SEC Form 4 · accession 0001140361-16-090885
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 27, 2016
Accepted (ET)
Dec 28, 2016 · 11:48 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 StockF1 | Dec 27, 2016 | G | 1,000 | — | D | 815,050 | D | |
| Common Stock | holding | — | — | — | 35,900 | I | Retirement Trust | |
| Common Stock | holding | — | — | — | 144,161 | I | Held by Spouse |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| OptionF2 | $6.73 | holding | — | — | — | — | Aug 12, 2019 | Common Stock | 250,000 | 250,000 | D |
Explanation of responses
- F1Charitable gift to South Nassau Communities Hospital.
- F2The 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.