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