0001209191-12-002929.txt : 20120110 0001209191-12-002929.hdr.sgml : 20120110 20120110105749 ACCESSION NUMBER: 0001209191-12-002929 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20111231 FILED AS OF DATE: 20120110 DATE AS OF CHANGE: 20120110 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: KOZAK JOHN W CENTRAL INDEX KEY: 0001221815 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 001-13006 FILM NUMBER: 12519056 MAIL ADDRESS: STREET 1: 50 NORTH THIRD STREET STREET 2: PO BOX 3500 CITY: NEWARK STATE: OH ZIP: 43058-3500 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 doc5.xml FORM 5 SUBMISSION X0304 5 2011-12-31 0 0 0 0000805676 PARK NATIONAL CORP /OH/ PRK 0001221815 KOZAK JOHN W 50 NORTH THIRD STREET NEWARK OH 43055 1 1 0 0 Chief Financial Officer Common Stock 2011-12-31 5 J 0 740.445 A 6283.779 I KSOP Common Stock 24286 D KSOP Update John W. Kozak by David L. Trautman, POA 2012-01-10