0001596771-15-000028.txt : 20150327 0001596771-15-000028.hdr.sgml : 20150327 20150327162406 ACCESSION NUMBER: 0001596771-15-000028 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20150325 FILED AS OF DATE: 20150327 DATE AS OF CHANGE: 20150327 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Diplomat Pharmacy, Inc. CENTRAL INDEX KEY: 0001610092 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-DRUG STORES AND PROPRIETARY STORES [5912] IRS NUMBER: 382063100 STATE OF INCORPORATION: MI FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 4100 S. SAGINAW ST. CITY: FLINT STATE: MI ZIP: 48507 BUSINESS PHONE: 888-720-4450 MAIL ADDRESS: STREET 1: 4100 S. SAGINAW ST. CITY: FLINT STATE: MI ZIP: 48507 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Hagerman Philip R CENTRAL INDEX KEY: 0001618897 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36677 FILM NUMBER: 15731287 MAIL ADDRESS: STREET 1: 4100 S. SAGINAW STREET CITY: FLINT STATE: MI ZIP: 48507 4 1 primary_doc.xml PRIMARY DOCUMENT X0306 4 2015-03-25 0 0001610092 Diplomat Pharmacy, Inc. DPLO 0001618897 Hagerman Philip R 4100 S. SAGINAW STREET FLINT MI 48507 1 1 1 0 Chairman and CEO Common Stock 2015-03-25 4 S 0 1001000 29 D 1104309 I Philip R. Hagerman Revocable Trust Common Stock 2015-03-25 4 S 0 250000 29 D 3891207 I 2007 Hagerman Family GST Common Stock 2015-03-25 4 S 0 250000 29 D 4449689 I The JH GST Trust Common Stock 2015-03-25 4 S 0 75000 29 D 1837500 I 2013 Irrev. Exempt Trust for Daughter Common Stock 2015-03-25 4 S 0 75000 29 D 1837500 I 2013 Irrev. Exempt Trust for Son Common Stock 2015-03-25 4 S 0 75000 29 D 1647917 I 2013 Irrev. Exempt Trust for Daughter Common Stock 2015-03-25 4 S 0 75000 29 D 1647916 I 2013 Irrev. Exempt Trust for Daughter Common Stock 646000 I 2014 Irrev. Exempt Trust for Son Common Stock 646000 I 2014 Irrev. Exempt Trust for Daughter Common Stock 646000 I 2014 Irrev. Exempt Trust for Daughter Common Stock 646000 I 2014 Irrev. Exempt Trust for Daughter Common Stock 1275000 I Philip Hagerman 2014 GRAT Common Stock 1275000 I Jocelyn Hagerman 2014 GRAT Common Stock 263500 I JH Marital Trust Common Stock 272000 I PH Marital Trust Common Stock 394910 I Irrevocable Trust for Son Common Stock 394910 I Irrevocable Trust for Daughter These shares are indirectly owned by Mr. Hagerman as the trustee of the Philip R. Hagerman Revocable Trust, The JH GST Trust, the 2013 Irrevocable Exempt Trusts and 2014 Irrevocable Exempt Trusts for two daughters, the Jocelyn Hagerman 2014 GRAT and the JH Marital Trust. Jocelyn Hagerman is Mr. Hagerman's wife. These shares are indirectly owned by her as a trustee of the 2007 Hagerman Family GST Trust, the 2013 Irrevocable Exempt Trusts and 2014 Irrevocable Exempt Trusts for a son and daughter, the Philip Hagerman 2014 GRAT and the PH Marital Trust. Jeffrey H. Kuras, by Power of Attorney 2015-03-27