SEC Form 4 · accession 0001127602-17-015419

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

Apr 21, 2017

Accepted (ET)

Apr 25, 2017 · 2:03 pm EDT

Rule 10b5-1 plan

unknown — predates the checkbox

Issuer CIK

0000922621

Table I — non-derivative securities

Security	Date	Code	Shares	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 Units^F2,F1,F3,F4	$0.00	Apr 21, 2017	A	58	A	—	—	Class A Common Stock	58	9,021	D
Class B Common Stock^F5	$0.00	holding	—	—	—	—	—	Class A Common Stock	2,808,000	1,170	I
Class B Common Stock^F5	$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").
F2Acquired pursuant to dividend reinvestment provisions of the Plan. The number of Phantom Units credited to the account of the reporting person was determined in accordance with the Plan, based on the closing price of the Class A Common Stock on April 20, 2017.
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 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 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.
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.