0000805676-22-000024.txt : 20220210 0000805676-22-000024.hdr.sgml : 20220210 20220210170701 ACCESSION NUMBER: 0000805676-22-000024 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: Herreman Kelly A CENTRAL INDEX KEY: 0001702544 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 001-13006 FILM NUMBER: 22615178 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 5 1 wf-form5_164453080453399.xml FORM 5 X0306 5 2021-12-31 0 0 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 0 D Common Shares 556.771 I Kelly Herreman Managing Agency Account Common Shares 1749.785 I KSOP PBRSUs Common Shares 247.92 247.92 D Reflects the transfer in April 2021 of 274.711 common shares of Park National Corporation ("Park"), previously beneficially owned directly by the reporting person, to the Kelly Herreman Managing Agency Account, where they are now beneficially owned indirectly. The number of common shares is shown to three decimal places as reflected in the document evidencing the transfer. Includes an aggregate of 225.231 common shares of 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, 2021 through the remainder of the fiscal year ended December 31, 2021. 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 Kelly A. Herreman 2022-02-10