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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number. | SEC 1474 (9-02) |
1. Title of Derivative Security (Instr. 3) |
2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) |
5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4, and 5) |
6. Date Exercisable and Expiration Date (Month/Day/Year) |
7. Title and Amount of Underlying Securities (Instr. 3 and 4) |
8. Price of Derivative Security (Instr. 5) |
9. Number of Derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) |
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Branch Gregory C C/O UNITED INSURANCE HOLDINGS CORP. 800 2ND AVENUE S ST. PETERSBURG, FL 33701 |
X |
/s/ Jessica Strathman, Attorney-in-Fact for Gregory C. Branch | 05/10/2018 | |
**Signature of Reporting Person | Date |
* | If the form is filed by more than one reporting person, see Instruction 4(b)(v). |
** | Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
(1) | The amount of securities beneficially owned as reported in column 5 include 118,588 shares that were previosly held by the Greg Branch Family LP and transferred to Branch Journey, LLC in December 2012. Reporting Person is the sole manager of Branch Journey, LLC. |
(2) | Held by the Reporting Person as Trustee of the O C Branch Jr. Revocable Trust f/b/o Christina M. Branch |
(3) | Held by the Reporting Person as Trustee of the O C Branch Jr. Revocable Trust f/b/o Overby C. Branch III |
(4) | Held by the Reporting Person as Trustee of the O C Branch Jr. Revocable Trust f/b/o Jennifer L. Branch |
(5) | Held by the Reporting Person as Trustee of the O C Branch Jr. Revocable Trust f/b/o Tracy L. Drake |
(6) | The amount of securities beneficially owned as reported in column 5 include 40,000 shares that were previously held by the Reporting Person and transferred to Branch Family Foundation, Inc. in 2018. Reporting Person is president and director of Branch Family Foundation Inc. |