SEC Form 5 · accession 0001596771-19-000011
Diplomat Pharmacy, Inc. · DPLO
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Philip R Hagerman
Director · 10% Owner
Period of report
Dec 31, 2018
Accepted (ET)
Feb 14, 2019 · 3:58 pm EST
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 | May 30, 2018 | G | 50,000 | $0.00 | D | 1,280,099 | I | Philip R. Hagerman Revocable Trust |
| Common StockF3 | May 30, 2018 | G | 50,000 | $0.00 | D | 367,528 | I | Jocelyn Hagerman Living Trust |
| Common Stock | holding | — | — | — | 5,222 | D | ||
| Common StockF3 | holding | — | — | — | 3,391,609 | I | 2007 Hagerman Family GST | |
| Common StockF2 | holding | — | — | — | 3,600,091 | I | The JH GST Trust | |
| Common StockF3 | holding | — | — | — | 1,475,876 | I | 2013 Irrev. Exempt Trust for Daughter | |
| Common StockF3 | holding | — | — | — | 1,475,876 | I | 2013 Irrev. Exempt Trust for Son | |
| Common StockF2 | holding | — | — | — | 1,075,293 | I | 2013 Irrev. Exempt Trust for Daughter | |
| Common StockF2 | holding | — | — | — | 1,311,292 | I | 2013 Irrev. Exempt Trust for Daughter | |
| Common StockF3 | holding | — | — | — | 313,337 | I | 2014 Irrev. Exempt Trust for Son | |
| Common StockF3 | holding | — | — | — | 313,337 | I | 2014 Irrev. Exempt Trust for Daughter | |
| Common StockF2 | holding | — | — | — | 313,337 | I | 2014 Irrev. Exempt Trust for Daughter | |
| Common StockF2 | holding | — | — | — | 313,337 | I | 2014 Irrev. Exempt Trust for Daughter | |
| Common StockF2 | holding | — | — | — | 263,500 | I | JH Marital Trust | |
| Common StockF3 | 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 | |
| Common Stock | holding | — | — | — | 367,256 | I | Irrevocable Non-Exempt Trust for Son | |
| Common Stock | holding | — | — | — | 367,256 | I | Irrevocable Non-Exempt Trust for Daughter |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1On May 30, 2018, 50,000 shares held by the Philip R. Hagerman Revocable Trust were donated to The Hagerman Foundation, an unaffiliated, nonprofit corporation.
- F2These shares are indirectly owned by Mr. Hagerman as trustee of the Philip R. Hagerman Revocable Trust, The JH GST Trust, the 2013 Irrevocable Exempt Trusts and 2014 Irrevocable Exempt Trusts for two daughters, and the JH Marital Trust.
- F3Jocelyn 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 Jocelyn Hagerman Living Trust, and the PH Marital Trust.
- F4On May 30, 2018, 50,000 shares held by the Jocelyn Hagerman Living Trust were donated to The Hagerman Foundation, an unaffiliated, nonprofit corporation.