0001596771-15-000075.txt : 20151028
0001596771-15-000075.hdr.sgml : 20151028
20151028153127
ACCESSION NUMBER: 0001596771-15-000075
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20151026
FILED AS OF DATE: 20151028
DATE AS OF CHANGE: 20151028
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: 151180130
MAIL ADDRESS:
STREET 1: 4100 S. SAGINAW STREET
CITY: FLINT
STATE: MI
ZIP: 48507
4
1
primary_doc.xml
PRIMARY DOCUMENT
X0306
4
2015-10-26
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
2015-10-26
4
J
0
156172
0
A
1462145
I
Philip R. Hagerman Revocable Trust
Common Stock
3891609
I
2007 Hagerman Family GST
Common Stock
2015-10-26
4
J
0
402
0
A
4450091
I
The JH GST Trust
Common Stock
2015-10-26
4
J
0
56624
0
D
1780876
I
2013 Irrev Exempt Trust for Daughter
Common Stock
2015-10-26
4
J
0
56624
0
D
1780876
I
2013 Irrev Exempt Trust for Son
Common Stock
1591293
I
2013 Irrev Exempt Trust for Daughter
Common Stock
1591292
I
2013 Irrev Exempt Trust for Daughter
Common Stock
2015-10-26
4
J
0
21462
0
D
624337
I
2014 Irrev Exempt Trust for Son
Common Stock
2015-10-26
4
J
0
21462
0
D
624337
I
2014 Irrev Exempt Trust for Daughter
Common Stock
2015-10-26
4
J
0
201
0
D
624337
I
2014 Irrev Exempt Trust for Daughter
Common Stock
2015-10-26
4
J
0
201
0
D
624337
I
2014 Irrev Exempt Trust for Daughter
Common Stock
1073336
I
Philip Hagerman 2014 GRAT
Common Stock
1073336
I
Jocelyn Hagerman 2014 GRAT
Common Stock
357836
I
Jocelyn Hagerman Living Trust
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
Represents shares transferred from trusts established for the benefit of the reporting person's children to trusts established for the benefit of the reporting person in satisfaction of previously contracted debt between the applicable trusts.
On July 17, 2015, 201,664 shares held by the Philip Hagerman 2014 GRAT were transferred to the Philip R. Hagerman Revocable Trust.
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 the 2014 Irrevocable Exempt Trusts for two daughters, the Jocelyn Hagerman 2014 GRAT and the JH Marital Trust.
Amounts indirectly owned by these trusts have been adjusted to reflect shares transferred from trusts established for the benefit of the reporting person's children to trusts established for the benefit of the reporting person's spouse in satisfaction of previously contracted debt between the trusts. These transfers did not affect the reporting person's pecuniary interest in any shares, only the form of indirect ownership.
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, the Jocelyn Hagerman Living Trust and the PH Marital Trust.
Number of shares in this column reflects reported transactions. The number of shares in this column also reflects shares transferred from trusts established for the benefit of the reporting person's children to trusts established for the benefit of the reporting person's spouse in satisfaction of previously contracted debt between the trusts; these transfers did not affect the reporting person's pecuniary interest in any shares, only the form of indirect ownership.
On July 17, 2015, 201,664 shares held by the Jocelyn Hagerman 2014 GRAT were transferred to the Jocelyn Hagerman Living Trust.
Jeffrey H. Kuras, by Power of Attorney
2015-10-28