-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, Madm/kMWbX7UmkNwDdm7CP7RuF4iFZQcAOVcfx19spuavkA/Nd6TRA3jCFiaKcMm 5DkO5XUkL88l9a8qfcywSA== 0001177103-04-000182.txt : 20040923 0001177103-04-000182.hdr.sgml : 20040923 20040923122540 ACCESSION NUMBER: 0001177103-04-000182 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040920 FILED AS OF DATE: 20040923 DATE AS OF CHANGE: 20040923 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: COONEY WILSON CHARLES CENTRAL INDEX KEY: 0001230670 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-24000 FILM NUMBER: 041042321 BUSINESS ADDRESS: STREET 1: 29350 GRAND COTEAU CITY: FAIR OAKS RANCH STATE: TX ZIP: 78015 BUSINESS PHONE: 830 981 8581 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 coo474.xml X0202 4 2004-09-20 0 0000922621 ERIE INDEMNITY CO ERIE 0001230670 COONEY WILSON CHARLES 29350 GRAND COTEAU FAIR OAKS RANCH TX 78015 1 0 0 0 Class A Common Stock 2004-09-20 4 P 0 148 49.4000 A 1148.0000 D Directors' Deferred Compensation Phantom Units 0.0000 Class A Common Stock 821.3180 821.3180 D Inadvertently failed to file Form 4 in a timely manner. 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. By: Linda A. Etter, Power of Attorney 2004-09-23 -----END PRIVACY-ENHANCED MESSAGE-----