Statement of Changes in Beneficial Ownership (4)
November 15 2017 - 9:44AM
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
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ONEILL ROBERT E
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2. Issuer Name
and
Ticker or Trading Symbol
PARK NATIONAL CORP /OH/
[
PRK
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__
X
__ Director
_____ 10% Owner
_____ Officer (give title below)
_____ Other (specify below)
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(Last)
(First)
(Middle)
50 N. THIRD STREET
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3. Date of Earliest Transaction
(MM/DD/YYYY)
11/14/2017
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(Street)
NEWARK, OH 43055
(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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Common Shares
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7/17/2017
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G
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V
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4290
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D
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$0
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0
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I
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By John J. O'Neill Investment Trust
(1)
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Common Shares
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7/17/2017
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G
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V
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342
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A
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$0
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19842
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I
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By John J. O'Neill Living Trust
(2)
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Common Shares
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11/10/2017
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G
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V
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19842
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D
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$0
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0
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I
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By John J. O'Neill Living Trust
(2)
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Common Shares
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11/10/2017
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G
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V
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3968
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A
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$0
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3968
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I
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Robert E. O'Neill Managing Agency
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Common Shares
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11/14/2017
(3)
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J
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3600
(3)
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D
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(3)
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368
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I
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Robert E. O'Neill Managing Agency
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Common Shares
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11/14/2017
(3)
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J
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3600
(3)
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A
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(3)
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7330
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D
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Common Shares
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4382.2622
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I
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Through DRIP
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Common Shares
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1000
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I
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By John J. O'Neill Irrevocable Living Trust FBO Alex O'Neill
(4)
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Common Shares
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1000
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I
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By John J. O'Neill Irrevocable Living Trust FBO Ellen O'Neill
(5)
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Common Shares
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500
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I
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Alexa Robinson-O'Neill (spouse) Managing Agency Account
(6)
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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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Explanation of Responses:
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(1)
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The reporting person became a successor co-trustee of the John J. O'Neill Investment Trust (the "JJO Investment Trust") upon the death of his father on November 16, 2014. Members of his immediate family are among the beneficiaries of the JJO Investment Trust. The reporting person disclaimed beneficial ownership of the Issuer's common shares held by the JJO Investment Trust prior to the distribution thereof in accordance with the terms of the JJO Investment Trust, except to the extent of his pecuniary interest therein, if any.
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(2)
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The reporting person became a successor co-trustee of the John J. O'Neill Living Trust (the "JJO Living Trust") upon the death of his father on November 16, 2014. The reporting person and members of his immediate family are among the beneficiaries of the JJO Living Trust. The reporting person disclaimed beneficial ownership of the Issuer's common shares held by the JJO Living Trust, prior to the distribution thereof in accordance with the terms of the JJO Living Trust, except to the extent of his pecuniary interest therein, if any.
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(3)
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Includes 3,600 of the Issuer's common shares previously owned indirectly by the reporting person through the Robert E. O'Neill Managing Agency Account which were transferred on November 14, 2017 to the reporting person's directly owned common shares.
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(4)
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The reporting person is a co-trustee of the John J. O'Neill Irrevocable Living Trust FBO Alex O'Neill. A member of the reporting person's immediate family is the beneficiary of this trust. The reporting person disclaims beneficial ownership of the Issuer's common shares in which he does not have a pecuniary interest, and this report shall not be deemed an admission that the reporting person is the beneficial owner of such Park common shares for purposes of Section 16 of the Securities Exchange Act of 1934 or for any other purpose.
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(5)
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The reporting person is a co-trustee of the John J. O'Neill Irrevocable Living Trust FBO Ellen O'Neill. A member of the reporting person's immediate family is the beneficiary of this trust. The reporting person disclaims beneficial ownership the Issuer's common shares in which he does not have a pecuniary interest, and this report shall not be deemed an admission that the reporting person is the beneficial owner of such Park common shares for purposes of Section 16 of the Securities Exchange Act of 1934 or for any other purpose.
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(6)
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The reporting person disclaims beneficial ownership of these common shares, and this report shall not be deemed an admission that the reporting person is the beneficial owner of these common shares for purposes of Section 16 of the Securities Exchange of Act of 1934 or for any other purpose.
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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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ONEILL ROBERT E
50 N. THIRD STREET
NEWARK, OH 43055
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X
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Signatures
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/s/ Robert E. O'Neill by Brady T. Burt, POA
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11/15/2017
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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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