Statement of Changes in Beneficial Ownership (4)
06 11월 2014 - 7:32AM
Edgar (US Regulatory)
FORM 4
[ ]
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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OMB APPROVAL
OMB Number:
3235-0287
Estimated average burden
hours per response...
0.5
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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
*
STADIUM CAPITAL MANAGEMENT LLC
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2. Issuer Name
and
Ticker or Trading Symbol
INTERMOUNTAIN COMMUNITY BANCORP
[
IMCB
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__
X
__ Director
__
X
__ 10% Owner
_____ Officer (give title below)
_____ Other (specify below)
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(Last)
(First)
(Middle)
199 ELM STREET
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3. Date of Earliest Transaction
(MM/DD/YYYY)
11/1/2014
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(Street)
NEW CANAAN, CT 06840-5321
(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)
___ Form filed by One Reporting Person
_
X
_ 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 Stock
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11/1/2014
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D
(1)
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356796
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D
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$0
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0
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I
(2)
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By Stadium Capital Partners, L.P.
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Common Stock
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11/1/2014
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D
(1)
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31026
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D
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$0
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0
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I
(3)
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By Stadium Capital Qualified Partners, L.P.
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Non-Voting Common Stock
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11/1/2014
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D
(1)
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1517874
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D
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$0
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0
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I
(2)
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By Stadium Capital Partners, L.P.
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Non-Voting Common Stock
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11/1/2014
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D
(1)
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131989
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D
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$0
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0
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I
(3)
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Stadium Capital Qualified Partners, L.P.
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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)
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2. Conversion or Exercise Price of Derivative Security
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3. Trans. Date
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3A. Deemed Execution Date, if any
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4. Trans. Code
(Instr. 8)
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5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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6. Date Exercisable and Expiration Date
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7. Title and Amount of Securities Underlying Derivative Security
(Instr. 3 and 4)
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8. Price of Derivative Security
(Instr. 5)
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9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4)
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10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4)
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11. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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(A)
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(D)
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Date Exercisable
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Expiration Date
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Title
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Amount or Number of Shares
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Explanation of Responses:
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(
1)
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Disposed of pursuant to a Plan of Merger between Intermountain Community Bancorp and Columbia Banking Systems, Inc., dated July 23, 2014.
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(
2)
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The reported securities are owned directly by Stadium Capital Partners, L.P., and indirectly by Stadium Capital Management, LLC as general partner of Stadium Capital Management GP, L.P., which is general partner of Stadium Capital Partners, L.P., Alexander M. Seaver as a manager of Stadium Capital Management, LLC, and Bradley R. Kent as a manager of Stadium Capital Management, LLC. Stadium Capital Management, LLC, Stadium Capital Management GP, L.P., Alexander M. Seaver and Bradley R. Kent disclaim beneficial ownership of the reported securities except to the extent of their respective pecuniary interests therein.
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(
3)
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The reported securities are owned directly by Stadium Capital Qualified Partners, L.P., and indirectly by Stadium Capital Management, LLC as general partner of Stadium Capital Management GP, L.P., which is general partner of Stadium Capital Qualified Partners, L.P., Alexander M. Seaver as a manager of Stadium Capital Management, LLC, and Bradley R. Kent as a manager of Stadium Capital Management, LLC. Stadium Capital Management, LLC, Stadium Capital Management GP, L.P.,Alexander M. Seaver and Bradley R. Kent disclaim beneficial ownership of the reported securities except to the extent of their respective pecuniary interests therein
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Remarks:
Stadium Capital Partners, L.P. and Stadium Capital Qualified Partners, L.P. are jointly entitled to appoint a representative to Intermountain's board of directors pursuant to their respective securities purchase agreements as reported by Intermountain in a Form 8-K filed with the SEC on 1/23/12. John L. Welborn Jr. was appointed to the board of Intermountain pursuant to these contractual rights.
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Reporting Owners
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Reporting Owner Name / Address
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Relationships
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Director
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10% Owner
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Officer
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Other
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STADIUM CAPITAL MANAGEMENT LLC
199 ELM STREET
NEW CANAAN, CT 06840-5321
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X
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X
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STADIUM CAPITAL PARTNERS L P
199 ELM STREET
NEW CANAAN, CT 06840-5321
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X
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X
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STADIUM CAPITAL QUALIFIED PARTNERS LP
199 ELM STREET
NEW CANAAN, CT 06840-5321
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X
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X
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SEAVER ALEXANDER M
199 ELM STREET
NEW CANAAN, CT 06840-5321
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X
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X
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KENT BRADLEY R
1000 NW WALL STREET, SUITE 210
BEND, OR 97701
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X
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X
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Stadium Capital Management GP, L.P.
199 ELM STREET
NEW CANAAN, CT 06840-5321
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X
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X
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Signatures
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Stadium Capital Partners, L.P., by Stadium Capital Management GP, L.P., its general partner, by Stadium Capital Management, LLC, its general partner, by Bradley R. Kent, Manager
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11/5/2014
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**
Signature of Reporting Person
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Date
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Stadium Capital Qualified Partners, L.P., by Stadium Capital Management GP, L.P., its general partner, by Stadium Capital Management, LLC, its general partner, by Bradley R. Kent, Manager
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11/5/2014
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**
Signature of Reporting Person
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Date
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Bradley R. Kent
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11/5/2014
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**
Signature of Reporting Person
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Date
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Alexander M. Seaver
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11/5/2014
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**
Signature of Reporting Person
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Date
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Stadium Capital Management GP, L.P., by Stadium Capital Management, LLC, its general partner by Bradley R.Kent, Manager
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11/5/2014
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**
Signature of Reporting Person
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Date
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Stadium Capital Management, LLC, by Bradley R. Kent, Manager
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11/5/2014
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**
Signature of Reporting Person
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Date
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
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*
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If the form is filed by more than one reporting person,
see
Instruction 4(b)(v).
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**
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Intentional misstatements or omissions of facts constitute Federal Criminal Violations.
See
18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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Note:
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File three copies of this Form, one of which must be manually signed. If space is insufficient,
see
Instruction 6 for procedure.
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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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