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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 |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Sheeley Michael J. 118 SECOND AVENUE SE CEDAR RAPIDS, IA 52401 |
VP/COO - United Life Ins. Co. |
/s/ Michael J. Sheeley by Michael T. Wilkins, Attorney-in-Fact | 09/09/2015 | |
**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) | Shares acquired through routine payroll deduction and participation in Issuer's Employee Stock Purchase Plan. |
(2) | Represents the approximate number of shares (excluding fractionals) acquired by the administrator of the Issuer's Employee Stock Purchase Plan for the Reporting Person, based on astatement of the administrator. |
(3) | The total number of securities beneficially held directly by the Reporting Person (excluding fractionals) includes: 1,354 shares held directly by Mr. Sheeley; 1,033 shares of restricted stock issued under the Issuer's Stock Plan which vest, subject to certain conditions, on 02/15/2018; 1,710 shares of restricted stock issued under the Issuer's Stock Plan which vest, subject to certain conditions, on 02/21/2019; and 1,439 shares of restricted stock issued under the Issuer's Stock Plan which vest, subject to certain conditions, on 02/20/2020. |