FORM 4 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP 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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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). |
1. Name and Address of Reporting Person*
(Street)
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2. Issuer Name and Ticker or Trading Symbol
FPIC INSURANCE GROUP INC [ FPIC ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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3. Date of Earliest Transaction
(Month/Day/Year) 12/06/2007 | ||||||||||||||||||||||||||
4. If Amendment, Date of Original Filed
(Month/Day/Year) |
6. Individual or Joint/Group Filing (Check Applicable Line)
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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) | 2. Transaction Date (Month/Day/Year) | 2A. Deemed Execution Date, if any (Month/Day/Year) | 3. Transaction Code (Instr. 8) | 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) | 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) | 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 7. Nature of Indirect Beneficial Ownership (Instr. 4) | |||
Code | V | Amount | (A) or (D) | Price | ||||||
Common Stock | 12/06/2007 | S | 400 | D | $43.02 | 9,670 | D | |||
Common Stock | 12/06/2007 | S | 300 | D | $43.03 | 9,370 | D | |||
Common Stock | 12/06/2007 | S | 400 | D | $43.04 | 8,970 | D | |||
Common Stock | 12/06/2007 | S | 600 | D | $43.07 | 8,370 | D | |||
Common Stock | 12/06/2007 | S | 900 | D | $43.09 | 7,470 | D | |||
Common Stock | 12/06/2007 | S | 400 | D | $43.12 | 7,070 | D | |||
Common Stock | 12/06/2007 | S | 35 | D | $43.298 | 7,035 | D | |||
Common Stock | 12/06/2007 | S | 165 | D | $43.3 | 6,870 | D | |||
Common Stock | 12/06/2007 | S | 100 | D | $43.31 | 6,770 | D | |||
Common Stock | 12/06/2007 | S | 600 | D | $43.338 | 6,170 | D | |||
Common Stock | 12/06/2007 | S | 232 | D | $43.35 | 5,938 | D | |||
Common Stock | 12/06/2007 | S | 200 | D | $43.36 | 5,738 | D | |||
Common Stock | 12/06/2007 | S | 68 | D | $43.374 | 5,670 | D | |||
Common Stock | 12/06/2007 | S | 500 | D | $43.39 | 5,170 | D | |||
Common Stock | 12/06/2007 | S | 500 | D | $43.41 | 4,670 | D | |||
Common Stock | 12/06/2007 | S | 200 | D | $43.47 | 4,470 | D | |||
Common Stock | 12/06/2007 | S | 100 | D | $43.49 | 4,370 | D | |||
Common Stock | 12/06/2007 | S | 100 | D | $43.5 | 4,270 | D | |||
Common Stock | 12/06/2007 | S | 600 | D | $46.06 | 3,670 | D | |||
Common Stock | 12/06/2007 | S | 600 | D | $46.16 | 3,070 | D |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||||||||||
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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 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: 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 | ||||||||
Director Stock Option (Dir Stock Opt Plan - right to buy) | $48.0625 | 12/10/2007 | G | V | 5,000 | 07/30/1999(1) | 01/30/2009 | Common Stock | 5,000 | $0 | 0 | D(2) | |||
Director Stock Option (Dir Stock Opt Plan - right to buy) | $48.0625 | 12/10/2007 | G | V | 5,000 | 07/30/1999(1) | 01/30/2009 | Common Stock | 5,000 | $0 | 5,000 | I(2) | David M. Shapiro Revocable Trust | ||
Director Stock Option (Dir Stock Opt Plan - right to buy) | $15.25 | 12/10/2007 | G | V | 5,000 | 11/06/2000(3) | 11/06/2009 | Common Stock | 5,000 | $0 | 0 | D(2) | |||
Director Stock Option (Dir Stock Opt Plan - right to buy) | $15.25 | 12/10/2007 | G | V | 5,000 | 11/06/2000(3) | 11/06/2009 | Common Stock | 5,000 | $0 | 5,000 | I(2) | David M. Shapiro Revocable Trust | ||
Director Stock Option (Dir Stock Opt Plan - right to buy) | $18.094 | 12/10/2007 | G | V | 1,500 | 12/06/2000(4) | 12/06/2009 | Common Stock | 1,500 | $0 | 0 | D(2) | |||
Director Stock Option (Dir Stock Opt Plan - right to buy) | $18.094 | 12/10/2007 | G | V | 1,500 | 12/06/2000(4) | 12/06/2009 | Common Stock | 1,500 | $0 | 1,500 | I(2) | David M. Shapiro Revocable Trust | ||
Director Stock Option (Dir Stock Opt Plan - right to buy) | $16.375 | 12/10/2007 | G | V | 1,000 | 03/15/2001(5) | 03/15/2010 | Common Stock | 1,000 | $0 | 0 | D(2) | |||
Director Stock Option (Dir Stock Opt Plan - right to buy) | $16.375 | 12/10/2007 | G | V | 1,000 | 03/15/2001(5) | 03/15/2010 | Common Stock | 1,000 | $0 | 1,000 | I(2) | David M. Shapiro Revocable Trust | ||
Director Stock Option (Dir Stock Opt Plan - right to buy) | $16.25 | 12/10/2007 | G | V | 500 | 03/15/2001(6) | 03/15/2010 | Common Stock | 500 | $0 | 0 | D(2) | |||
Director Stock Option (Dir Stock Opt Plan - right to buy) | $16.25 | 12/10/2007 | G | V | 500 | 03/15/2001(6) | 03/15/2010 | Common Stock | 500 | $0 | 500 | I(2) | David M. Shapiro Revocable Trust | ||
Director Stock Option (Dir Stock Opt Plan - right to buy) | $15.5 | 12/10/2007 | G | V | 5,000 | 06/07/2001(7) | 06/07/2010 | Common Stock | 5,000 | $0 | 0 | D(2) | |||
Director Stock Option (Dir Stock Opt Plan - right to buy) | $15.5 | 12/10/2007 | G | V | 5,000 | 06/07/2001(7) | 06/07/2010 | Common Stock | 5,000 | $0 | 5,000 | I(2) | David M. Shapiro Revocable Trust | ||
Director Stock Option (Dir Stock Opt Plan - right to buy) | $12.9 | 12/10/2007 | G | V | 5,000 | 06/06/2002(8) | 06/06/2011 | Common Stock | 5,000 | $0 | 0 | D(2) | |||
Director Stock Option (Dir Stock Opt Plan - right to buy) | $12.9 | 12/10/2007 | G | V | 5,000 | 06/06/2002(8) | 06/06/2011 | Common Stock | 5,000 | $0 | 5,000 | I(2) | David M. Shapiro Revocable Trust | ||
Director Stock Option (Dir Stock Opt Plan - right to buy) | $14.7 | 12/10/2007 | G | V | 5,000 | 06/05/2003(9) | 06/05/2012 | Common Stock | 5,000 | $0 | 0 | D(2) | |||
Director Stock Option (Dir Stock Opt Plan - right to buy) | $14.7 | 12/10/2007 | G | V | 5,000 | 06/05/2003(9) | 06/05/2012 | Common Stock | 5,000 | $0 | 5,000 | I(2) | David M. Shapiro Revocable Trust | ||
Director Stock Option (Dir Stock Opt Plan - right to buy) | $12.2 | 12/10/2007 | G | V | 5,000 | 06/04/2004(10) | 06/04/2013 | Common Stock | 5,000 | $0 | 0 | D(2) | |||
Director Stock Option (Dir Stock Opt Plan - right to buy) | $12.2 | 12/10/2007 | G | V | 5,000 | 06/04/2004(10) | 06/04/2013 | Common Stock | 5,000 | $0 | 5,000 | I(2) | David M. Shapiro Revocable Trust | ||
Director Stock Option (Dir Stock Opt Plan - right to buy) | $26.9 | 12/10/2007 | G | V | 5,000 | 06/02/2005(11) | 06/02/2014 | Common Stock | 5,000 | $0 | 0 | D(2) | |||
Director Stock Option (Dir Stock Opt Plan - right to buy) | $26.9 | 12/10/2007 | G | V | 5,000 | 06/02/2005(11) | 06/02/2014 | Common Stock | 5,000 | $0 | 5,000 | I(2) | David M. Shapiro Revocable Trust |
Explanation of Responses: |
1. The option vested on July 30, 1999 |
2. The reported transactions involved the reporting person's transfer of options to a revocable trust for the benefit of one or more members of this reporting person's immediate family. |
3. The option vested in equal installments on November 6, 2000, 2001 and 2002 |
4. The option vested in equal installments on December 6, 2000, 2001 and 2002 |
5. The option vested in equal installments on March 15, 2001, 2002 and 2003 |
6. The option vested in equal installments on March 15, 2001, 2002 and 2003 |
7. The option vested in equal installments on June 7, 2001, 2002 and 2003 |
8. The option vested in equal installments on June 6, 2002, 2003 and 2004 |
9. The option vested in equal installments on June 5, 2003, 2004 and 2005 |
10. The option vested in equal installments on June 4, 2004, 2005 and 2006 |
11. The option vested in equal installments on June 2, 2005, 2006 and 2007 |
Remarks: |
/s/ T. Malcolm Graham, Attorney-In-Fact | 12/10/2007 | |
** Signature of Reporting Person | Date | |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | ||
* 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). | ||
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. | ||
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 Number. |