-----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, Mz7ZvA7FkDRhJ6qX0RK93RCVUbS0l10oWKCHy7IWFuYn5zhEV3e2p9WWyC/NzG65 8Own7qXf/VC6wF+j3tCtKQ== 0001177103-05-000051.txt : 20050202 0001177103-05-000051.hdr.sgml : 20050202 20050202120918 ACCESSION NUMBER: 0001177103-05-000051 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20050201 FILED AS OF DATE: 20050202 DATE AS OF CHANGE: 20050202 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: 05568148 MAIL ADDRESS: STREET 1: 9201 UNIVERSITY CITY BLVD. CITY: CHARLOTTE STATE: NC ZIP: 28223 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 lil578.xml X0202 4 2005-02-01 0 0000922621 ERIE INDEMNITY CO ERIE 0001177125 LILLY CLAUDE C III UNIVERSITY OF NORTH CAROLINA, CHARLOTTE 9201 UNIVERSITY CITY BLVD. CHARLOTTE NC 28223 1 0 0 0 Class A Common Stock 800.0000 D Directors' Deferred Compensation Phantom Units 2005-02-01 4 J 0 134.149 0 A Class A Common Stock 134.1490 1695.9431 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. By: Linda A. Etter, Power of Attorney 2005-02-02 -----END PRIVACY-ENHANCED MESSAGE-----