-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, HSvCi5htnKCQv60du0LyZrpbwXmx7DzelsVjwkDuRWvrdsmnM/lAHBH5bEtOZMyu XdPxM6EVSKVHGpVTUKhFgQ== 0001005477-07-000590.txt : 20070130 0001005477-07-000590.hdr.sgml : 20070130 20070130214108 ACCESSION NUMBER: 0001005477-07-000590 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20070130 FILED AS OF DATE: 20070130 DATE AS OF CHANGE: 20070130 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Employers Holdings, Inc. CENTRAL INDEX KEY: 0001379041 STANDARD INDUSTRIAL CLASSIFICATION: FIRE, MARINE & CASUALTY INSURANCE [6331] IRS NUMBER: 043850065 STATE OF INCORPORATION: NV FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 9790 GATEWAY DRIVE CITY: RENO STATE: NV ZIP: 89521 BUSINESS PHONE: 775-327-2936 MAIL ADDRESS: STREET 1: 9790 GATEWAY DRIVE CITY: RENO STATE: NV ZIP: 89521 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Ong Katherine W CENTRAL INDEX KEY: 0001388042 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-33245 FILM NUMBER: 07566160 BUSINESS ADDRESS: BUSINESS PHONE: 775-327-2764 MAIL ADDRESS: STREET 1: 9790 GATEWAY DRIVE STREET 2: SUITE 200 CITY: RENO STATE: NV ZIP: 89521 3 1 edgar123.xml FORM 3 X0202 3 2007-01-30 0 0001379041 Employers Holdings, Inc. EIG 0001388042 Ong Katherine W 9790 GATEWAY DRIVE RENO NV 89521 1 0 0 0 No securities are beneficially owned 0 I See footnotes 1 and 2 As of the date of this Form 3, Ms. Ong has no direct or indirect beneficial interests in any security of Employers Holdings, Inc. (the "Company"). Ms. Ong is a director of Hobbs, Ong & Associates, Inc., a Las Vegas accounting firm, which holds a policy issued by Employers Insurance Company of Nevada, an indirect wholly-owned subsidiary of the Company. The policy owned by Hobbs, Ong & Associates, Inc. entitles it to receive consideration consisting of an estimated 732 shares of common stock (assuming no exercise of the over-allotment option granted by the Company to the underwriters) as a result of the conversion of the Company from a Nevada mutual insurance company owned by its members to a Nevada stock corporation. If the over-allotment option is exercised, Hobbs, Ong & Associates, Inc.'s entitlement to consideration in the conversion will change. By virtue of her ownership interests in Hobbs, Ong & Associates, Inc., Ms. Ong may be deemed to beneficially own any shares listed as beneficially owned by Hobbs, Ong & Associates, Inc. Ms. Ong will disclaim beneficial ownership of such shares except to the extent of her pecuniary interests therein and the inclusion of the shares in this report shall not be deemed an admission of beneficial ownership of all of the reported shares for purposes of Section 16 or any other purpose. /s/ Lenard T. Ormsby, as attorney-in-fact for Katherine W. Ong 2007-01-30 -----END PRIVACY-ENHANCED MESSAGE-----