SEC Form 4
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*
BANDI ANNE

(Last) (First) (Middle)
5701 STIRLING ROAD

(Street)
DAVIE FL 33314

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
BRISTOL WEST HOLDINGS INC [ BRW ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Sr. VP Operations
3. Date of Earliest Transaction (Month/Day/Year)
07/03/2007
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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 07/03/2007 D 37,171 D $22.5(1) 0 D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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
Employee Stock Option (right to buy) $3.83 07/03/2007 D 65,190 (2) 03/31/2011 Common Stock 65,190 $18.67 0 D
Employee Stock Option (right to buy) $3.83 07/03/2007 D 1,304 (3) 01/01/2012 Common Stock 1,304 $18.67 0 D
Employee Stock Option (right to buy) $7.67 07/03/2007 D 1,141 (4) 05/01/2013 Common Stock 1,141 $14.83 0 D
Employee Stock Option (right to buy) $20.91 07/03/2007 D 658 (5) 04/05/2014 Common Stock 658 $1.51 0 D
Explanation of Responses:
1. Disposed of pursuant to merger agreement between issuer, Farmers Group Inc. and BWH Acquisition Company in exchange for cash.
2. This option, which provided for vesting in five equal annual installments beginning March 31, 2002, was converted in the merger into the right to receive cash.
3. This option, which provided for vesting in two equal annual installments beginning January 1, 2003, was converted in the merger into the right to receive cash.
4. This option, which provided for vesting in two equal annual installments beginning May 1, 2004, was converted in the merger into the right to receive cash.
5. This option, which provided for vesting in two equal annual installments beginning April 5, 2005, was converted in the merger into the right to receive cash.
Remarks:
/s/ Richard W. Probert, by Power of Attorney for Reporting Person 07/05/2007
** 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).
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