Filing Details

1)

NAME OF REPORTING PERSON

 

Mid-Southern Savings Bank, FSB Employee Stock Ownership Plan ("ESOP")

 

2)

CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP

        a)     [   ]

        b)     [X]

 

3)

SEC USE ONLY

 

4)

CITIZENSHIP OR PLACE OF ORGANIZATION

 

        Not applicable

 

 

 

NUMBER OF

SHARES

BENEFICIALLY

OWNED BY

EACH

REPORTING

PERSON WITH

5)

SOLE VOTING POWER

199,642

 

6)

SHARED VOTING POWER

5,147

 

7)

SOLE DISPOSITIVE POWER

204,789

 

8)

SHARED DISPOSITIVE POWER

0

 

9)

AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON

204,789

 

 

10)

CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES

CERTAIN SHARES        [  ]

 

11)

PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9

 

12)

TYPE OF REPORTING PERSON

EP

ITEM 1(a).

NAME OF ISSUER:

 

Mid-Southern Bancorp, Inc. (the "Corporation")

 

ITEM 1(b).

ADDRESS OF ISSUER'S PRINCIPAL EXECUTIVE OFFICES: 

 

300 North Water Street, Salem, Indiana 47167

 

ITEM 2(a).

NAME OF PERSON FILING:

 

Mid-Southern Savings Bank, FSB Employee Stock Ownership Plan

 

ITEM 2(b).

ADDRESS OF PRINCIPAL BUSINESS OFFICE:

 

300 North Water Street, Salem, Indiana 47167

 

ITEM 2(c).

CITIZENSHIP:

 

Not applicable.

 

ITEM 2(d).

TITLE OF CLASS OF SECURITIES:

 

Common stock, par value $.01 per share (the "Common Stock")

 

ITEM 2(e).

CUSIP NUMBER:  59548Q 10 7

ITEM 3.

IF THIS STATEMENT IS FILED PURSUANT TO SECTION 240.13d-1(b) OR 240.13d-2(b) or (c), CHECK WHETHER THE PERSON FILING IS:

 

 

(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 Section 240.13d-1(b)(1)(ii)(E);

 

(f)

[X ]

An employee benefit plan or endowment fund in accordance with Section 240.13d-1(b)(1)(ii)(F);

 

(g)

[    ]

A parent holding company or control person in accordance with Section 240.13d-1(b)(1)(ii)(G);

 

(h)

[    ]

A savings association 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 of 1940 (15 U.S.C. 80a-3);

(j)

[    ]

A non-U.S. institution in accordance with Section 240.13d-1(b)(1)(ii)(J);

 

(j)

[    ]

Group, in accordance with Section 240.13d-1(b)(1)(ii)(K). If filing as a non-U.S. institution in accordance with Section 240.13d-1(b)(1)(ii)(J), please specify the type of institution:________

ITEM 4.

OWNERSHIP:

 

The ESOP holds an aggregate of 204,789 shares of the Corporation's Common Stock (5.74% of the Corporation's outstanding shares as of December 31, 2018).  The ESOP has sole voting power with respect to shares held by it which have not been allocated to participant accounts, shared voting power with respect to shares held by it which have been allocated to participant accounts and sole dispositive power with respect to all shares (allocated and unallocated) held by the ESOP.

 

The ESOP Trustee may be deemed to beneficially own the 204,789 shares held by the ESOP.  However, the Trustee expressly disclaims beneficial ownership of all of such shares.  Other than the shares held by the ESOP, the Trustee does not beneficially own any shares of Common Stock.

 

Pursuant to the ESOP, participants in the ESOP are entitled to instruct the Trustee as to the voting of the shares allocated to their ESOP accounts.  The trustee will vote unallocated shares and allocated shares for which participants do not timely provide instructions on any matter in the same ratio as those shares for which participants provide timely instructions, subject to fulfillment of the trustee's fiduciary responsibilities.

 

ITEM 5.

OWNERSHIP OF FIVE PERCENT OR LESS OF A CLASS:

 

 Not applicable.

 

ITEM 6.

OWNERSHIP OF MORE THAN FIVE PERCENT ON BEHALF OF ANOTHER PERSON:

 

 Not applicable.

  

ITEM 7.

IDENTIFICATION AND CLASSIFICATION OF THE SUBSIDIARY WHICH ACQUIRED THE SECURITY BEING REPORTED ON BY THE PARENT HOLDING COMPANY:

 

 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. 

CERTIFICATION:

 

By signing below I certify that, to the best of my knowledge and belief, the securities referred to above were acquired and are held in the ordinary course of business and were not acquired and are not held for the purpose of or with the effect of changing or influencing the control of the issuer of the securities and were not acquired and are not held in connection with or as a participant in any transaction having that purpose or effect, other than activities solely in connection with a nomination under Section 240.14a-11.

 

MID-SOUTHERN SAVINGS BANK, FSB

EMPLOYEE STOCK OWNERSHIP PLAN

 

Date: January 31, 2019 

 

By:

First Bankers Trust Services, Inc.,

as Trustee

 

 

Name: 

Linda Shultz 

 

 

Title: 

Trust Officer 

FIRST BANKERS TRUST SERVICES, INC.

 

Date: January 31, 2019 

 

By:

 

 

Name:

Linda Shultz 

 

 

Title: 

Trust Officer 

By: 

 

Name: Linda Shultz

Title:   Trust Officer 

By: 

 

First Bankers Trust Services, Inc.,

    as Trustee

Name: Linda Shultz

Title:   Trust Officer