Initial Statement of Beneficial Ownership (3)
01 Maio 2023 - 5:25PM
Edgar (US Regulatory)
FORM 3
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
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3235-0104
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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
*
Lindstrom David E |
2. Date of Event Requiring Statement (MM/DD/YYYY)
4/27/2023
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3. Issuer Name and Ticker or Trading Symbol
MidWestOne Financial Group, Inc. [MOFG]
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(Last)
(First)
(Middle)
102 S. CLINTON STREET, P.O. BOX 1700 |
4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
_____ Director _____ 10% Owner
___X___ Officer (give title below) _____ Other (specify below)
EVP, Consumer Banking / |
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(Street)
IOWA CITY, IA 52244-1700
(City)
(State)
(Zip)
| 5. If Amendment, Date Original Filed(MM/DD/YYYY)
| 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 Beneficially Owned
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1.Title of Security
(Instr. 4) | 2. Amount of Securities Beneficially Owned
(Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I)
(Instr. 5) | 4. Nature of Indirect Beneficial Ownership
(Instr. 5) |
| Common Stock | 8910.638 (1) | D | |
| Common Stock | 843 | I | By ESOP (2) |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security
(Instr. 4) | 2. Date Exercisable and Expiration Date
(MM/DD/YYYY) | 3. Title and Amount of Securities Underlying Derivative Security
(Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
(Instr. 5) | 6. Nature of Indirect Beneficial Ownership
(Instr. 5) |
| Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
| Explanation of Responses: |
| (1) | Includes 484.705 unvested restricted stock units from February 15, 2021 award, 884.695 unvested restricted stock units from February 15, 2022 award, 1,238.944 unvested restricted stock units from February 15, 2023 award. The restricted stock units vest in equal annual installments over their respective three-year vesting periods. |
| (2) | Shares held in the MidWestOne Financial Group, Inc. Employee Stock Ownership Plan as of April 27, 2023. |
Reporting Owners
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| Reporting Owner Name / Address | Relationships |
| Director | 10% Owner | Officer | Other |
Lindstrom David E
102 S. CLINTON STREET
P.O. BOX 1700
IOWA CITY, IA 52244-1700 |
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| EVP, Consumer Banking |
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Signatures
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| Kenneth R. Urmie, Corporate Secretary, for David E. Lindstrom under Power of Attorney dated April 21, 2023 | | 5/1/2023 |
| **Signature of Reporting Person | Date |
| Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. |
| * | If the form is filed by more than one reporting person, see Instruction 5(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). |
| Note: | File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. |
| 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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