SEC Form 5 · accession 0001140361-16-048413

KINGSTONE COMPANIES, INC. · KINS

Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗

Reporting owner

Barry Goldstein

Officer — President, COB, CEO · Director · 10% Owner

Period of report

Dec 31, 2015

Accepted (ET)

Jan 22, 2016 · 10:18 am EST

Rule 10b5-1 plan

unknown — predates the checkbox

Issuer CIK

0000033992

Table I — non-derivative securities

Security	Date	Code	Shares	Price	A/D	Owned after	D/I	Nature of ownership
Common Stock^F1	Aug 13, 2015	G	1,000	—	D	826,500	D
Common Stock^F2	Oct 20, 2015	G	1,500	—	D	826,500	D
Common Stock^F2	Oct 20, 2015	G	1,500	—	D	826,500	D
Common Stock^F3	Dec 1, 2015	G	4,500	—	D	826,500	D
Common Stock^F4	Dec 2, 2015	G	1,000	—	D	826,500	D
Common Stock^F5	Dec 8, 2015	G	1,000	—	D	826,500	D
Common Stock^F6	Dec 21, 2015	G	1,000	—	D	826,500	D
Common Stock^F2	Dec 29, 2015	G	3,000	—	D	826,500	D
Common Stock	holding	—	—		—	35,000	I	Retirement Trust

Table II — derivative securities

Security	Conv. / exercise price	Date	Code	Shares	A/D	Exercisable	Expires	Underlying	Underlying shares	Owned after	D/I
Option^F7	$6.73	holding	—	—	—	—	Aug 12, 2019	Common Stock	250,000	250,000	D

Explanation of responses

F1Charitable gift to Stony Brook Foundation.
F2Gift to family member.
F3Charitable gift to University of Buffalo Foundation.
F4Charitable gift to Giving Back Foundation.
F5Charitable gift to South Nassau Communities Hospital.
F6Charitable gift to UJA Federation.
F7The option is exercisable to the extent of 62,500 shares on each of August 12, 2014, 2015, 2016 and 2017.

Remarks

This filing shall not be deemed an admission that the Reporting Person is, for purposes of Section 16 of the Securities Exchange Act of 1934 or otherwise, the beneficial owner of any equity securities covered by this statement.