| |
Indiana
(State of Incorporation)
|
| |
20-3489991
(I.R.S. Employer
Identification Number) |
|
| |
Large accelerated filer
☐
|
| |
Accelerated filer
☒
|
|
| |
Non-accelerated filer
☐
|
| |
Smaller reporting company
☐
|
|
| | | | |
Emerging growth company
☐
|
|
| | | | | | 1 | | | |
| | | | | | 2 | | | |
| | | | | | 3 | | | |
| | | | | | 4 | | | |
| | | | | | 5 | | | |
| | | | | | 6 | | | |
| | | | | | 8 | | | |
| | | | | | 9 | | | |
| | | | | | 14 | | | |
| | | | | | 26 | | | |
| | | | | | 28 | | | |
| | | | | | 29 | | | |
| | | | | | 30 | | | |
| | | | | | 32 | | | |
| | | | | | 32 | | |
| |
SEC Registration Fee
|
| | | $ | 29,520 | | |
| |
Rating Agency Fees
|
| | | | * | | |
| |
Accounting Fees and Expenses
|
| | | | * | | |
| |
Legal Fees and Expenses
|
| | | | * | | |
| |
Trustee’s Fees and Expenses
|
| | | | * | | |
| |
Blue Sky Fees
|
| | | | * | | |
| |
Printing and Engraving Fees
|
| | | | * | | |
| |
Miscellaneous
|
| | | | * | | |
| |
Total
|
| | | | * | | |
| |
Exhibit No.
|
| |
Description
|
|
| |
1.1*
|
| | Form of Underwriting Agreement | |
| |
4.1
|
| | | |
| |
4.2
|
| | | |
| |
4.3*
|
| | Form of Preferred Stock Certificate | |
| |
4.4*
|
| | Form of Deposit Agreement (including form of Depositary Receipt) | |
| |
4.5
|
| | | |
| |
4.6
|
| | Form of Subordinated Indenture (incorporated by reference to Exhibit 4.6 to registration statement on Form S-3 filed on August 9, 2017). | |
| |
4.7*
|
| | Form of Senior Note | |
| |
4.8*
|
| | Form of Subordinated Note | |
| |
4.9*
|
| | Form of Warrant Agreement (including Form of Warrant Certificate) | |
| |
4.10*
|
| | Form of Purchase Contract (including Form of Purchase Contract Certificate) | |
| |
4.11*
|
| | Form of Unit Agreement (including Form of Unit Certificate) | |
| |
5.1
|
| | | |
| |
23.1
|
| | | |
| |
23.2
|
| | | |
| |
24.1
|
| | | |
| |
25.1**
|
| | Statement of Eligibility of Trustee under Senior Indenture | |
| |
25.2**
|
| | Statement of Eligibility of Trustee under Subordinated Indenture | |
| |
107
|
| | |
| |
Signature
|
| |
Title
|
| |
Date
|
|
| |
/s/ David B. Becker
David B. Becker
|
| |
Chairman and Chief Executive Officer
(Principal Executive Officer) |
| |
December 19, 2023
|
|
| |
/s/ Kenneth J. Lovik
Kenneth J. Lovik
|
| |
Executive Vice President and Chief Financial Officer
(Principal Financial Officer and Principal Accounting Officer) |
| |
December 19, 2023
|
|
| |
/s/ Aasif M. Bade
Aasif M. Bade
|
| | Director | | |
December 19, 2023
|
|
| |
/s/ Justin P. Christian
Justin P. Christian
|
| | Director | | |
December 19, 2023
|
|
| |
/s/ Ann Colussi Dee
Ann Colussi Dee
|
| | Director | | |
December 19, 2023
|
|
| |
/s/ Joseph A. Fenech
Joseph A. Fenech
|
| | Director | | |
December 19, 2023
|
|
| |
Signature
|
| |
Title
|
| |
Date
|
|
| |
/s/ John K. Keach, Jr.
John K. Keach, Jr.
|
| | Director | | |
December 19, 2023
|
|
| |
/s/ Jean L. Wojtowicz
Jean L. Wojtowicz
|
| | Director | | |
December 19, 2023
|
|