0001495925-12-000053.txt : 20120702 0001495925-12-000053.hdr.sgml : 20120702 20120702131449 ACCESSION NUMBER: 0001495925-12-000053 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20120701 FILED AS OF DATE: 20120702 DATE AS OF CHANGE: 20120702 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Bullard W. Dale CENTRAL INDEX KEY: 0001507312 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35009 FILM NUMBER: 12939512 MAIL ADDRESS: STREET 1: C/O FORTEGRA FINANCIAL CORPORATION STREET 2: 100 WEST BAY STREET CITY: JACKSONVILLE STATE: FL ZIP: 32202 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Fortegra Financial Corp CENTRAL INDEX KEY: 0001495925 STANDARD INDUSTRIAL CLASSIFICATION: INSURANCE AGENTS BROKERS & SERVICES [6411] IRS NUMBER: 581461399 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 10151 DEERWOOD PARK BOULEVARD, BLD 100 CITY: JACKSONVILLE STATE: FL ZIP: 32256 BUSINESS PHONE: 800-888-2738 MAIL ADDRESS: STREET 1: 10151 DEERWOOD PARK BOULEVARD, BLD 100 CITY: JACKSONVILLE STATE: FL ZIP: 32256 4 1 edgar.xml PRIMARY DOCUMENT X0306 4 2012-07-01 0001495925 Fortegra Financial Corp FRF 0001507312 Bullard W. Dale C/O FORTEGRA FINANCIAL CORPORATION 10151 DEERWOOD PARK BLVD, BLDG. 100 JACKSONVILLE FL 32256 0 1 0 0 EVP, Chief Mrktg Officer Common Stock, par value $0.01 per share 2012-07-01 4 A 0 3000 0 A 171854 D Common Stock, par value $0.01 per share 33656 I See footnote Common Stock, par value $0.01 per share 2625 I By spouse Option, Right to Buy 8.00 2012-07-01 4 A 0 15000 0 A 2022-07-01 Common Stock 15000 42300 D Held by Issuer FBO Reporting Person. Of these options, which are exempt under Rule 16b-3(d), one-third vest when the Compensation Committe of the Board determines that the Company has achieved annual Adjusted EBITDA of $46,000,000 and the remainder vest ratably on each of the two anniversaries of such determination. /s/ Christopher D. Romaine, attorney in fact 2012-07-02