Initial Statement of Beneficial Ownership (3)
11 Octobre 2019 - 1:12AM
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
OMB Number:
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
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DRAKE FRED L |
2. Date of Event Requiring Statement (MM/DD/YYYY)
10/10/2019
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3. Issuer Name and Ticker or Trading Symbol
HBT Financial, Inc. [HBT]
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(Last)
(First)
(Middle)
401 N. HERSHEY ROAD |
4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
__X__ Director ___X___ 10% Owner ___X___ Officer (give title below) _____ Other (specify below) Chief Executive Officer / |
(Street)
BLOOMINGTON, IL 61702
(City)
(State)
(Zip)
| 5. If Amendment, Date Original Filed(MM/DD/YYYY)
| 6. Individual or Joint/Group Filing(Check Applicable Line)
___ Form filed by One Reporting Person
_X_ 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, $0.01 par value | 17210400 (1) | I | See Footnote (1) |
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) | Consists of shares of common stock held by the Heartland Bancorp, Inc. Voting Trust U/A/D May 4, 2016 (the "Voting Trust"). Mr. Drake is the trustee of the Voting Trust and exercises sole voting and investment control over the common stock held thereby. Mr. Drake may be deemed to be the beneficial owner of securities held by the Voting Trust to the extent that he or his immediate family members are beneficiaries of such trust. Mr. Drake disclaims beneficial ownership of the shares held by the Voting Trust except to the extent of his pecuniary interest therein. |
Remarks: Exhibit 24.1 - Power of Attorney for Fred L. Drake Exhibit 24.2 - Power of Attorney for Heartland Bancorp, Inc. Voting Trust U/A/D May 4, 2016 |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
DRAKE FRED L 401 N. HERSHEY ROAD BLOOMINGTON, IL 61702 | X | X | Chief Executive Officer |
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HEARTLAND BANCORP, INC. VOTING TRUST U/A/D 5/4/2016 401 N. HERSHEY ROAD BLOOMINGTON, IL 61702 |
| X |
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Signatures
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/s/ Andrea E. Zurkamer, attorney-in-fact for Fred L. Drake | | 10/10/2019 |
**Signature of Reporting Person | Date |
/s/ Andrea E. Zurkamer, attorney-in-fact for Heartland Bancorp, Inc. Voting Trust U/A/D 5/4/2016 | | 10/10/2019 |
**Signature of Reporting Person | Date |
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