0000805676-22-000028.txt : 20220210
0000805676-22-000028.hdr.sgml : 20220210
20220210170854
ACCESSION NUMBER: 0000805676-22-000028
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: Miller Matthew R
CENTRAL INDEX KEY: 0001565840
FILING VALUES:
FORM TYPE: 5
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-13006
FILM NUMBER: 22615215
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
5
1
wf-form5_164453091053659.xml
FORM 5
X0306
5
2021-12-31
0
0
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
0
D
Common Shares
3985.392
I
Matthew R. Miller Managing Agency Account
Common Shares
4025.883
I
KSOP
PBRSUs
Common Shares
850.0
850
D
Reflects the transfer in April 2021 of 989.430 common shares of Park National Corporation ("Park"), previously beneficially owned directly by the reporting person, to the Matthew R. Miller Managing Agency Account, where they are now beneficially owned indirectly.
Includes an aggregate of 128.559 common shares of Park acquired by the reporting person through the election of dividend reinvestment with respect to common shares held in the Matthew R. Miller Managing Agency Account (the reinvestment terms of which are substantially similar to those of Park's Dividend Reinvestment Plan) since the most recent reportable transaction date of March 31, 2021 through the remainder of the fiscal year ended December 31, 2021.
Includes an aggregate of 261.896 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 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 Matthew R. Miller
2022-02-10