SEC Form 4 · accession 0001593968-18-000366
ICC Holdings, Inc. · ICCH
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Norman D. Schmeichel
Officer — VP Chief Information Officer
Period of report
Feb 20, 2018
Accepted (ET)
Feb 21, 2018 · 3:11 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001681903
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock | holding | — | — | — | 7,500 | I | 401(k) | |
| Common Stock | holding | — | — | — | 721 | I | By ESOP |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Restricted Stock UnitF1,F2,F3,F4 | $0.00 | Feb 20, 2018 | A | 1,500 | A | — | — | ICC Holdings, Inc. Common Stock | 1,500 | 1,500 | D |
Explanation of responses
- F1Granted in the form of a restricted stock unit, with 1/3 vesting on each anniversary of the date of grant.
- F2No exercise price for this type of award
- F3No exercisable date for this type of award
- F4No expiration date for this type of award