FORM 3 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES 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*
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 06/01/2005 |
3. Issuer Name and Ticker or Trading Symbol
OLD REPUBLIC INTERNATIONAL CORP [ ORI ] |
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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5. If Amendment, Date of Original Filed
(Month/Day/Year) |
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6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Beneficially Owned | |||
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1. Title of Security (Instr. 4) | 2. Amount of Securities Beneficially Owned (Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 4. Nature of Indirect Beneficial Ownership (Instr. 5) |
Common Stock | 0 | D | |
Common Stock | 5,930 | I | By ESSOP |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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1. Title of Derivative Security (Instr. 4) | 2. Date Exercisable and Expiration Date (Month/Day/Year) | 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 6. Nature of Indirect Beneficial Ownership (Instr. 5) | ||
Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
Employee Stock Option | 03/15/1997 | 12/31/2006 | Common Stock(1) | 17,550(2) | $11.89 | D | |
Employee Stock Option | 03/15/1998 | 12/31/2007 | Common Stock(1) | 20,250(2) | $19.36 | D | |
Employee Stock Option | 03/15/1999 | 12/31/2008 | Common Stock(1) | 24,000(2) | $13 | D | |
Employee Stock Option | 03/15/2000 | 12/31/2009 | Common Stock(1) | 22,500(2) | $8 | D | |
Employee Stock Option | 03/22/2001 | 12/31/2010 | Common Stock(1) | 52,500(2) | $17.95 | D | |
Employee Stock Option | 03/21/2002 | 12/31/2011 | Common Stock(1) | 45,000(3) | $21.07 | D | |
Employee Stock Option | 03/20/2003 | 12/31/2012 | Common Stock(1) | 60,000(3) | $17.96 | D | |
Employee Stock Option | 03/23/2004 | 12/31/2013 | Common Stock(1) | 60,000(4) | $24.15 | D | |
Employee Stock Option | 04/15/2005 | 12/31/2014 | Common Stock(1) | 42,500(4) | $23.01 | D |
Explanation of Responses: |
1. An optionee may also exercise options for Series G-3 Preferred Stock on March 1, June 1, September 1 or December 1 of each year. Each share of Series G-3 Preferred Stock is convertible, after being held six months into .95 shares of Common Stock. |
2. These shares vest at the rate of 10% per year and will accelerate to 10% for each year of employment of an optionee if the closing market price, per share, of the Company's Common Stock reaches 150% of the Exercise Price. |
3. These shares vest at the rate of 10% the first year, 15% the second year, 20% the third year, 25% the fourth year and 30% the fifth year and will accelerate at the rate of 10% for each year of employment of an optionee if the closing market price, per share, of the Company's Common Stock reaches 150% of the Exercise Price. |
4. These shares vest on December 31 of each year at the rate of 10% the first year, 15% the second year, 20% the third year, 25% the fourth year and 30% the fifth year. |
William J. Dasso, Power of Attorney for Christopher Nard | 06/06/2005 | |
** 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 5 (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. |