0001339147-16-000009.txt : 20160919
0001339147-16-000009.hdr.sgml : 20160919
20160919161646
ACCESSION NUMBER: 0001339147-16-000009
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20160915
FILED AS OF DATE: 20160919
DATE AS OF CHANGE: 20160919
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
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: 161891916
MAIL ADDRESS:
STREET 1: 28819 FRANKLIN ROAD
CITY: SOUTHFIELD
STATE: MI
ZIP: 48034
4
1
wf-form4_147431619349448.xml
FORM 4
X0306
4
2016-09-15
0
0001502292
Conifer Holdings, Inc.
CNFR
0001339147
MELOCHE HAROLD J
550 W. MERRILL STREET
SUITE 200
BIRMINGHAM
MI
48009
0
1
0
0
CFO, Treasurer
Common Stock
2016-09-15
4
A
0
2448
8.17
A
41448
D
Consists of restricted stock units, the shares underlying which will vest in annual increments of 20% beginning on the first anniversary of the date of grant, so that all of the shares will be vested on the five-year anniversary.
Brian J. Roney, by Power of Attorney
2016-09-19