0001437749-23-000097.txt : 20230103 0001437749-23-000097.hdr.sgml : 20230103 20230103085925 ACCESSION NUMBER: 0001437749-23-000097 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230101 FILED AS OF DATE: 20230103 DATE AS OF CHANGE: 20230103 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Poulsen Jennifer A CENTRAL INDEX KEY: 0001675305 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-34527 FILM NUMBER: 23500447 MAIL ADDRESS: STREET 1: 100 7TH ST., APT. 1401 CITY: PITTSBURGH STATE: PA ZIP: 15222 FORMER NAME: FORMER CONFORMED NAME: Roxbury Jennifer A DATE OF NAME CHANGE: 20160523 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: EMCLAIRE FINANCIAL CORP CENTRAL INDEX KEY: 0000858800 STANDARD INDUSTRIAL CLASSIFICATION: NATIONAL COMMERCIAL BANKS [6021] IRS NUMBER: 251606091 STATE OF INCORPORATION: PA FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 612 MAIN ST CITY: EMLENTON STATE: PA ZIP: 16373 BUSINESS PHONE: 7248672311 MAIL ADDRESS: STREET 1: POST OFFICE BOX D STREET 2: 612 MAIN STREET CITY: EMLENTON STATE: PA ZIP: 16373 4 1 rdgdoc.xml FORM 4 X0306 4 2023-01-01 1 0000858800 EMCLAIRE FINANCIAL CORP EMCF 0001675305 Poulsen Jennifer A 2242 SHANNON MILLS DRIVE RENFREW PA 16053 1 SVP, COO, and Secretary Common Stock 2023-01-01 4 D 0 8048 D 0 D Common Stock 2023-01-01 4 D 0 2811 D 0 I By 401(k) plan Disposed of pursuant to merger agreement among Issuer, Farmers National Bank Corp.("Farmers") and FMNB Merger Subsidiary V, LLC, a wholly owned subsidiary of Farmers, whereby each share of common stock of the Issuer was exchanged for either (i) 2.15 shares of common stock of Farmers or (ii) $40.00 in cash, at the election of the holder, subject to proration and allocation as set forth in the merger agreement. Includes shares acquired pursuant to a dividend reinvestment plan. /s/ Jennifer A. Poulsen 2023-01-03