Check the appropriate box to designate the rule pursuant to which this Schedule is filed: | ||
£ | Rule 13d-1(b) | |
£ | Rule 13d-1(c) | |
T | Rule 13d-1(d) |
CUSIP No. 59851103 | ||||||||||||||||
1. | Names of Reporting Persons | |||||||||||||||
John S. Koza | ||||||||||||||||
2. | Check the Appropriate Box if Member of a Group (See Instructions) | |||||||||||||||
(a) | £ | |||||||||||||||
(b) | T | |||||||||||||||
3. | SEC Use Only | |||||||||||||||
4. | Citizenship or Place of Organization | United States | ||||||||||||||
Number of Shares Beneficially Owned by Each Reporting Person With | 5. | Sole Voting Power | 825,746 | |||||||||||||
6. | Shared Voting Power | 60,325 | ||||||||||||||
7. | Sole Dispositive Power | 825,746 | ||||||||||||||
8. | Shared Dispositive Power | 60,325 | ||||||||||||||
9. | Aggregate Amount Beneficially Owned by Each Reporting Person | 886,071 | ||||||||||||||
10. | Check if the Aggregate Amount in Row (9) Excludes Certain Shares (See Instructions) | £ | ||||||||||||||
11. | Percent of Class Represented by Amount in Row (9) | 10.4 | % | |||||||||||||
12. | Type of Reporting Person (See Instructions) | IN | ||||||||||||||
CUSIP No. 59851103 | ||||||||||||||||
1. | Names of Reporting Persons | |||||||||||||||
Patricia C. Koza | ||||||||||||||||
2. | Check the Appropriate Box if Member of a Group (See Instructions) | |||||||||||||||
(a) | £ | |||||||||||||||
(b) | T | |||||||||||||||
3. | SEC Use Only | |||||||||||||||
4. | Citizenship or Place of Organization | United States | ||||||||||||||
Number of Shares Beneficially Owned by Each Reporting Person With | 5. | Sole Voting Power | 60,325 | |||||||||||||
6. | Shared Voting Power | 825,746 | ||||||||||||||
7. | Sole Dispositive Power | 60,325 | ||||||||||||||
8. | Shared Dispositive Power | 825,746 | ||||||||||||||
9. | Aggregate Amount Beneficially Owned by Each Reporting Person | 886,071 | ||||||||||||||
10. | Check if the Aggregate Amount in Row (9) Excludes Certain Shares (See Instructions) | £ | ||||||||||||||
11. | Percent of Class Represented by Amount in Row (9) | 10.4 | % | |||||||||||||
12. | Type of Reporting Person (See Instructions) | IN | ||||||||||||||
ITEM 1. | ||||||
(a) | Name of Issuer | |||||
MidWestOne Financial Group, Inc. | ||||||
(b) | Address of Issuer's Principal Executive Offices | |||||
102 South Clinton St. | ||||||
Iowa City, IA 52240 | ||||||
ITEM 2. | ||||||
(a) | Name of Person Filing | |||||
(i) | John S. Koza | |||||
(ii) | Patricia C. Koza | |||||
(b) | Address of Principal Business Office or, if none, Residence | |||||
(i) | The address for John S. Koza is: | |||||
C/O MidWestOne Financial Group, Inc. | ||||||
102 South Clinton St. | ||||||
Iowa City, IA 52240 | ||||||
(ii) | The address for Patricia C. Koza is: | |||||
C/O MidWestOne Financial Group, Inc. | ||||||
102 South Clinton St. | ||||||
Iowa City, IA 52240 | ||||||
(c) | Citizenship | |||||
(i) | John S. Koza - United States | |||||
(ii) | Patricia C. Koza - United States | |||||
(d) | Title of Class of Securities | |||||
Common Stock, par value $1.00 per share |
(e) | CUSIP Number | ||||
598511103 | |||||
ITEM 3. | If this statement is filed pursuant to §§ 240.13d-1(b), or 240.13d-2(b) or (c), check whether the person filing is a: | ||||
(a) | £ | Broker or dealer registered under section 15 of the Act (15 U.S.C. 78o); | |||
(b) | £ | Bank as defined in section 3(a)(6) of the Act (15 U.S.C. 78c); | |||
(c) | £ | Insurance company as defined in section 3(a)(19) of the Act (15 U.S.C. 78c); | |||
(d) | £ | Investment company registered under Section 8 of the Investment Company Act of 1940 (15 U.S.C. 80a-8); | |||
(e) | £ | An investment adviser in accordance with § 240.13d-1(b)(1)(ii)(E); | |||
(f) | £ | An employee benefit plan or endowment fund in accordance with § 240.13d‑1(b)(1)(ii)(F); | |||
(g) | £ | A parent holding company or control person in accordance with § 240.13d‑1(b)(1)(ii)(G); | |||
(h) | £ | A savings associations as defined in Section 3(b) of the Federal Deposit Insurance Act (12 U.S.C. 1813); | |||
(i) | £ | A church plan that is excluded from the definition of an investment company under section 3(c)(14) of the Investment Company Act (15 U.S.C. 80a-3); | |||
(j) | £ | A non-U.S. institution in accordance with § 240.13d-1(b)(1)(ii)(J); | |||
(k) | £ | Group, in accordance with § 240.13d-1(b)(1)(ii)(K). | |||
If filing as a non-U.S. institution in accordance with § 240.13d-1(b)(1)(ii)(J), please specify the type of institution: Not applicable | |||||
ITEM 4. | Ownership | ||||
(a) | Amount beneficially owned: | ||||
John S. Koza - 886,071 shares* | |||||
Patricia C. Koza - 886,071 shares* | |||||
*Comprised of shares held as follows: (i) 125 restricted stock units beneficially owned by Mr. Koza and vesting on January 21, 2014, over which Mr. Koza holds sole investment and voting power; (ii) 206,061 shares of Common Stock beneficially owned by Mr. Koza individually and over which Mr. Koza holds sole investment and voting power; (iii) 619,560 shares of Common Stock held in various family trust accounts, over which Mr. Koza holds sole investment and voting power; and (iv) 60,325 shares of Common Stock beneficially owned by Ms. Koza individually and over which Ms. Koza holds sole investment and voting power. In accordance with Rule 13d-4, Mr. Koza disclaims beneficial ownership of the shares described in clause (iv) hereof, and Ms. Koza disclaims beneficial ownership of the shares described in clauses (i), (ii) and (iii) hereof. | |||||
(b) | Percent of class: | ||||
John S. Koza - 10.4%† | |||||
Patricia C. Koza - 10.4%† | |||||
†The applicable percentage ownership for each Reporting Person is based upon the sum of: (i) 8,481,799 shares of Common Stock outstanding as of December 31, 2013; and (ii) 125 shares of Common Stock issuable pursuant to restricted stock units vesting on January 21, 2014, which are beneficially owned by the Reporting Persons. | |||||
(c) | Number of shares as to which the person has: | ||||
(i) | Sole power to vote or to direct the vote: | ||||
Please see Row 5 on the cover page hereto for each Reporting Person, as well as the notes to Item 4(a) above, which such information is hereby incorporated by reference into this Item 4(c)(i). | |||||
(ii) | Shared power to vote or to direct the vote: | ||||
Please see Row 6 on the cover page hereto for each Reporting Person, as well as the notes to Item 4(a) above, which such information is hereby incorporated by reference into this Item 4(c)(ii). | |||||
(iii) | Sole power to dispose or to direct the disposition of: | ||||
Please see Row 7 on the cover page hereto for each Reporting Person, as well as the notes to Item 4(a) above, which such information is hereby incorporated by reference into this Item 4(c)(iii). | |||||
(iv) | Shared power to dispose or to direct the disposition of: | ||||
Please see Row 8 on the cover page hereto for each Reporting Person, as well as the notes to Item 4(a) above, which such information is hereby incorporated by reference into this Item 4(c)(iv). | |||||
ITEM 5. | Ownership of Five Percent or Less of a Class | ||||
If this statement is being filed to report the fact that as of the date hereof the reporting person has ceased to be the beneficial owner of more than 5 percent of the class of securities, check the following: £ | |||||
ITEM 6. | Ownership of Five Percent or Less of a Class | ||||
Not Applicable. | |||||
ITEM 7. | Identification and Classification of the Subsidiary Which Acquired the Security Being Reported on By the Parent Holding Company or Control Person | ||||
Not Applicable. | |||||
ITEM 8. | Identification and Classification of Members of the Group | ||||
Not Applicable. | |||||
ITEM 9. | Notice of Dissolution of Group | ||||
Not Applicable. | |||||
ITEM 10. | Certifications | ||||
Not Applicable. | |||||
Dated: | February 5, 2014 | |||||
/s/ JOHN S. KOZA | ||||||
John S. Koza | ||||||
/s/ PATRICIA C. KOZA | ||||||
Patricia C. Koza | ||||||
/s/ JOHN S. KOZA | ||||||
John S. Koza | ||||||
/s/ PATRICIA C. KOZA | ||||||
Patricia C. Koza | ||||||