0001209191-22-000811.txt : 20220104
0001209191-22-000811.hdr.sgml : 20220104
20220104163317
ACCESSION NUMBER: 0001209191-22-000811
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20211231
FILED AS OF DATE: 20220104
DATE AS OF CHANGE: 20220104
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: FOX SAUL A
CENTRAL INDEX KEY: 0001099187
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-34809
FILM NUMBER: 22506581
MAIL ADDRESS:
STREET 1: 950 TOWER LANE
STREET 2: SUITE 1150
CITY: FOSTER CITY
STATE: CA
ZIP: 94404
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Global Indemnity Group, LLC
CENTRAL INDEX KEY: 0001494904
STANDARD INDUSTRIAL CLASSIFICATION: FIRE, MARINE & CASUALTY INSURANCE [6331]
IRS NUMBER: 981304287
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 3 BALA PLAZA EAST
STREET 2: SUITE 300
CITY: BALA CYNWYD
STATE: PA
ZIP: 19004
BUSINESS PHONE: 610-664-1500
MAIL ADDRESS:
STREET 1: 3 BALA PLAZA EAST
STREET 2: SUITE 300
CITY: BALA CYNWYD
STATE: PA
ZIP: 19004
FORMER COMPANY:
FORMER CONFORMED NAME: Global Indemnity Ltd
DATE OF NAME CHANGE: 20161107
FORMER COMPANY:
FORMER CONFORMED NAME: Global Indemnity plc
DATE OF NAME CHANGE: 20100622
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2021-12-31
0
0001494904
Global Indemnity Group, LLC
GBLI
0001099187
FOX SAUL A
3 BALA PLAZA EAST, SUITE 300
BALA CYNWYD
PA
19004
1
0
1
0
Class A Common Shares
2021-12-31
4
A
0
5388
25.78
A
1701243
I
See Footnote
Class A Common Shares
293715
I
See Footnote
Represents a grant of 3,394 Class A Common Shares ("A Common Shares") in recognition of services rendered as a board member of the Issuer and GBLI Holdings, LLC, an indirect, wholly owned subsidiary of the Issuer and 1,994 A Common Shares granted as a tax gross-up. Vesting has been deferred to the earlier of January 1, 2024 or a change in control of the Issuer.
Includes 1,015,908 A Common Shares held by Mercury Assets Delaware LLC and Common Shares owned indirectly by Mercury Assets Delaware LLC through its limited partnership interest in Fox Mercury Investments, L.P., which holds 979,050 A Common Shares. The sole member of Mercury Assets Delaware LLC is Benjerome Trust. Mr. Fox is the sole trustee of the Benjerome Trust. Mr. Fox disclaims beneficial ownership of these securities except to the extent of his indirect pecuniary interest therein.
A Common Shares owned indirectly by Fox Paine Global, Inc. through its indirect limited partnership interest in Fox Mercury Investments, L.P., which holds 979,050 A Common Shares. Mr. Fox is a director of Fox Paine Global, Inc. Mr. Fox disclaims beneficial ownership of these securities except to the extent of his indirect pecuniary interest therein.
/s/Stephen W. Ries, Attorney-in-fact
2022-01-04