Statement of Changes in Beneficial Ownership (4)
14 October 2017 - 1:41AM
Edgar (US Regulatory)
FORM 4
[ ]
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue.
See
Instruction 1(b).
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0287
Estimated average burden
hours per response...
0.5
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Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
*
SHAPIRO NATHAN
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2. Issuer Name
and
Ticker or Trading Symbol
BALDWIN & LYONS INC
[
BWINA / B
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__
X
__ Director
__
X
__ 10% Owner
_____ Officer (give title below)
_____ Other (specify below)
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(Last)
(First)
(Middle)
111 CONGRESSIONAL BLVD.
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3. Date of Earliest Transaction
(MM/DD/YYYY)
10/11/2017
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(Street)
CARMEL, IN 46032
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
_
X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1.Title of Security
(Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code
(Instr. 8)
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4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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Class A Common Stock
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146645
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D
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Class A Common Stock
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239296
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I
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Various
(1)
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Class A Common Stock
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755009
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I
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Various
(3)
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Class B Common Stock
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103897
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D
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Class B Common Stock
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10/11/2017
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G
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V
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3000
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D
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(4)
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607125
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I
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Various
(1)
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Class B Common Stock
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1799375
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I
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Various
(3)
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Table II - Derivative Securities Beneficially Owned (
e.g.
, puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security
(Instr. 3)
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2. Conversion or Exercise Price of Derivative Security
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3. Trans. Date
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3A. Deemed Execution Date, if any
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4. Trans. Code
(Instr. 8)
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5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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6. Date Exercisable and Expiration Date
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7. Title and Amount of Securities Underlying Derivative Security
(Instr. 3 and 4)
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8. Price of Derivative Security
(Instr. 5)
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9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4)
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10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4)
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11. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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(A)
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(D)
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Date Exercisable
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Expiration Date
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Title
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Amount or Number of Shares
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Right to sell (put)
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(2)
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12/31/1981
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(2)
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Class B Common
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187500
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187500
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D
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Right to sell (put)
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(2)
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12/31/1981
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(2)
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Class A Common
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46875
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46875
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D
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Explanation of Responses:
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(1)
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Owned by (a) New Horizons, Inc., (44,859 shares of Class A and 26,000 shares of class B) of which the undersigned is controlling stockholder; (b) Illinois Diversified, (21,375 shares of Class A and 85,500 shares of Class B) a general partnership as to which beneficial ownership is held by the undersigned; and (c) NS Associates, Inc., (173,062 shares of Class A and 495,625 shares of Class B) of which the undersigned is the controlling shareholder.
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(2)
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All puts are exercisable at any time at 90% of the Company's most recently published quarterly book value prior to the date of exercise. These rights have no expiration date.
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(3)
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Owned by (a) Gelbart Fur Dressers (not Inc.), (178,500 shares of Class A and 714,000 shares of Class B) and Jay Ell Company (not Inc.), (41,250 shares of Class A and 165,000 shares of Class B) limited partnerships; (b) Diversified Enterprises (not Inc.), (178,125 shares of Class A and 559,500 shares of Class B) a general partnership; (c) Shapiro Family L.P. - Gift Share (353,250 shares of Class A and 360,875 shares of Class B); ) and (d) Emlin Cosmetics, Inc. (3,884 shares of Class A). Beneficial ownership is shared by the undersigned and other family members for all shares owned by these entities.
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(4)
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No price was entered as the transaction is a bona fide gift and is exempt under Section 16(b).
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Reporting Owners
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Reporting Owner Name / Address
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Relationships
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Director
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10% Owner
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Officer
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Other
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SHAPIRO NATHAN
111 CONGRESSIONAL BLVD.
CARMEL, IN 46032
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X
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X
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Signatures
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William Vens on behalf of Nathan Shapiro under power of attorney
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10/13/2017
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**
Signature of Reporting Person
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Date
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
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*
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If the form is filed by more than one reporting person,
see
Instruction 4(b)(v).
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**
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Intentional misstatements or omissions of facts constitute Federal Criminal Violations.
See
18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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Note:
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File three copies of this Form, one of which must be manually signed. If space is insufficient,
see
Instruction 6 for procedure.
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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.
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