Filing Details

Accession Number:
0001596771-15-000064
Form Type:
4
Zero Holdings:
No
Publication Time:
2015-08-20 16:10:04
Reporting Period:
2015-08-18
Filing Date:
2015-08-20
Accepted Time:
2015-08-20 16:10:04
SEC Url:
Form 4 Filing
Issuer
Cik Name Symbol Sector (SIC) IRS No
1502292 Conifer Holdings Inc. CNFR Fire, Marine & Casualty Insurance (6331) 271298795
Insiders
Cik Name Reported Address Insider Title Director Officer Large Shareholder Other
1115666 G James Petcoff 550 W. Merrill Street
Suite 200
Birmingham MI 48009
Chairman And Ceo Yes Yes 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 Acquisiton 2015-08-18 95,238 $0.00 1,915,223 No 4 A Indirect James G. Petcoff Rev Trust
Common Stock Acquisiton 2015-08-18 199,693 $10.50 2,114,916 No 4 P Indirect James G. Petcoff Rev Trust
Equity Swap Involved Form Type Code Nature of Ownership Explanation
No 4 A Indirect James G. Petcoff Rev Trust
No 4 P Indirect James G. Petcoff Rev Trust
Footnotes
  1. Consists of restricted stock units, the shares underlying which will vest in annual increments of 20% beginning on the first anniversary of the date of grant, so that all of the shares will be vested on the five-year anniversary.
  2. These shares are owned indirectly by Mr. Petcoff as trustee of the James G. Petcoff Revocable Trust. Mr. Petcoff is Chairman, CEO and a director of the issuer.