0001127602-16-049797.txt : 20160425 0001127602-16-049797.hdr.sgml : 20160425 20160425104217 ACCESSION NUMBER: 0001127602-16-049797 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20160422 FILED AS OF DATE: 20160425 DATE AS OF CHANGE: 20160425 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: BORNEMAN J RALPH JR CENTRAL INDEX KEY: 0001145522 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-24000 FILM NUMBER: 161588147 MAIL ADDRESS: STREET 1: NATIONAL PENN BANCSHARES INC STREET 2: PHILADELPHIA & READING AVENUES CITY: BOYERTOWN STATE: PA ZIP: 19512 4 1 form4.xml PRIMARY DOCUMENT X0306 4 2016-04-22 0000922621 ERIE INDEMNITY CO ERIE 0001145522 BORNEMAN J RALPH JR 17 E. PHILADELPHIA AVENUE PO BOX 584 BOYERTOWN PA 19512 1 Class A Common Stock 50000 D Directors' Deferred Compensation Phantom Units 0 2016-04-22 4 J 0 101.216 93.62 A Class A Common Stock 101.216 13081.8311 D Conversion price is not applicable to shares granted under the Outside Directors' Deferred Compensation Plan. Acquired under dividend reinvestment for 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 2016-04-25