SEC Form 4 · accession 0001127602-15-023342
ERIE INDEMNITY CO · ERIE
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Susan Hirt Hagen
Director
Period of report
Jun 15, 2015
Accepted (ET)
Jul 24, 2015 · 12:50 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000922621
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Class A Common Stock | holding | — | — | — | 6,658,800 | I | By Family Trust |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Directors' Deferred Compensation Phantom UnitsF1,F3,F4 | $0.00 | Jul 22, 2015 | J | 99 | A | — | — | Class A Common Stock | 99 | 12,135 | D |
| Class B Common StockF5 | $0.00 | Jun 15, 2015 | J | 1,170 | D | — | — | Class A Common Stock | 2,808,000 | 0 | I |
| Class B Common StockF5 | $0.00 | Jun 15, 2015 | J | 1,170 | D | — | — | Class A Common Stock | 2,808,000 | 0 | I |
| Class B Common StockF5 | $0.00 | holding | — | — | — | — | — | Class A Common Stock | 28,800 | 12 | I |
Explanation of responses
- F1Conversion price is not applicable to shares granted under the Outside Directors' Deferred Compensation Plan.
- F2Acquired under dividend reinvestment for Directors' Deferred Compensation Plan
- F3The shares subject to this reporting are phantom Share Credits which are periodically credited to the accounts of certain Directors of Erie Indemnity Company pursuant to its Outside Directors Stock Plan. These Credit Shares are actually paid to the reporting individual in shares of Erie Indemnity Company Class A Common Stock when their service as a Director of Erie Indemnity Company ends. There is no exercisable date for these securities.
- F4The shares subject to this reporting are phantom Share Credits which are periodically credited to the accounts of certain Directors of Erie Indemnity Company pursuant to its Outside Directors Stock Plan. These Credit Shares are actually paid to the reporting individual in shares of Erie Indemnity Company Class A Common Stock when their service as a Director of Erie Indemnity Company ends. There is no expiration date for these securities.
- F5Pursuant to the Articles of Incorporation of the Company, as amended, shares of Class B Common Stock (voting) of Erie Indemnity Company are convertible at any time to shares of Class A Common Stock (non-voting) at a conversion rate of 2,400 shares of Class A Stock for each share of Class B Stock. There are no exercise or expiration dates associated with this conversion feature and no specific exercise price when a Class B share is converted into Class A shares.
- F6The reporting person, Susan Hirt Hagen, passed away on June 15, 2015.