0001209191-22-017769.txt : 20220310 0001209191-22-017769.hdr.sgml : 20220310 20220310094605 ACCESSION NUMBER: 0001209191-22-017769 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220308 FILED AS OF DATE: 20220310 DATE AS OF CHANGE: 20220310 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: RONEY BRIAN J CENTRAL INDEX KEY: 0001339151 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37536 FILM NUMBER: 22727701 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 2022-03-08 0 0001502292 Conifer Holdings, Inc. CNFR 0001339151 RONEY BRIAN J 550 WEST MERRILL STREET SUITE 200 BIRMINGHAM MI 48009 0 1 0 0 President Stock Option (right to buy) 4.53 2022-03-08 4 A 0 265000 0.00 A 2032-03-08 Common Stock 265000 295000 D Represents an option grant for the purchase of 265,000 shares. Vesting will occur in annual increments of 20% beginning on the first anniversary of the date of grant, so that all the options will be vested on the five-year anniversary. Brian J. Roney 2022-03-10