0001209191-22-027329.txt : 20220506 0001209191-22-027329.hdr.sgml : 20220506 20220505130850 ACCESSION NUMBER: 0001209191-22-027329 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220503 FILED AS OF DATE: 20220505 DATE AS OF CHANGE: 20220505 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: MELOCHE HAROLD J CENTRAL INDEX KEY: 0001339147 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37536 FILM NUMBER: 22895245 MAIL ADDRESS: STREET 1: 28819 FRANKLIN ROAD CITY: SOUTHFIELD STATE: MI ZIP: 48034 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Conifer Holdings, Inc. CENTRAL INDEX KEY: 0001502292 STANDARD INDUSTRIAL CLASSIFICATION: FIRE, MARINE & CASUALTY INSURANCE [6331] IRS NUMBER: 271298795 STATE OF INCORPORATION: MI FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 550 WEST MERRILL STREET STREET 2: SUITE 200 CITY: BIRMINGHAM STATE: MI ZIP: 48009 BUSINESS PHONE: (248) 559-0840 MAIL ADDRESS: STREET 1: 550 WEST MERRILL STREET STREET 2: SUITE 200 CITY: BIRMINGHAM STATE: MI ZIP: 48009 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2022-05-03 0 0001502292 Conifer Holdings, Inc. CNFR 0001339147 MELOCHE HAROLD J 550 WEST MERRILL STREET SUITE 200 BIRMINGHAM MI 48009 0 1 0 0 CFO, Treasurer Common Stock 2022-05-03 4 F 0 679 2.16 D 51267 D No shares were sold - these shares were withheld by the Issuer to satisfy tax withholding requirements in connection with the vesting of restricted stock units Brian J. Roney, by Power of Attorney 2022-05-05