SEC Form 4
FORM 4 | UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP 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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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). |
1. Name and Address of Reporting Person*
(Street)
| 2. Issuer Name and Ticker or Trading Symbol QUAINT OAK BANCORP INC [ QNTO ] | 5. Relationship of Reporting Person(s) to Issuer (Check all applicable)
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3. Date of Earliest Transaction (Month/Day/Year) 11/29/2017 | ||||||||||||||||||||||||||
4. If Amendment, Date of Original Filed (Month/Day/Year) | 6. Individual or Joint/Group Filing (Check Applicable Line)
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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) | 2. Transaction Date (Month/Day/Year) | 2A. Deemed Execution Date, if any (Month/Day/Year) | 3. Transaction Code (Instr. 8) | 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) | 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) | 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 7. Nature of Indirect Beneficial Ownership (Instr. 4) | |||
Code | V | Amount | (A) or (D) | Price | ||||||
Common Stock | 11/29/2017 | M | 4,234 | A | $5 | 8,832(1)(2) | D | |||
Common Stock | 11/29/2017 | F | 1,598(3) | D | $13.25 | 7,234(1) | D | |||
Common Stock | 2,820(1) | I | By IRA | |||||||
Common Stock | 1,200(1) | I | By Spouse | |||||||
Common Stock | 10,644.052(1)(4) | I | By ESOP | |||||||
Common Stock | 525.97(5) | I | By 401(k) Plan |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||||||||||
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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 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: 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 | ||||||||
Employee Stock Option (Right to Buy) | $5(6) | 11/29/2017 | M | 4,234 | 05/14/2013(7) | 05/14/2018 | Common Stock | 4,234(6) | $0 | 0 | D | ||||
Employee Stock Option (Right to Buy) | $8.1(6) | (8) | 05/08/2023 | Common Stock | 10,000(6) | 10,000(6) | D |
Explanation of Responses: |
1. On September 8, 2015, the Issuer effected a 2-for-1 stock split. The number of shares reported throughout this Form 4 have been adjusted to reflect the stock split. |
2. Includes 640 shares granted pursuant to the 2008 Recognition and Retention Plan that represent the unvested portion of a grant amount originally covering 3,200 shares (adjusted to reflect the 2-for-1 stock split) that are vesting ratably over five years at 20% per year commencing on May 8, 2014. |
3. Represents previously owned shares of common stock delivered to the Issuer in payment for the exercise price of the subject options. |
4. Includes shares allocated to the reporting person's ESOP account since the last filed Form 4. |
5. Includes shares acquired in the Quaint Oak Bank 401(k) Plan since the last filed Form 4, based on a report dated November 29, 2017. |
6. In accordance with the terms of the stock option plan and stock incentive plan the exercise price of the options and number of shares subject to the option have been adjusted to reflect the stock split. |
7. The options vested at a rate of 20% per year beginning on May 14, 2009. |
8. The options are vesting ratably over five years at 20% per year commencing May 8, 2014. |
Remarks: |
/s/Diane J. Colyer | 11/30/2017 | |
** 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 Number. |