Statement of Changes in Beneficial Ownership (4)
October 06 2017 - 7:18PM
Edgar (US Regulatory)
FORM 4
[ ]
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue.
See
Instruction 1(b).
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0287
Estimated average burden
hours per response...
0.5
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Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
*
SCOTT RANDALL I
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2. Issuer Name
and
Ticker or Trading Symbol
FIRST INTERSTATE BANCSYSTEM INC
[
FIBK
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__
X
__ Director
__
X
__ 10% Owner
_____ Officer (give title below)
_____ Other (specify below)
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(Last)
(First)
(Middle)
PO BOX 30918
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3. Date of Earliest Transaction
(MM/DD/YYYY)
10/4/2017
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(Street)
BILLINGS, MT 59116-0918
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
_
X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1.Title of Security
(Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code
(Instr. 8)
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4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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Class A Common Stock
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10/4/2017
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M
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1430
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A
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$0.00
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1430
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I
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By Spouse
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Class A Common Stock
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19391
(1)
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I
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By Trust
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Class A Common Stock
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9648
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I
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By 401(k)
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Table II - Derivative Securities Beneficially Owned (
e.g.
, puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security
(Instr. 3)
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2. Conversion or Exercise Price of Derivative Security
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3. Trans. Date
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3A. Deemed Execution Date, if any
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4. Trans. Code
(Instr. 8)
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5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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6. Date Exercisable and Expiration Date
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7. Title and Amount of Securities Underlying Derivative Security
(Instr. 3 and 4)
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8. Price of Derivative Security
(Instr. 5)
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9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4)
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10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4)
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11. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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(A)
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(D)
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Date Exercisable
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Expiration Date
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Title
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Amount or Number of Shares
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Class B Common Stock
(2)
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$0.00
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10/4/2017
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M
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1430
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(2)
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(2)
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Class A Common Stock
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1430
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$0.00
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75335
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I
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By Spouse
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Class B Common Stock
(2)
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$0.00
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(2)
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(2)
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Class A Common Stock
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156279
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156279
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I
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By Trust
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Class B Common Stock
(2)
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$0.00
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(2)
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(2)
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Class A Common Stock
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3795676
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3795676
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I
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As Managing General Partner of NBar5 Ltd. Partnership
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Class B Common Stock
(2)
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$0.00
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(2)
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(2)
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Class A Common Stock
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85836
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85836
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I
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By Self as Co-Trustee
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Class B Common Stock
(2)
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$0.00
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(2)
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(2)
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Class A Common Stock
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803310
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803310
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I
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By Partnership
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Explanation of Responses:
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(1)
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This number includes 716 shares that were held directly by Reporting Person but transferred by Reporting Person on August 8, 2017 into Reporting Person's Revocable Trust. This transfer did not affect Reporting Person's beneficial ownership.
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(2)
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On March 5, 2010, the Company recapitalized its existing common stock. The recapitalization included, among other things, a redesignation of existing common stock as Class B common stock and the creation of a new class of common stock designated as Class A common stock, which is listed on the NASDAQ stock market under the symbol "FIBK". The Class B common stock is convertible at any time into Class A common stock on a share for share basis at the discretion of the holder. The conversion feature of the Class B common stock does not expire.
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Reporting Owners
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Reporting Owner Name / Address
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Relationships
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Director
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10% Owner
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Officer
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Other
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SCOTT RANDALL I
PO BOX 30918
BILLINGS, MT 59116-0918
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X
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X
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Signatures
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/s/ EMILY L. ADAM, Attorney-in-Fact for Reporting Person
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10/6/2017
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**
Signature of Reporting Person
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Date
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
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*
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If the form is filed by more than one reporting person,
see
Instruction 4(b)(v).
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**
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Intentional misstatements or omissions of facts constitute Federal Criminal Violations.
See
18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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Note:
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File three copies of this Form, one of which must be manually signed. If space is insufficient,
see
Instruction 6 for procedure.
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Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number.
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