SEC Form 3 · accession 0001174947-18-001478
Federal Life Group, Inc. · FLF
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Anders Raaum
Officer — Chief Financial Officer
Period of report
Dec 11, 2018
Accepted (ET)
Dec 12, 2018 · 3:51 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001743886
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | holding | — | — | — | 28,667 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Stock optionsF2 | $10.00 | holding | — | — | — | Dec 10, 2019 | Dec 10, 2028 | Common stock | 35,000 | — | D |
Explanation of responses
- F1Includes 11,667 shares of restricted common stock that vest 25% per year commencing December 10, 2019.
- F2Options vest 25% per year commencing December 10, 2019.