FORM 4 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). |
1. Name and Address of Reporting Person*
(Street)
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2. Issuer Name and Ticker or Trading Symbol
Heritage Insurance Holdings, Inc. [ HRTG ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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3. Date of Earliest Transaction
(Month/Day/Year) 02/13/2023 | ||||||||||||||||||||||||||
4. If Amendment, Date of Original Filed
(Month/Day/Year) |
6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | ||||||||||
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1. Title of Security (Instr. 3) | 2. Transaction Date (Month/Day/Year) | 2A. Deemed Execution Date, if any (Month/Day/Year) | 3. Transaction Code (Instr. 8) | 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) | 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) | 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 7. Nature of Indirect Beneficial Ownership (Instr. 4) | |||
Code | V | Amount | (A) or (D) | Price | ||||||
COMMON STOCK | 02/13/2023 | P | 202,460 | A | $1.96(1) | 2,811,115(2) | D | |||
COMMON STOCK | 100,000(3) | D | ||||||||
COMMON STOCK | 50,000(4) | D | ||||||||
COMMON STOCK | 22,000(5) | D | ||||||||
COMMON STOCK | 460,000(6) | I | see footnote | |||||||
COMMON STOCK | 120,000(7) | I | see footnote |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||||||||||
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1. Title of Derivative Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) | 6. Date Exercisable and Expiration Date (Month/Day/Year) | 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) | 8. Price of Derivative Security (Instr. 5) | 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) | 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) | ||||
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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Explanation of Responses: |
1. The price reported in column 4 is a weighted average price. The shares were purchased in multiple transactions at prices ranging from $1.93 to $2.00, inclusive. The reporting person undertakes to provide to the issuer, any security holder of the issuer, or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the ranges set forth in this footnote. |
2. These securities are owned solely by Raymond T. Hyer, who is a member of a group with the other Reporting Persons for purposes of Section 13(d) of the Exchange Act. |
3. These securities are owned solely by Kathleen Hyer. Raymond T. Hyer may be deemed to have a pecuniary interest in these securities. |
4. These securities are owned solely by Tara Tira. |
5. These securities are owned solely by Sean W. Poole. |
6. These securities are held of record by Futura Circuits Corp., which is 100% owned by Raymond T. Hyer. |
7. These securities are held of record by Hyer Family Partnership, LLC, which is approx. 29% owned by Raymond T. Hyer, with the remainder owned by other individuals, including Tara Tira and Sean W. Poole. Each disclaims beneficial ownership except to the extent of their pecuniary interest in these securities. |
/s/ Raymond T. Hyer | 02/15/2023 | |
/s/ Kathleen A. Hyer, by Raymond T. Hyer as attorney-in fact | 02/15/2023 | |
/s/ Tara K. Tira, by Raymond T. Hyer as attorney-in fact | 02/15/2023 | |
/s/ Sean W. Poole, by Raymond T. Hyer as attorney-in fact | 02/15/2023 | |
/s/ Raymond T. Hyer (P of Futura Circuits | 02/15/2023 | |
/s/ Sean Poole, (Mgr of HFP), by Raymond T. Hyer as attorney-in fact | 02/15/2023 | |
** Signature of Reporting Person | Date | |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | ||
* If the form is filed by more than one reporting person, see Instruction 4 (b)(v). | ||
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). | ||
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. | ||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |