0001127602-18-003528.txt : 20180202 0001127602-18-003528.hdr.sgml : 20180202 20180202134219 ACCESSION NUMBER: 0001127602-18-003528 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20180201 FILED AS OF DATE: 20180202 DATE AS OF CHANGE: 20180202 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: 18569848 MAIL ADDRESS: STREET 1: 11810 BIG CANOE STREET 2: 575 RED FOX DRIVE CITY: BIG CANOE STATE: 2Q ZIP: 30143 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 4 1 form4.xml PRIMARY DOCUMENT X0306 4 2018-02-01 0000922621 ERIE INDEMNITY CO ERIE 0001177125 LILLY CLAUDE C III 3290 SALINGER WAY TALLAHASSEE FL 32311 1 Class A Common Stock 2018-02-01 4 J 0 0.0007 0 A 691.0185 I By IRA For Self Directors' Deferred Compensation Phantom Units 0 2018-02-01 4 J 0 120.598 118.76 A Class A Common Stock 120.598 14762.6801 D Directors' Deferred Compensation Phantom Units 0 2018-02-01 4 J 0 0.0061 0 D Class A Common Stock 0.0061 14762.674 D A de minimus adjustment of 0.0007 shares to correct rounding of fractional shares in order to reconcile to the filer's records. 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. A de minimus adjustment of 0.0061 shares to correct rounding of fractional shares in order to reconcile to the Directors' Deferred Compensation Plan records. Rebecca A. Buona, Power of Attorney 2018-02-02