, 2021 through the remainder of the fiscal year ended December 31, 2021. The number shown in this Form 5 compared to the reporting person's Form 4 dated Oct. 25, 2021, which reported 8,199.953 common shares, reflects the addition of 0.009 common share of Park for the correct total of 8,199.962 common shares beneficially owned indirectly in the C. Daniel DeLawder Managing Agency Account. 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, 2022. /s/ Brady T. Burt, Attorney-in-Fact for C. Daniel DeLawder 2022-02-10