FORM 5 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 ANNUAL 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). | |||||||||||||||||
Form 3 Holdings Reported. | |||||||||||||||||
Form 4 Transactions Reported. |
1. Name and Address of Reporting Person*
(Street)
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2. Issuer Name and Ticker or Trading Symbol
UNITED FIRE GROUP INC [ UFCS ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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3. Statement for Issuer's Fiscal Year Ended
(Month/Day/Year) 12/31/2014 | ||||||||||||||||||||||||||
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 at end of Issuer's Fiscal Year (Instr. 3 and 4) | 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 7. Nature of Indirect Beneficial Ownership (Instr. 4) | ||||||||
Amount | (A) or (D) | Price | |||||||||||||
Common Stock | 18,963(1) | D | |||||||||||||
Common Stock | 2,334(2) | I | By 401(k) Plan for self | ||||||||||||
Common Stock | 214,637(3) | I | By self as co-trustee of Issuer's Employee Stock Ownership Plan |
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) | |||
(A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | |||||||||
Stock Option (right to buy) | $32.39 | (4) | 02/18/2015 | Common Stock | 5,000 | 5,000 | D | |||||||
Stock Option (right to buy) | $39.13 | (4) | 02/17/2016 | Common Stock | 5,000 | 5,000 | D | |||||||
Stock Option (right to buy) | $35.23 | (4) | 02/16/2017 | Common Stock | 10,000 | 10,000 | D | |||||||
Stock Option (right to buy) | $33.43 | (4) | 05/21/2018 | Common Stock | 8,463 | 8,463 | D | |||||||
Stock Option (right to buy) | $22.42 | (5) | 05/19/2020 | Common Stock | 3,000 | 3,000 | D | |||||||
Stock Option (right to buy) | $20.54 | (6) | 02/18/2021 | Common Stock | 9,467 | 9,467 | D | |||||||
Stock Option (right to buy) | $23.96 | (7) | 02/15/2023 | Common Stock | 9,998 | 9,998 | D | |||||||
Stock Option (right to buy) | $29.61 | (8) | 02/21/2024 | Common Stock | 15,971 | 15,971 | D |
Explanation of Responses: |
1. The total number of securities beneficially held directly by the Reporting Person includes: 3,894 shares of restricted stock issued under the Issuer's Stock Plan which vest, subject to certain conditions, on 02/18/2016; 2,850 shares of restricted stock issued under the Issuer's Stock Plan which vest, subject to certain conditions, on 02/15/2018; 4,934 shares of restricted stock issued under the Issuer's Stock Plan which vest, subject to certain conditions, on 02/21/2019; and 7,285 shares held by the Reporting Person individually. |
2. The number of securities shown as being held in or acquired by the Issuer's 401(k) account for the Reporting Person's benefit are the approximate number of shares of Issuer common stock (excluding fractionals) for which the Reporting Person has the right to direct the vote under the Issuer's 401(k) Plan. Such shares are not directly allocated to 401(k) Plan participants, but are instead held in a unitized fund consisting primarily of Issuer common stock, together with a small percentage of short-term investments. 401(k) Plan participants acquire units of this fund. |
3. The Reporting Person serves as Co-Trustee of this employee benefit plan and disclaims beneficial ownership of any Issuer securities held by this plan that are not allocated for his individual benefit. This report shall not be deemed an admission that the Reporting Person is the beneficial owner of such securities for purposes under Section 16 of the Securities Exchange Act of 1934 or for any other purpose. Currently only 1,871 shares held in this plan are allocated specifically for the Reporting Person's individual benefit. |
4. All options currently exercisable. |
5. 2,400 options currently exercisable. Remaining options vest and become exercisable on 05/19/2015. |
6. 5,681 options currently exercisable. Remaining options vest and become exercisable in equal installments on 02/18/2015 and 02/18/2016, respectively. |
7. 2,000 options currently exercisable. Remaining options vest and become exercisable in equal installments on 02/15/2015, 02/15/2016, 02/15/2017 and 02/15/2018, respectively. |
8. Options vest and become exercisable in equal installments on 02/21/2015, 02/21/2016, 02/21/2017, 02/21/2018 and 02/21/2019, respectively. |
Remarks: |
/s/ Michael T. Wilkins | 02/13/2015 | |
** 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. |