FORM 4 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). |
1. Name and Address of Reporting Person*
(Street)
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2. Issuer Name and Ticker or Trading Symbol
Global Indemnity Group, LLC [ GBLI ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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3. Date of Earliest Transaction
(Month/Day/Year) 01/14/2022 | ||||||||||||||||||||||||||
4. If Amendment, Date of Original Filed
(Month/Day/Year) |
6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | ||||||||||
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1. Title of Security (Instr. 3) | 2. Transaction Date (Month/Day/Year) | 2A. Deemed Execution Date, if any (Month/Day/Year) | 3. Transaction Code (Instr. 8) | 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) | 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) | 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 7. Nature of Indirect Beneficial Ownership (Instr. 4) | |||
Code | V | Amount | (A) or (D) | Price |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||||||||||
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1. Title of Derivative Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) | 6. Date Exercisable and Expiration Date (Month/Day/Year) | 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) | 8. Price of Derivative Security (Instr. 5) | 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) | 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) | ||||
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Class B Common Shares | (1) | 01/14/2022 | P(2) | 763,777(2) | (1) | (1) | Class A Common Shares | 3,707,785 | (2) | 3,707,785 | I | See Footnote(3) | |||
Class B Common Shares | (1) | (1) | (1) | Class A Common Shares | 66,482 | 66,482 | I | See Footnote(4) | |||||||
Class B Common Shares | (1) | (1) | (1) | Class A Common Shares | 121,057 | 121,057 | I | See Footnote(5) | |||||||
Class B Common Shares | (1) | (1) | (1) | Class A Common Shares | 51,882 | 51,882 | I | See Footnote(6) |
Explanation of Responses: |
1. Each Class B Common Share ("B Common Share") of Global Indemnity Group, LLC ("Issuer") is convertible into one Issuer Class A Common Share ("A Common Share" and, together with B Common Shares, "Common Shares"). |
2. The reported securities are held by Fox Paine Capital Fund II International, L.P. ("Fund II"), a limited partnership in which Mr. Fox has an indirect pecuniary interest. On January 14, 2022, Mercury Assets Delaware, LLC, a limited liability company, was assigned by a limited partner of Fund II ("Assignor") Assignor's partnership interest representing a 20.6% interest in Fund II for an aggregate purchase price of $23,163,474.00 (the "Assignment"), which aggregate purchase price was allocable among Assignor's beneficial interest in cash and Common Shares held by Fund II and liabilities acquired as a result of the Assignment. The sole member of Mercury Assets Delaware, LLC is the Benjerome Trust. Mr. Fox is the sole trustee of the Benjerome Trust. |
3. Common Shares owned by Fund II. The sole general partner of Fund II is FP International LPH, L.P. ("FPI LPH"). The sole general partner of FPI LPH is Fox Paine International GP, Ltd. ("GPLTD"). As a result, GPLTD may be deemed to control the Common Shares owned by Fund II. Fox Mercury Investments, L.P. is a minority shareholder of GPLTD. Mr. Fox disclaims beneficial ownership of these securities except to the extent of his indirect pecuniary interest therein. |
4. Common Shares owned by FPI LPH. The sole general partner of FPI LPH is GPLTD. As a result, GPLTD may be deemed to control the Common Shares owned by FPI LPH. Mr. Fox disclaims beneficial ownership of these securities except to the extent of his indirect pecuniary interest therein. |
5. Common Shares owned indirectly by Mercury Assets Delaware LLC through its limited partnership interest in Fox Mercury Investments, L.P., which holds 979,050 A Common Shares and 172,939 B Common Shares. The sole member of Mercury Assets Delaware LLC is Benjerome Trust. Mr. Fox is the sole trustee of the Benjerome Trust. Mr. Fox disclaims beneficial ownership of these securities except to the extent of his indirect pecuniary interest therein. |
6. Common Shares owned indirectly by Fox Paine Global, Inc. through its indirect limited partnership interest in Fox Mercury Investments, L.P., which holds 979,050 A Common Shares and 172,939 B Common Shares. Mr. Fox is a director of Fox Paine Global, Inc. Mr. Fox disclaims beneficial ownership of these securities except to the extent of his indirect pecuniary interest therein. |
Remarks: |
/s/Stephen W. Ries, Attorney-in-Fact | 01/19/2022 | |
** Signature of Reporting Person | Date | |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | ||
* If the form is filed by more than one reporting person, see Instruction 4 (b)(v). | ||
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). | ||
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. | ||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |