Statement of Changes in Beneficial Ownership (4)
January 03 2020 - 12:33PM
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
*
Mefford Jeffrey S. |
2. Issuer Name and Ticker or Trading Symbol
Midland States Bancorp, Inc.
[
MSBI
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director _____ 10% Owner __X__ Officer (give title below) _____ Other (specify below) President
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Midland States Bank |
(Last)
(First)
(Middle)
1201 NETWORK CENTRE DR. |
3. Date of Earliest Transaction
(MM/DD/YYYY)
12/31/2019 |
(Street)
EFFINGHAM, IL 62401
(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 | 12/31/2019 | | A | | 32.2560 | A | $28.96 (1) | 48985.9310 | 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 |
Option (right to buy) | $18.16 | | | | | | | (2) | 12/6/2020 | Common Stock | 9520 | | 9520 | D | |
Option (right to buy) | $16 | | | | | | | (3) | 12/13/2022 | Common Stock | 5500 | | 5500 | D | |
Option (right to buy) | $23 | | | | | | | (4) | 11/3/2025 | Common Stock | 10702 | | 10702 | D | |
Option (right to buy) | $16.59 | | | | | | | (5) | 12/10/2023 | Common Stock | 6661 | | 6661 | D | |
Option (right to buy) | $21 | | | | | | | (6) | 12/2/2024 | Common Stock | 7885 | | 7885 | D | |
Option (right to buy) | $14.75 | | | | | | | (7) | 12/16/2021 | Common Stock | 5559 | | 5559 | D | |
Option (right to buy) | $18 | | | | | | | (8) | 8/5/2024 | Common Stock | 10000 | | 10000 | D | |
Option (right to buy) | $28.59 | | | | | | | (9) | 11/16/2026 | Common Stock | 5341 | | 5341 | D | |
Explanation of Responses: |
(1) | Represents shares acquired by the reporting person in the ESPP pursuant to the reinvestment of dividends received during the quarter on shares held in the ESPP by the reporting person at the time such dividend was paid. Pursuant to the ESPP, the price used for each dividend reinvestment is the closing price of the Issuers shares on the last day of the quarter. |
(2) | These options vest in four equal annual installments beginning one year after the 12/06/2010 date of grant. |
(3) | These options vest in four equal annual installments beginning one year after the 12/13/2012 date of grant. |
(4) | These options vest in four equal annual installments beginning one year after the 11/03/2015 date of grant. |
(5) | These options vest in four equal annual installments beginning one year after the 12/10/2013 date of grant. |
(6) | These options vest in four equal annual installments beginning one year after the 12/02/2014 date of grant. |
(7) | These options vest in four equal annual installments beginning one year after the 12/16/2011 date of grant. |
(8) | Options vested on 12/31/2017. |
(9) | These options vest in four equal annual installments beginning one year after the 11/16/2016 date of grant. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Mefford Jeffrey S. 1201 NETWORK CENTRE DR. EFFINGHAM, IL 62401 |
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| President | Midland States Bank |
Signatures
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/s/ Mefford Jeffrey S | | 1/3/2020 |
**Signature of Reporting Person | Date |
/s/ Douglas J. Tucker, attorney-in-fact | | 1/3/2020 |
**Signature of Reporting Person | Date |
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