Filing Details

Accession Number:
0001140361-13-000898
Form Type:
4
Zero Holdings:
No
Publication Time:
2013-01-03 21:22:15
Reporting Period:
2012-09-27
Filing Date:
2013-01-03
Accepted Time:
2013-01-03 21:22:15
SEC Url:
Form 4 Filing
Issuer
Cik Name Symbol Sector (SIC) IRS No
1071264 Jacksonville Bancorp Inc JAXB State Commercial Banks (6022) 593472981
Insiders
Cik Name Reported Address Insider Title Director Officer Large Shareholder Other
1503574 P John Sullivan 1185 Avenue Of The Americas
Suite 2000
New York NY 10036
Yes No Yes No
Reported Non-Derivative Transactions
Sec. Name Acquisiton - Disposition Date Amount Price Remaning Holdings Equity Swap Involved Form Type Code Nature of Ownership Explanation
Series B Preferred Stock Acquisiton 2012-09-27 5,000 $1,000.00 5,000 No 4 P Indirect Held by CapGen Capital Group IV LP
Series B Preferred Stock Disposition 2012-12-31 5,000 $0.00 0 No 4 S Indirect Held by CapGen Capital Group IV LP
Series A Mandatorily Convertible Preferred Stock Acquisiton 2012-12-31 5,000 $5,000,000.00 5,000 No 4 P Indirect Held by CapGen Capital Group IV LP
Series A Mandatorily Convertible Preferred Stock Acquisiton 2012-12-31 22,530 $22,530,000.00 22,530 No 4 P Indirect Held by CapGen Capital Group IV LP
Series A Mandatorily Convertible Preferred Stock Acquisiton 2012-12-31 200 $200,000.00 200 No 4 P Indirect Held by John Sullivan 2012 Credit Shelter Trust
Equity Swap Involved Form Type Code Nature of Ownership Explanation
No 4 P Indirect Held by CapGen Capital Group IV LP
No 4 S Indirect Held by CapGen Capital Group IV LP
No 4 P Indirect Held by CapGen Capital Group IV LP
No 4 P Indirect Held by CapGen Capital Group IV LP
No 4 P Indirect Held by John Sullivan 2012 Credit Shelter Trust
Footnotes
  1. CapGen Capital Group IV LP ("CapGen LP") acquired the shares of Noncumulative, Nonvoting Perpetual Preferred Stock, Series B (the "Series B Preferred Stock") of Jacksonville Bancorp, Inc. (the "Issuer") reported in this row on September 27, 2012. CapGen Capital Group IV LLC ("CapGen LLC") is the sole general partner of CapGen LP.
  2. The shares reported in this row were (in the case of disposition) or are (in the case of acquisition) owned directly by CapGen LP. As a principal member and member of the investment committee of CapGen LLC, the sole general partner of CapGen LP, Mr. Sullivan may be deemed to be the indirect beneficial owner of such shares under Rule 16a-1(c)(2) promulgated under the Securities Exchange Act of 1934, as amended (the "Exchange Act"). Mr. Sullivan disclaims that he is the beneficial owner of such shares, except to the extent of his pecuniary interest.
  3. Upon receipt of regulatory approval, the Series B Preferred Stock became exchangeable, on a one-for-one basis, into shares of Series A Mandatorily Convertible Preferred Stock ("Series A Preferred Stock"). On December 31, 2012, the 5,000 shares of Series B Preferred Stock were exchanged into 5,000 shares of Series A Preferred Stock.
  4. Upon receipt of requisite shareholder approvals, each share of Series A Preferred Stock will convert into 2,000 shares of common stock and/or nonvoting common stock (subject to adjustments), as more fully described in the Series A Preferred Stock Designation.