Filing Details

Accession Number:
0001596771-14-000086
Form Type:
4
Zero Holdings:
No
Publication Time:
2014-10-10 15:02:07
Reporting Period:
2014-10-09
Filing Date:
2014-10-10
Accepted Time:
2014-10-10 15:02:07
SEC Url:
Form 4 Filing
Issuer
Cik Name Symbol Sector (SIC) IRS No
1610092 Diplomat Pharmacy Inc. DPLO Retail-Drug Stores And Proprietary Stores (5912) 382063100
Insiders
Cik Name Reported Address Insider Title Director Officer Large Shareholder Other
1618897 R Philip Hagerman 4100 S. Saginaw Street
Flint MI 48507
Chairman And Ceo Yes Yes Yes No
1620336 Trust Revocable Hagerman R. Philip 4100 S. Saginaw Street
Flint MI 48507
No No Yes No
1620614 Trust Gst Jh 4100 S. Saginaw Street
Flint MI 48507
No No Yes No
1620615 Trust Gst Family Hagerman 2007 4100 S. Saginaw Street
Flint MI 48507
No No Yes No
1621081 Jocelyn Hagerman 4100 S. Saginaw Street
Flint MI 48507
No No Yes No
Reported Non-Derivative Transactions
Sec. Name Acquisiton - Disposition Date Amount Price Remaning Holdings Equity Swap Involved Form Type Code Nature of Ownership Explanation
Common Stock Disposition 2014-10-09 1,925,000 $13.00 2,682,809 No 4 S Indirect Philip R. Hagerman Rev Trust
Common Stock Disposition 2014-10-09 350,000 $13.00 4,246,207 No 4 S Indirect 2007 Hagerman Family GST
Common Stock Disposition 2014-10-09 350,000 $13.00 4,804,689 No 4 S Indirect The JH GST Trust
Common Stock Disposition 2014-10-09 145,833 $13.00 1,766,667 No 4 S Indirect 2013 Irrev Exempt Trust for Daughter
Common Stock Disposition 2014-10-09 145,833 $13.00 1,766,667 No 4 S Indirect 2013 Irrev Exempt Trust for Daughter
Equity Swap Involved Form Type Code Nature of Ownership Explanation
No 4 S Indirect Philip R. Hagerman Rev Trust
No 4 S Indirect 2007 Hagerman Family GST
No 4 S Indirect The JH GST Trust
No 4 S Indirect 2013 Irrev Exempt Trust for Daughter
No 4 S Indirect 2013 Irrev Exempt Trust for Daughter
Reported Non-Derivative Holdings
Sec. Name Remaning Holdings Nature of Ownership Explanation
Common Stock 1,912,500 Indirect 2013 Irrev Exempt Trust for Son
Common Stock 1,912,500 Indirect 2013 Irrev Exempt Trust for Daughter
Common Stock 646,000 Indirect 2014 Irrev Exempt Trust for Son
Common Stock 646,000 Indirect 2014 Irrev Exempt Trust for Daughter
Common Stock 646,000 Indirect 2014 Irrev Exempt Trust for Daughter
Common Stock 646,000 Indirect 2014 Irrev Exempt Trust for Daughter
Common Stock 1,275,000 Indirect Philip Hagerman 2014 GRAT
Common Stock 1,275,000 Indirect Jocelyn Hagerman 2014 GRAT
Common Stock 263,500 Indirect JH Marital Trust
Common Stock 272,000 Indirect PH Marital Trust
Common Stock 394,910 Indirect Irrevocable Trust for Son
Common Stock 394,910 Indirect Irrevocable Trust for Daughter
Footnotes
  1. Reflects the conversion of shares of Class B nonvoting common stock into shares of Common Stock on a 1:1 basis and a stock split that will be effected as a stock dividend of 8,500 shares for each share of common stock which will occur immediately prior to the completion of the Issuer's initial public offering.
  2. These shares are owned directly by the Philip R. Hagerman Revocable Trust, a ten percent owner of the issuer, and indirectly by Philip Hagerman as trustee of the trust. Mr. Hagerman is Chairman, CEO and a director of the issuer.
  3. These shares are owned directly by the 2007 Hagerman Family GST Trust, a ten percent owner of the issuer, and indirectly by Jocelyn Hagerman as trustee of the trust. Mrs. Hagerman is the wife of Philip Hagerman.
  4. These shares are owned directly by The JH GST Trust, a ten percent owner of the issuer, and indirectly by Philip R. Hagerman as trustee of the trust.
  5. As trustee of the 2013 Irrevocable Exempt Trusts and 2014 Irrevocable Exempt Trusts for a son and daughter, the Philip Hagerman 2014 GRAT and the PH Marital Trust, Jocelyn Hagerman indirectly owns these shares.
  6. These shares are indirectly owned by Mr. Hagerman, who serves as the trusteee of the 2013 Irrevocable Exempt Trusts and 2014 Irrevocable Exempt Trusts for two daugthers, the Jocelyn Hagerman 2014 GRAT and the JH Marital Trust.