FORM 5 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
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OMB APPROVAL
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1. Name and Address of Reporting Person* |
2. Issuer Name and Ticker or Trading Symbol |
6. Relationship of Reporting Person(s) to Issuer (Check all applicable) __X__Director _____10% owner_____Officer (give title below) _____Other (Specify below) TITLE DIRECTOR |
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3. I.R.S. Identification Number of Reporting Person, if an entity (Voluntary) |
4. Statement for |
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5. If Amendment, Date of Original (Month/Day/Year) |
7. Individual or Joint Group Filing (Check Applicable Line) |
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Table 1 - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned |
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1. Title of Security (Instr. 3) |
2. Transaction Date |
2A. Deemed Execution Date, if any (Month/ |
3. Transaction Code |
4. Securities Acquired (A) |
5. Amount of Securities Beneficially Owned at End of Issuer's Fiscal Year (Instr. 3 and 4) |
6. Owner- ship Form: Direct (D) or Indirect (I) |
7. Nature of Indirect Beneficial Ownership |
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COMMON STOCK |
5,779 |
D |
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COMMON STOCK |
7,903 |
I |
BY SPOUSE |
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If the form is filed by more than one reporting person, see Instruction 4(b)(v). |
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FORM 5 (continued) |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned |
(e.g. puts, calls, warrants, options, convertible securities) |
1. Title of Derivative Security (Instr. 3) |
2. Conversion or Exercise Price of Deri- vative Security |
3. Trans- action Date (Month/ Day/ Year) |
3A. Deemed Execution Date, if any (Month/ |
4. Trans- action Code (Instr. 8) |
5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4, and 5) |
6. Date Exercisable and Expiration Date (Month/Day/ Year) |
7. Title and Amount of Underlying Securities |
8. Price of Derivative Security (Instr. 5) |
9. Number of Derivative Securities Beneficially Owned at End of Month (Instr. 4) |
10. Owner- ship Form of Derivative Security: Direct (D) or Indirect (I) |
11. Nature of Indirect Beneficial Owner- ship (Instr. 4) |
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Explanation of Responses: See continuation page(s) for footnotes
/S/ DAVID W. GOODRICH _________________________________________ |
1/21/2003 |
**Signature of Reporting Person |
Date |
**Intentional misstatements or omissions of facts constitute Federal Criminal Violations. |
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FORM 5 (continued) |
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GOODRICH, DAVID W. |
Irwin Financial Corporation (IFC) |
500 Washington Street |
12/31/2002 |
Columbus IN 47201 |
FOOTNOTES:
1. Between 2/15/02 and 12/31/02, the reporting person acquired 90 shares of Irwin Financial Corporation common stock under the Irwin Financial Corporation Dividend and Common Stock Purchase Plan. The information in this report is as of 12/31/02. The Plan provides for the purchase of fractional shares. The number reported is the nearest whole number. |
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