SEC Form 4 · accession 0000814585-16-000027
MBIA INC · MBI
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Ram D Wertheim
Officer — EVP, Chief Legal Off. & Secy.
Period of report
Feb 12, 2016
Accepted (ET)
Feb 17, 2016 · 5:50 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000814585
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1,F2 | Feb 12, 2016 | M | 250,000 | $4.02 | A | 677,798 | D | |
| Common StockF3 | Feb 12, 2016 | F | 191,493 | $6.43 | D | 486,305 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Common Stock | $4.02 | Feb 12, 2016 | M | 250,000 | D | Feb 12, 2014 | Feb 12, 2016 | Common Stock | 250,000 | 0 | D |
Explanation of responses
- F1Represents shares acquired pursuant to Net Settlement Procedure for exercise of employee stock options.
- F2Balance reflects adjustment for retirement plan shares.
- F3Represents shares forfeited pursuant to Net Settlement Procedure for exercise of employee stock options.