-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, TXPYYG3nrUN5OqxQ9TbfPEqJnHL+w9s4Ocec4SStrWJsaeSQDcSZFWsAVVrquZPa uDivpBf3BV7WrMbTKBDbQw== 0001179110-05-001507.txt : 20050121 0001179110-05-001507.hdr.sgml : 20050121 20050121152410 ACCESSION NUMBER: 0001179110-05-001507 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20050121 FILED AS OF DATE: 20050121 DATE AS OF CHANGE: 20050121 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: FULLER LYNN B CENTRAL INDEX KEY: 0001184324 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-15393 FILM NUMBER: 05541424 MAIL ADDRESS: STREET 1: 1398 CENTRAL AVE CITY: DUBUQUE STATE: IA ZIP: 52001 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: HEARTLAND FINANCIAL USA INC CENTRAL INDEX KEY: 0000920112 STANDARD INDUSTRIAL CLASSIFICATION: STATE COMMERCIAL BANKS [6022] IRS NUMBER: 421405748 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1398 CENTRAL AVE CITY: DUBUQUE STATE: IA ZIP: 52001 BUSINESS PHONE: 5635892000 MAIL ADDRESS: STREET 1: 1398 CENTRAL AVE CITY: DUBUQUE STATE: IA ZIP: 52001 4 1 edgar.xml FORM 4 - X0202 4 2005-01-21 0 0000920112 HEARTLAND FINANCIAL USA INC HTLF 0001184324 FULLER LYNN B 1398 CENTRAL AVE. DUBUQUE IA 52001 1 1 0 0 President & CEO Common Stock 2005-01-21 4 M 0 13500 12.00 A 497389 I As Trustee Common Stock 21000 I Partnership Common Stock 6000 I By Spouse Common Stock 1676.503 I By Son Common Stock 116772 I As Trustee Common Stock 502.942 I Minor Son Common Stock 2583.159 I IRA Non-Qualified Stock Option (Right to Buy) 12.00 2005-01-21 4 M 0 13500 0 D 2010-01-17 Common Stock 13500 0 D Non-Qualified Stock Option (Right to Buy) 8.67 2011-06-01 Common Stock 15000 15000 D Non-Qualified Stock Option (Right to Buy) 8.80 2012-01-15 Common Stock 8250 8250 D Non-Qualified Stock Option (Right to Buy) 11.84 2013-01-21 Common Stock 15000 15000 D Non-Qualified Stock Option (Right To Buy) 19.48 2014-01-20 Common Stock 15000 15000 D The reporting person disclaims beneficial ownership of these securities,and this report shall not be deemed to be an admission that the reporting person is the beneficial owner of such securities for purposes of Section 16 or any other purpose. Shares held by Lynn B. Fuller Trust Under Agreement dated 5-7-96, Lynn B. Fuller Trustee Shares held by the Emma O. Fuller Trust dated 9-3-85 Dubuque Bank & Trust, L.S. Fuller & L.B. Fuller, co-trustees Represents options to buy granted under the Company's 1993 Stock Option Plan, a Rule 16(b)(3) plan, which options vest one-third per year beginning on the 3rd anniversary of date of grant. These shares participate in a Dividend Reinvestment Plan. Includes 1,097 shares purchased through the Employee Stock Purchase Plan on 12/31/04. /s/ Lynn B. Fuller 2005-01-21 -----END PRIVACY-ENHANCED MESSAGE-----