- Statement of Changes in Beneficial Ownership (4)
May 17 2012 - 7:48PM
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
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hours per response...
0.5
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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(f) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
*
SHERMAN DONALD A
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2. Issuer Name
and
Ticker or Trading Symbol
DELPHI FINANCIAL GROUP INC/DE
[
DFG
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__
X
__ Director
_____ 10% Owner
__
X
__ Officer (give title below)
_____ Other (specify below)
President & COO
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(Last)
(First)
(Middle)
C/O DELPHI CAPITAL MANAGEMENT, INC., 590 MADISON AVENUE, 30TH FLOOR
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3. Date of Earliest Transaction
(MM/DD/YYYY)
5/15/2012
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(Street)
NEW YORK, NY 10022
(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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5/15/2012
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D
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35935
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D
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$43.875
(1)
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0
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D
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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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Stock Option (right to buy)
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$17.5245
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5/15/2012
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D
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6420
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11/12/2002
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8/14/2012
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Class A Common Stock
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6420
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(2)
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0
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D
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Stock Option (right to buy)
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$19.56
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5/15/2012
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D
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7668
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8/27/2003
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5/29/2013
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Class A Common Stock
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7668
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(2)
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0
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D
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Stock Option (right to buy)
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$26.3333
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5/15/2012
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D
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5696
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8/4/2004
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5/6/2014
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Class A Common Stock
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5696
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(2)
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0
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D
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Stock Option (right to buy)
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$27.8533
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5/15/2012
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D
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4038
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8/23/2005
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5/25/2015
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Class A Common Stock
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4038
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(2)
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0
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D
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Stock Option (right to buy)
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$36.0533
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5/15/2012
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D
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150000
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4/19/2007
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4/19/2016
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Class A Common Stock
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150000
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(2)
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0
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D
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Stock Option (right to buy)
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$34.62
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5/15/2012
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D
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19000
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6/8/2007
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6/8/2016
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Class A Common Stock
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19000
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(2)
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0
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D
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Restricted Share Units
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(3)
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5/15/2012
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D
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17144
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(4)
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(4)
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Class A Common Stock
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17144
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(5)
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0
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D
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Stock Option (right to buy)
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$40.83
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5/15/2012
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D
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51432
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2/7/2008
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2/16/2017
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Class A Common Stock
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51432
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(2)
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0
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D
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Restricted Share Units
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(3)
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5/15/2012
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D
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30027
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(4)
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(4)
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Class A Common Stock
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30027
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(5)
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0
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D
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Stock Option (right to buy)
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$29.14
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5/15/2012
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D
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90082
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2/6/2009
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2/15/2018
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Class A Common Stock
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90082
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(2)
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0
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D
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Restricted Share Units
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(3)
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5/15/2012
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D
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41195
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(4)
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(4)
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Class A Common Stock
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41195
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(5)
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0
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D
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Stock Option (right to buy)
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$21.24
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5/15/2012
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D
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123587
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2/11/2011
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2/11/2020
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Class A Common Stock
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123587
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(2)
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0
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D
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Restricted Share Units
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(3)
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5/15/2012
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D
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38510
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(4)
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(4)
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Class A Common Stock
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38510
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(5)
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0
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D
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Stock Option (right to buy)
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$31.16
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5/15/2012
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D
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115532
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2/9/2012
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2/18/2021
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Class A Common Stock
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115532
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(2)
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0
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D
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Explanation of Responses:
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(
1)
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Disposed of pursuant to the Agreement and Plan of Merger dated as of December 21, 2011 by and among the issuer, Tokio Marine Holdings, Inc. and TM Investment (Delaware) Inc. (the "Merger Agreement"), pursuant to which each of the shares was converted into the right to receive $43.875 in cash. In addition, pursuant to the terms of the Merger Agreement, a special cash dividend of $1.00 per share was paid in respect of such shares on May 16, 2012.
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(
2)
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Pursuant to the terms of the Merger Agreement, such option, whether or not fully vested, was cancelled in exchange for the right to receive a cash payment equal to the amount by which $44.875 exceeded the exercise price per share of such option, multiplied by the number of shares of Class A Common Stock underlying such option.
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(
3)
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1-for-1.
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(
4)
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The terms of these restricted share units provided that the reporting person would, subject to the satisfaction of various time vesting requirements, receive the underlying shares of Class A Common Stock after a six-month period following the termination of his employment.
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(
5)
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Pursuant to the terms of the Merger Agreement, such restricted share units, whether or not fully vested, were cancelled in exchange for the right to receive a cash payment of $43.875 per underlying share of Class A Common Stock. In addition, pursuant to the terms of the Merger Agreement, a payment in the amount of $1.00 per share of Class A Common Stock underlying such units was made on May 16, 2012.
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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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SHERMAN DONALD A
C/O DELPHI CAPITAL MANAGEMENT, INC.
590 MADISON AVENUE, 30TH FLOOR
NEW YORK, NY 10022
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X
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President & COO
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Signatures
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Chad W. Coulter, Attorney-in-Fact for Donald A. Sherman
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5/17/2012
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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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