Filing Details

Accession Number:
0001209191-22-045529
Form Type:
4
Zero Holdings:
No
Publication Time:
2022-08-12 10:53:38
Reporting Period:
2022-08-10
Accepted Time:
2022-08-12 10:53:38
SEC Url:
Form 4 Filing
Issuer
Cik Name Symbol Sector (SIC) IRS No
1502292 Conifer Holdings Inc. CNFR () 4
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
Executive Chairman And Co-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 2022-08-10 750,000 $2.00 2,898,607 No 4 P Indirect James G. Petcoff Rev Trust
Equity Swap Involved Form Type Code Nature of Ownership Explanation
No 4 P Indirect James G. Petcoff Rev Trust
Reported Non-Derivative Holdings
Sec. Name Remaning Holdings Nature of Ownership Explanation
Common Stock 480,275 Direct
Common Stock 24,543 Indirect PH Real Estate, LLC
Footnotes
  1. 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.
  2. These shares are owned by PH Real Estate, LLC, a Michigan limited liability company. Mr. James G. Petcoff and his spouse have a majority interest in PH Real Estate, LLC and have the sole power to vote and dispose of all shares owned by PH Real Estate, LLC.