SEC Form 4 · accession 0001127602-18-003528
ERIE INDEMNITY CO · ERIE
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Claude C Lilly III
Director
Period of report
Feb 1, 2018
Accepted (ET)
Feb 2, 2018 · 1:42 pm EST
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 | Feb 1, 2018 | J | 0 | $0.00 | A | 691 | I | By IRA For Self |
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 UnitsF2,F4,F5 | $0.00 | Feb 1, 2018 | J | 121 | A | — | — | Class A Common Stock | 121 | 14,763 | D |
| Directors' Deferred Compensation Phantom UnitsF2,F4,F5 | $0.00 | Feb 1, 2018 | J | 0 | D | — | — | Class A Common Stock | 0 | 14,763 | D |
Explanation of responses
- F1A de minimus adjustment of 0.0007 shares to correct rounding of fractional shares in order to reconcile to the filer's records.
- F2Conversion price is not applicable to shares granted under the Outside Directors' Deferred Compensation Plan.
- F3Acquired under Directors' Deferred Compensation Plan
- 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 exercisable date for these securities.
- F5The 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.
- F6A de minimus adjustment of 0.0061 shares to correct rounding of fractional shares in order to reconcile to the Directors' Deferred Compensation Plan records.