0000905729-19-000241.txt : 20191231 0000905729-19-000241.hdr.sgml : 20191231 20191231115228 ACCESSION NUMBER: 0000905729-19-000241 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20191230 FILED AS OF DATE: 20191231 DATE AS OF CHANGE: 20191231 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Clarkston Ventures, LLC CENTRAL INDEX KEY: 0001718951 STATE OF INCORPORATION: MI FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37536 FILM NUMBER: 191318684 BUSINESS ADDRESS: STREET 1: 81 WEST LONG LAKE ROAD CITY: BLOOMFIELD HILLS STATE: MI ZIP: 48304 BUSINESS PHONE: (248) 723-8000 MAIL ADDRESS: STREET 1: 91 WEST LONG LAKE ROAD CITY: BLOOMFIELD HILLS STATE: MI ZIP: 48304 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 ownership.xml X0306 4 2019-12-30 0 0001502292 Conifer Holdings, Inc. CNFR 0001718951 Clarkston Ventures, LLC 91 WEST LONG LAKE ROAD BLOOMFIELD HILLS MI 48304 0 0 1 0 Common Stock 2019-12-30 4 P 0 28344 4.00 A 2135769 D /s/ Jeffrey A. Hakala 2019-12-30