Statement of Changes in Beneficial Ownership (4)
25 January 2023 - 10:20AM
Edgar (US Regulatory)
FORM 4
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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3235-0287
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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
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Young William E |
2. Issuer Name and Ticker or Trading Symbol
SOUTHERN MISSOURI BANCORP, INC.
[
SMBC
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__X__ Director _____ 10% Owner _____ Officer (give title below) _____ Other (specify below)
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(Last)
(First)
(Middle)
2991 OAK GROVE RD |
3. Date of Earliest Transaction
(MM/DD/YYYY)
1/24/2023 |
(Street)
POPLAR BLUFF, MO 63901
(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 | 1/24/2023 | | A | | 56649 | A | (1) | 56649 | I | By Rev Trust |
Common | 1/24/2023 | | A | | 297829 | A | (1) | 297829 | I | By Young Corporation |
Common | 1/24/2023 | | A | | 1524 | A | (1) | 1524 | I | Custodian for son |
Common | 1/24/2023 | | A | | 541 | A | (1) | 541 | I | Custodian for daughter |
Common | 1/24/2023 | | A | | 306 | A | (1) | 306 | I | Custodian for son |
Common | 1/24/2023 | | A | | 2351 | A | (1) | 2351 | I | Custodian for son |
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) | Received in exchange for shares of the common stock of Citizens Bancshares Co, ("Citizens") in connection with the merger of Citizens with and into Southern Missouri Bancorp, Inc. ("SMBI"). Under the terms of the merger agreement between SMBI and Citizens, at the effective time of the Merger each share of Citizens common stock outstanding immediately prior to the effective time was exchanged for 1.1755 shares of Southern Missouri Common Stock. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Young William E 2991 OAK GROVE RD POPLAR BLUFF, MO 63901 | X |
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Signatures
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/s/ William E. Young | | 1/24/2023 |
**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 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). |
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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