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