0001596771-15-000081.txt : 20151208 0001596771-15-000081.hdr.sgml : 20151208 20151208081314 ACCESSION NUMBER: 0001596771-15-000081 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20151207 FILED AS OF DATE: 20151208 DATE AS OF CHANGE: 20151208 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: 151274078 MAIL ADDRESS: STREET 1: 4100 S. SAGINAW STREET CITY: FLINT STATE: MI ZIP: 48507 4 1 primary_doc.xml PRIMARY DOCUMENT X0306 4 2015-12-07 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 1462145 I Philip R. Hagerman Revocable Trust Common Stock 3891609 I 2007 Hagerman Family GST Common Stock 4450091 I The JH GST Trust Common Stock 2015-12-07 4 S 0 230000 33.6 D 1550876 I 2013 Irrev Exempt Trust for Daughter Common Stock 2015-12-07 4 S 0 230000 33.6 D 1550876 I 2013 Irrev Exempt Trust for Son Common Stock 2015-12-07 4 S 0 376000 33.6 D 1215293 I 2013 Irrev Exempt Trust for Daughter Common Stock 2015-12-07 4 S 0 220000 33.6 D 1371292 I 2013 Irrev Exempt Trust for Daughter Common Stock 2015-12-07 4 S 0 311000 33.6 D 313337 I 2014 Irrev Exempt Trust for Son Common Stock 2015-12-07 4 S 0 311000 33.6 D 313337 I 2014 Irrev Exempt Trust for Daughter Common Stock 2015-12-07 4 S 0 311000 33.6 D 313337 I 2014 Irrev Exempt Trust for Daughter Common Stock 2015-12-07 4 S 0 311000 33.6 D 313337 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 Irrev Trust for Son Common Stock 394910 I Irrev 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, the Jocelyn Hagerman Living Trust and the PH Marital Trust. Jeffrey H. Kuras, by Power of Attorney 2015-12-08