SEC Form 4
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*
Golden Meryl S.

(Last) (First) (Middle)
15 JOYS LANE

(Street)
KINGSTON NY 12401

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
KINGSTONE COMPANIES, INC. [ KINS ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
X Officer (give title below) Other (specify below)
COO
3. Date of Earliest Transaction (Month/Day/Year)
10/31/2022
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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 10/31/2022 A 4,448(1) A $1.82 66,848(2) D
Common Stock 01/03/2023 A 101,111 A $0(3) 167,959(4) D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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
Stock Option $8.72 (5) 09/25/2024 Common Stock 50,000 50,000 D
Explanation of Responses:
1. The shares were acquired pursuant to the Company's Employee Stock Purchase Plan.
2. Includes 52,400 shares received pursuant to unvested restricted stock grants. Such shares vest to the extent of 800 shares on each of December 13, 2022, December 13, 2023 and December 13, 2024, 10,000 shares on each of January 3, 2023, January 3, 2024 and January 3, 2025 and 10,000 shares on each of January 4, 2023 and January 4, 2024.
3. Shares received pursuant to restricted stock grant. Vests in two nearly equal annual installments beginning January 3, 2024.
4. Includes 142,711 shares received pursuant to unvested restricted stock grants. Such shares vest to the extent of 10,000 shares on each of January 4, 2023 and January 4, 2024, 800 shares on each of December 13, 2023 and December 13, 2024, 50,556 shares on January 3, 2024, 50,555 shares on December 31, 2024, and 10,000 shares on each of January 3, 2024 and January 3, 2025.
5. The option is exercisable to the extent of 12,500 shares on each of September 25, 2019, September 25, 2020, September 25, 2021 and September 25, 2022.
/s/ Meryl S. Golden 01/25/2023
** 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.