SEC Form 4 · accession 0001127602-16-065818
ERIE INDEMNITY CO · ERIE
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Elizabeth A Vorsheck
Director · 10% Owner
Period of report
Nov 1, 2016
Accepted (ET)
Nov 2, 2016 · 1:27 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 | — | — | — | 69,516 | D | ||
| Class A Common Stock | holding | — | — | — | 324,300 | I | By Audrey C. Hirt 1989/1990 Income Trust For E. Vorsheck | |
| Class A Common Stock | holding | — | — | — | 500,000 | I | By Elizabeth A. Vorsheck 2009 10-year GRAT | |
| Class A Common Stock | holding | — | — | — | 162,533 | I | By Elizabeth Vorsheck Trustee Elizabeth Vorsheck Revocable Trust U/A DTD 05/03/99 | |
| Class A Common Stock | holding | — | — | — | 372,565 | I | By Frank William Hirt 1989/1990 Trust For E. Vorsheck | |
| Class A Common Stock | holding | — | — | — | 3,000,000 | I | VEIC Limited Partnership |
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,F2,F3 | $0.00 | Nov 1, 2016 | A | 160 | A | — | — | Class A Common Stock | 160 | 8,740 | D |
| Class B Common StockF4 | $0.00 | holding | — | — | — | — | — | Class A Common Stock | 2,808,000 | 1,170 | I |
| Class B Common StockF4 | $0.00 | holding | — | — | — | — | — | Class A Common Stock | 2,808,000 | 1,170 | I |
Explanation of responses
- F1Conversion price is not applicable to shares granted under the Erie Indemnity Company Deferred Compensation Plan for Outside Directors (the "Plan").
- F2The 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 the Plan. These Share Credits 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.
- 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 the Plan. These Share Credits 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.
- F4Pursuant 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.