0000814585-16-000046.txt : 20161201 0000814585-16-000046.hdr.sgml : 20161201 20161201160625 ACCESSION NUMBER: 0000814585-16-000046 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20161129 FILED AS OF DATE: 20161201 DATE AS OF CHANGE: 20161201 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: MBIA INC CENTRAL INDEX KEY: 0000814585 STANDARD INDUSTRIAL CLASSIFICATION: SURETY INSURANCE [6351] IRS NUMBER: 061185706 STATE OF INCORPORATION: CT FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1 MANHATTANVILLE ROAD STREET 2: SUITE 301 CITY: PURCHASE STATE: NY ZIP: 10577 BUSINESS PHONE: 914-273-4545 MAIL ADDRESS: STREET 1: 1 MANHATTANVILLE ROAD STREET 2: SUITE 301 CITY: PURCHASE STATE: NY ZIP: 10577 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Fallon William C CENTRAL INDEX KEY: 0001334233 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-09583 FILM NUMBER: 162028398 MAIL ADDRESS: STREET 1: C/O MBIA STREET 2: 113 KING STREET CITY: ARMONK STATE: NY ZIP: 10504 4 1 primary_doc.xml PRIMARY DOCUMENT X0306 4 2016-11-29 0 0000814585 MBIA INC MBI 0001334233 Fallon William C C/O MBIA 1 MANHATTANVILLE ROAD, SUITE 301 PURCHASE NY 10577 0 1 0 0 President & COO Common Stock 2016-11-29 4 M 0 200000 5.05 A 1240334 D Common Stock 2016-11-29 4 F 0 150676 10.29 D 1089658 D Common Stock 5.05 2016-11-29 4 M 0 200000 0 A 2016-11-29 2017-03-04 Common Stock 200000 0 D Represents shares acquired pursuant to Net Settlement Procedure for exercise of employee stock options. Balance reflects adjustment for retirement plan shares. Represents shares forfeited pursuant to Net Settlement Procedure for exercise of employee stock options. /S/ Ram D. Wertheim Attorney-in-Fact 2016-12-01