0001127602-15-003716.txt : 20150202 0001127602-15-003716.hdr.sgml : 20150202 20150202161544 ACCESSION NUMBER: 0001127602-15-003716 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20150202 FILED AS OF DATE: 20150202 DATE AS OF CHANGE: 20150202 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: ERIE INDEMNITY CO CENTRAL INDEX KEY: 0000922621 STANDARD INDUSTRIAL CLASSIFICATION: INSURANCE AGENTS BROKERS & SERVICES [6411] IRS NUMBER: 250466020 STATE OF INCORPORATION: PA FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 100 ERIE INSURANCE PL CITY: ERIE STATE: PA ZIP: 16530 BUSINESS PHONE: 8148702000 MAIL ADDRESS: STREET 1: 100 ERIE INSURANCE PLACE CITY: ERIE STATE: PA ZIP: 16530 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: LILLY CLAUDE C III CENTRAL INDEX KEY: 0001177125 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-24000 FILM NUMBER: 15567133 MAIL ADDRESS: STREET 1: 512 S. BROAD STREET CITY: CLINTON STATE: SC ZIP: 29325 4 1 form4.xml PRIMARY DOCUMENT X0306 4 2015-02-02 0000922621 ERIE INDEMNITY CO ERIE 0001177125 LILLY CLAUDE C III 512 S. BROAD STREET CLINTON SC 29325 1 Class A Common Stock 637.8249 I By IRA For Self Directors' Deferred Compensation Phantom Units 0 2015-02-02 4 J 0 178.648 86.66 A Class A Common Stock 178.648 11762.1881 D Conversion price is not applicable to shares granted under the Outside Directors' Deferred Compensation Plan. Acquired under Directors' Deferred Compensation Plan The shares subject to this reporting are phantom Share Credits which are periodically credited to the accounts of certain Directors of Erie Indemnity Company pursuant to its Outside Directors Stock Plan. These Credit Shares are actually paid to the reporting individual in shares of Erie Indemnity Company Class A Common Stock when their service as a Director of Erie Indemnity Company ends. There is no exercisable date for these securities. The shares subject to this reporting are phantom Share Credits which are periodically credited to the accounts of certain Directors of Erie Indemnity Company pursuant to its Outside Directors Stock Plan. These Credit Shares are actually paid to the reporting individual in shares of Erie Indemnity Company Class A Common Stock when their service as a Director of Erie Indemnity Company ends. There is no expiration date for these securities. Chandra M. Burns, Power of Attorney 2015-02-02 EX-24 2 doc1.txt POWER OF ATTORNEY (PUBLIC): CLAUDELILLYPOA LIMITED POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS THAT I, CLAUDE C. LILLY III, hereby make, constitute and appoint CHANDRA M. BURNS, of ERIE INDEMNITY COMPANY, 100 Erie Insurance Place, Erie, Pennsylvania 16530, my agent, with full power and authority and in my name and stead to act for me in all matters concerning the preparation, execution, acknowledgment, delivery and filing of all reports required to be filed by me under Section 16(a) of the Securities Exchange Act of 1934, as fully as I could do personally, and in so acting for me in my name to prepare, execute, acknowledge, deliver and file all papers, forms and instruments and perform all acts and things necessary or convenient for and incidental to the exercise of such power and authority. I hereby ratify and confirm whatsoever my agent shall and may do by virtue hereof. This Power of Attorney shall continue in force and may be accepted and relied upon by any one to whom it is presented despite my purported revocation of it or my death, until actual written notice of such event is received by such person. In the event of my incapacity, from whatever cause, this Power of Attorney shall not thereby be revoked and shall not be affected by my disability or incapacity, and shall be accepted and relied upon by anyone to whom it is presented despite such incapacity, subject to it becoming void and of no further effect only upon receipt by such person either of written notice of the appointment of a guardian of my estate following adjudication of incapacity, or upon receipt of written notice of my death. It is intended that this Power of Attorney shall be in all respects construed according to and governed by the laws of the Commonwealth of Pennsylvania. /s/CLAUDE C. LILLY III