Statement of Changes in Beneficial Ownership (4)
January 20 2021 - 4:10PM
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).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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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
*
BECKER DAVID B |
2. Issuer Name and Ticker or Trading Symbol
First Internet Bancorp
[
INBK
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__X__ Director _____ 10% Owner __X__ Officer (give title below) _____ Other (specify below) Chairman, President and CEO |
(Last)
(First)
(Middle)
11201 USA PARKWAY |
3. Date of Earliest Transaction
(MM/DD/YYYY)
1/18/2021 |
(Street)
FISHERS, IN 46037
(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 Stock | 1/18/2021 | | A | | 8351 (1) | A | $0 | 352196 (2) | D | |
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) | 2. Conversion or Exercise Price of Derivative Security | 3. Trans. Date | 3A. Deemed Execution Date, if any | 4. Trans. Code (Instr. 8) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) | 6. Date Exercisable and Expiration Date | 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) | 8. Price of Derivative Security (Instr. 5) | 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) | 10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) |
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Explanation of Responses: |
(1) | Represents grant of RSUs under the First Internet Bancorp 2013 Equity Incentive Plan. The RSUs are scheduled to vest in substantially equal annual installments on December 31, 2021, December 31, 2022,and December 31, 2023. |
(2) | Includes 423 shares acquired on January 15, 2020 pursuant to the First Internet Bancorp Dividend Reinvestment and Stock Purchase Plan, 9 restricted stock units acquired on January 15, 2021 pursuant to the terms of outstanding restricted stock units as a result of the payment of cash dividends paid on our common stock and 104 shares acquired on January 5, 2021 pursuant to the First Internet Bancorp Employee Stock Purchase Plan. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
BECKER DAVID B 11201 USA PARKWAY FISHERS, IN 46037 | X |
| Chairman, President and CEO |
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Signatures
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/s/ Kenneth J. Lovik, Attorney-in-Fact for David B. Becker (power of attorney previously filed) | | 1/20/2021 |
**Signature of Reporting Person | Date |
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