0001339147-19-000008.txt : 20190917 0001339147-19-000008.hdr.sgml : 20190917 20190917161823 ACCESSION NUMBER: 0001339147-19-000008 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190916 FILED AS OF DATE: 20190917 DATE AS OF CHANGE: 20190917 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: 191097320 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 wf-form4_156875148660432.xml FORM 4 X0306 4 2019-09-16 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 2019-09-16 4 F 0 136 3.75 D 54105 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 2019-09-17