SEC Form 4 · accession 0001596771-15-000075
Diplomat Pharmacy, Inc. · DPLO
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Philip R Hagerman
Officer — Chairman and CEO · Director · 10% Owner
Period of report
Oct 26, 2015
Accepted (ET)
Oct 28, 2015 · 3:31 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001610092
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF2,F3,F4 | Oct 26, 2015 | J | 156,172 | $0.00 | A | 1,462,145 | I | Philip R. Hagerman Revocable Trust |
| Common StockF3 | Oct 26, 2015 | J | 402 | $0.00 | A | 4,450,091 | I | The JH GST Trust |
| Common StockF5 | Oct 26, 2015 | J | 56,624 | $0.00 | D | 1,780,876 | I | 2013 Irrev Exempt Trust for Daughter |
| Common StockF5 | Oct 26, 2015 | J | 56,624 | $0.00 | D | 1,780,876 | I | 2013 Irrev Exempt Trust for Son |
| Common StockF6,F5 | Oct 26, 2015 | J | 21,462 | $0.00 | D | 624,337 | I | 2014 Irrev Exempt Trust for Son |
| Common StockF6,F5 | Oct 26, 2015 | J | 21,462 | $0.00 | D | 624,337 | I | 2014 Irrev Exempt Trust for Daughter |
| Common StockF6,F3 | Oct 26, 2015 | J | 201 | $0.00 | D | 624,337 | I | 2014 Irrev Exempt Trust for Daughter |
| Common StockF6,F3 | Oct 26, 2015 | J | 201 | $0.00 | D | 624,337 | I | 2014 Irrev Exempt Trust for Daughter |
| Common StockF4,F5 | holding | — | — | — | 3,891,609 | I | 2007 Hagerman Family GST | |
| Common StockF4,F3 | holding | — | — | — | 1,591,293 | I | 2013 Irrev Exempt Trust for Daughter | |
| Common StockF4,F3 | holding | — | — | — | 1,591,292 | I | 2013 Irrev Exempt Trust for Daughter | |
| Common StockF2,F5 | holding | — | — | — | 1,073,336 | I | Philip Hagerman 2014 GRAT | |
| Common StockF7,F3 | holding | — | — | — | 1,073,336 | I | Jocelyn Hagerman 2014 GRAT | |
| Common StockF4,F7,F5 | holding | — | — | — | 357,836 | I | Jocelyn Hagerman Living Trust | |
| Common StockF3 | holding | — | — | — | 263,500 | I | JH Marital Trust | |
| Common StockF5 | holding | — | — | — | 272,000 | I | PH Marital Trust | |
| Common Stock | holding | — | — | — | 394,910 | I | Irrevocable Trust for Son | |
| Common Stock | holding | — | — | — | 394,910 | I | Irrevocable Trust for Daughter |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1Represents shares transferred from trusts established for the benefit of the reporting person's children to trusts established for the benefit of the reporting person in satisfaction of previously contracted debt between the applicable trusts.
- F2On July 17, 2015, 201,664 shares held by the Philip Hagerman 2014 GRAT were transferred to the Philip R. Hagerman Revocable Trust.
- F3These shares are indirectly owned by Mr. Hagerman as the trustee of the Philip R. Hagerman Revocable Trust, The JH GST Trust, the 2013 Irrevocable Exempt Trusts and the 2014 Irrevocable Exempt Trusts for two daughters, the Jocelyn Hagerman 2014 GRAT and the JH Marital Trust.
- F4Amounts indirectly owned by these trusts have been adjusted to reflect shares transferred from trusts established for the benefit of the reporting person's children to trusts established for the benefit of the reporting person's spouse in satisfaction of previously contracted debt between the trusts. These transfers did not affect the reporting person's pecuniary interest in any shares, only the form of indirect ownership.
- F5Jocelyn Hagerman is Mr. Hagerman's wife. These shares are indirectly owned by her as a trustee of the 2007 Hagerman Family GST Trust, the 2013 Irrevocable Exempt Trusts and 2014 Irrevocable Exempt Trusts for a son and daughter, the Philip Hagerman 2014 GRAT, the Jocelyn Hagerman Living Trust and the PH Marital Trust.
- F6Number of shares in this column reflects reported transactions. The number of shares in this column also reflects shares transferred from trusts established for the benefit of the reporting person's children to trusts established for the benefit of the reporting person's spouse in satisfaction of previously contracted debt between the trusts; these transfers did not affect the reporting person's pecuniary interest in any shares, only the form of indirect ownership.
- F7On July 17, 2015, 201,664 shares held by the Jocelyn Hagerman 2014 GRAT were transferred to the Jocelyn Hagerman Living Trust.