Statement of Changes in Beneficial Ownership (4)
27 May 2021 - 9:45AM
Edgar (US Regulatory)
FORM 4
[X]
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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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
*
Mead Ronald L |
2. Issuer Name and Ticker or Trading Symbol
FBL FINANCIAL GROUP INC
[
FFG
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director _____ 10% Owner __X__ Officer (give title below) _____ Other (specify below) VP - Sales and Distribution |
(Last)
(First)
(Middle)
5400 UNIVERSITY AVENUE |
3. Date of Earliest Transaction
(MM/DD/YYYY)
5/25/2021 |
(Street)
WEST DES MOINES, IA 50266
(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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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) | 2. Conversion or Exercise Price of Derivative Security | 3. Trans. Date | 3A. Deemed Execution Date, if any | 4. Trans. 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 | 7. Title and Amount of Securities Underlying Derivative Security (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) |
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Restricted Stock Units (Cash Settled) | (1) | 5/25/2021 | | D | | | 1316 | (1) | 2/1/2026 | Class A Common Stock | 1316.0 | (1) | 0 | D | |
Restricted Stock Units (Cash Settled) | (1) | 5/25/2021 | | D | | | 264 | (1) | 2/1/2025 | Class A Common Stock | 264.0 | (1) | 0 | D | |
Restricted Stock Units (Cash Settled) | (1) | 5/25/2021 | | D | | | 143 | (1) | 2/1/2024 | Class A Common Stock | 143.0 | (1) | 0 | D | |
Restricted Stock Units (Cash Settled) | (1) | 5/25/2021 | | D | | | 92 | (1) | 2/1/2023 | Class A Common Stock | 92.0 | (1) | 0 | D | |
Restricted Stock Units (Cash Settled) | (1) | 5/25/2021 | | D | | | 46 | (1) | 2/1/2022 | Class A Common Stock | 46.0 | (1) | 0 | D | |
Explanation of Responses: |
(1) | Each unit of cash settled RSUs represented the economic equivalent of one share of FBL Financial Group, Inc. Class A common stock. The cash settled RSUs were subject to vesting schedules of 20% of the units on each of the first five anniversaries of the grant date, ending on the expiration date. In conjunction with the merger of FBL Financial Group, Inc. and 5400 Merger Sub, Inc., pursuant to an agreement and plan of merger dated January 11, 2021 and amended on May 2, 2021, these RSUs were cancelled and exchanged for the right to receive an amount in cash equal to $61.00 per unit, plus the aggregate sum of any cash dividend equivalents in respect of such units, with payment to be made in accordance with the vesting schedules applicable to the RSUs prior to the Merger, subject to the continued employment of the reporting person. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Mead Ronald L 5400 UNIVERSITY AVENUE WEST DES MOINES, IA 50266 |
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| VP - Sales and Distribution |
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Signatures
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By: Mark Wickham per filed confirming stmt For: Ronald L Mead | | 5/26/2021 |
**Signature of Reporting Person | Date |
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