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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
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. | SEC 1474 (9-02) |
1. Title of Derivative Security (Instr. 3) |
2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction 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 (Month/Day/Year) |
7. Title and Amount of Underlying Securities (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) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Junior Preferred Stock | (1) | 03/25/2014 | C | 359,474 | (1) | (1) | Common Stock | 359,474 | $ 0 | 0 | I | By Texas Independent Bancshares, Inc. (2) | |||
Series A Preferred Stock | (1) | 03/25/2014 | C | 6,537 | (1) | (1) | Common Stock | 6,537 | $ 0 | 0 | I | By Texas Independent Bancshares, Inc. (2) | |||
Series B Preferred Stock | (1) | 03/25/2014 | C | 19,005 | (1) | (1) | Common Stock | 19,005 | $ 0 | 0 | I | By Texas Independent Bancshares, Inc. (2) | |||
Series C Preferred Stock | (1) | 03/25/2014 | C | 20,262 | (1) | (1) | Common Stock | 20,262 | $ 0 | 0 | I | Texas Independent Bancshares, Inc. (2) |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
DOYLE CHARLES T 13785 RESEARCH BLVD. SUITE 150 AUSTIN, TX 78750 |
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/s/ M. Scott Kerr, as attorney-in-fact | 03/27/2014 | |
**Signature of Reporting Person | Date |
* | If the form is filed by more than one reporting person, see Instruction 4(b)(v). |
** | Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
(1) | The Preferred Stock was automatically converted into Common Stock on a one-for-one basis immediately prior to the closing of the Issuer's initial public offering and has no expiration date. |
(2) | Shares held by Texas Independent Bancshares, Inc. Mr. Doyle is the Chairman of the Board of Texas Independent Bancshares, Inc. and as such may be deemed to share voting and dispositive power over the shares held by Texas Independent Bancshares, Inc. Mr. Doyle disclaims beneficial ownership of the shares held by Texas Independent Bancshares, Inc., except to the extent of any pecuniary interest therein. |
(3) | Texas Independent Bancshares, Inc. sold these shares as a selling stockholder in connection with the issuer's initial public offering. |