SEC Form 3
FORM 3 | UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES 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*
(Street)
| 2. Date of Event Requiring Statement (Month/Day/Year) 02/01/2022 | 3. Issuer Name and Ticker or Trading Symbol FIRST INTERSTATE BANCSYSTEM INC [ FIBK ] | |||||||||||||
4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
| 5. If Amendment, Date of Original Filed (Month/Day/Year) | ||||||||||||||
6. Individual or Joint/Group Filing (Check Applicable Line)
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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) |
Class A Common Stock | 548,256(1) | I | See footnote(2) |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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1. Title of Derivative Security (Instr. 4) | 2. Date Exercisable and Expiration Date (Month/Day/Year) | 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form: 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 | ||||
Class B Common Stock | (3) | (3) | Class A Common Stock | 2,391,090 | 0.00 | I | See footnote(4) |
1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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Explanation of Responses: |
1. As a result of certain agreements entered into by and among the reporting persons, the Issuer, and certain other stockholders of the Issuer, the reporting persons may be deemed members of a group with the other signatories thereto and may be deemed to share beneficial ownership of the securities reported herein. Each of the reporting persons disclaims beneficial ownership of any such securities, except to the extent of its pecuniary interest therein. The reporting persons expect to file future Forms 4, if any, together with Julie A Scott. |
2. Composed of 131,731 shares held of record by Juliana Sarah Scott Rose Trust, 131,731 shares held of record by Elizabeth Lauren Scott Rose Trust, 94,863 shares held of record by Holland Elizabeth Scott Trust, 94,863 shares held of record by Harper Grace Scott Trust, 94,863 shares held of record by Harrison William Scott Trust, and 205 shares held of record by the estate of Thomas W Scott. |
3. The Class B Common Stock is convertible at any time into Class A Common Stock on a share for share basis at the discretion of the holder. The conversion feature of the Class B Common Stock does not expire. |
4. Composed of 1,933 shares held of record by Julie Scott Rose, 397,210 shares held of record by Julie A Scott Rose Trustee of the Julie A Scott Rose Trust Dated 5-14-2002, 10,424 shares held of record by First Interstate Bank & Julie Scott Rose, Co-TTEEs of the Joan D Scott Trust Dtd 10/16/12, 222,528 shares held of record by IXL Limited Liability Company, 1,669,660 shares held of record by Thomas W Scott Trust Dtd 8/22/95, Thomas W Scott Trustee, and 89,335 shares held of record by Exempt Thomas W Scott Marital Trust 2. |
Remarks: |
Exhibit 24 - Power of Attorney Form 1 of 2 |
JULIE SCOTT ROSE, By: /s/ Timothy Leuthold, Attorney-in-Fact for Reporting Person | 02/10/2022 | |
JULIE A SCOTT ROSE TRUSTEE OF THE JULIE A SCOTT ROSE TRUST DATED 5-14-2002, By: /s/ Timothy Leuthold, Attorney-in-Fact for Reporting Person | 02/10/2022 | |
FIRST INTERSTATE BANK & JULIE SCOTT ROSE, CO-TTEES OF THE JOAN D SCOTT TRUST DTD 10/16/12, By: /s/ Timothy Leuthold, Attorney-in-Fact for Reporting Person | 02/10/2022 | |
IXL LIMITED LIABILITY COMPANY, By: /s/ Timothy Leuthold, Attorney-in-Fact for Reporting Person | 02/10/2022 | |
JULIANA SARAH SCOTT ROSE TRUST, By: /s/ Timothy Leuthold, Attorney-in-Fact for Reporting Person | 02/10/2022 | |
ELIZABETH LAUREN SCOTT ROSE TRUST, By: /s/ Timothy Leuthold, Attorney-in-Fact for Reporting Person | 02/10/2022 | |
HOLLAND ELIZABETH SCOTT TRUST, By: /s/ Timothy Leuthold, Attorney-in-Fact for Reporting Person | 02/10/2022 | |
HARPER GRACE SCOTT TRUST, By: /s/ Timothy Leuthold, Attorney-in-Fact for Reporting Person | 02/10/2022 | |
HARRISON WILLIAM SCOTT TRUST, By: /s/ Timothy Leuthold, Attorney-in-Fact for Reporting Person | 02/10/2022 | |
THOMAS W SCOTT TRUST DTD 8/22/95, THOMAS W SCOTT TRUSTEE, By: /s/ Timothy Leuthold, Attorney-in-Fact for Reporting Person | 02/10/2022 | |
** Signature of Reporting Person | Date | |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | ||
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v). | ||
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). | ||
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. | ||
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 Number. |