SEC Form 5 · accession 0001327749-17-000015
DONEGAL GROUP INC · DGICA
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Jack Lee Hess
Director
Period of report
Dec 31, 2016
Accepted (ET)
Jan 25, 2017 · 2:02 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000800457
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Class A Common StockF1 | May 6, 2011 | J | 171 | — | A | 3,879 | D | |
| Class A Common Stock | holding | — | — | — | 17,800 | I | Retirement Plan |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1Reporting Person acquired the right to receive these shares of Class A common stock ("DGICA") as a result of the May 6, 2011 merger of Union National Financial Corporation ("UNFC") with and into Donegal Financial Services Corporation, pursuant to which each share of common stock of UNFC was converted into the right to receive 0.2134 DGICA shares and $5.45 in cash. Due to an administrative oversight by the exchange agent, the 171 shares of DGICA that Reporting Person was entitled to receive as a result of the merger were not issued to Reporting Person's account until January 5, 2017.