-----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, DbzYxHnocFIuLIlvKvjptwkdnyBpAJ1ibFSRvUzLOHq8Ep732ro4g52n9+tRQDzK MQ7tdQfABm3qdRgStDUHkw== 0000914760-10-000023.txt : 20100216 0000914760-10-000023.hdr.sgml : 20100215 20100216170931 ACCESSION NUMBER: 0000914760-10-000023 CONFORMED SUBMISSION TYPE: SC 13G/A PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20100216 DATE AS OF CHANGE: 20100216 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: Shaw Jerome M CENTRAL INDEX KEY: 0001378133 FILING VALUES: FORM TYPE: SC 13G/A MAIL ADDRESS: STREET 1: 29621 NORTHWESTERN HIGHWAY CITY: SOUTHFIELD STATE: MI ZIP: 48034 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: FIRST MERCURY FINANCIAL CORP CENTRAL INDEX KEY: 0000929186 STANDARD INDUSTRIAL CLASSIFICATION: FIRE, MARINE & CASUALTY INSURANCE [6331] IRS NUMBER: 383164336 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G/A SEC ACT: 1934 Act SEC FILE NUMBER: 005-82499 FILM NUMBER: 10609470 BUSINESS ADDRESS: STREET 1: 29621 NORTHWESTERN HWY STREET 2: PO BOX 5096 CITY: SOUTHFIELD STATE: MI ZIP: 48034 BUSINESS PHONE: 8103584010 MAIL ADDRESS: STREET 1: 29621 NORTHWESTERN HGWY STREET 2: PO BOX 5096 CITY: SOUTHFIELD STATE: MI ZIP: 48086 SC 13G/A 1 f73847_13ga3.htm AMENDMENT NO. 3

 

 

UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

SCHEDULE 13G

Under the Securities Exchange Act of 1934

(Amendment No. 3)*

FIRST MERCURY FINANCIAL CORPORATION

(Name of Issuer)

Common Stock

(Title of Class of Securities)

320841 10 9

(CUSIP Number)

December 31, 2009

(Date of Event Which Requires Filing of this Statement)

Check the appropriate box to designate the rule pursuant to which this Schedule is filed:

 

o Rule 13d-1(b)

 

o Rule 13d-1(c)

 

x Rule 13d-1(d)

* The remainder of this cover page shall be filled out for a reporting person’s initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter the disclosures provided in a prior cover page.

The information required in the remainder of this cover page shall not be deemed to be “filed” for the purpose of Section 18 of the Securities Exchange Act of 1934 (“Act”) or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act (however, see the Notes).

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CUSIP No.

 

320841 10 9

 

 

 

 

 

 

 

 

 

  

 

 

 

 

 

1

 

NAMES OF REPORTING PERSONS
Jerome Shaw

 

 

 

 

 

 

2

 

CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (SEE INSTRUCTIONS)

 

(a)   o

 

(b)   o

 

 

 

3

 

SEC USE ONLY

 

 

 

 

 

 

 

4

 

CITIZENSHIP OR PLACE OF ORGANIZATION

 

 

 

USA

 

 

 

 

 

5

 

SOLE VOTING POWER

 

 

 

NUMBER OF

 

1,935,222

 

 

 

 

SHARES

6

 

SHARED VOTING POWER

BENEFICIALLY

 

 

OWNED BY

 

None

 

 

 

 

EACH

7

 

SOLE DISPOSITIVE POWER

REPORTING

 

 

PERSON

 

1,935,222

 

 

 

 

WITH:

8

 

SHARED DISPOSITIVE POWER

 

 

 

 

 

None

 

 

 

9

 

AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON

 

 

 

1,935,222

 

 

 

10

 

CHECK IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES (SEE INSTRUCTIONS)

 

 

 

o

 

 

 

11

 

PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9)

 

 

 

11.3% based on Common Stock outstanding as of November 6, 2009.

 

 

 

12

 

TYPE OF REPORTING PERSON (SEE INSTRUCTIONS)

 

 

 

IN

 

 

 

SCHEDULE 13G/A

 

 

 

Item 1(a)

 

Name of Issuer.

First Mercury Financial Corporation

 

 

 

Item 1(b)

 

Address of Issuer’s Principal Executive Offices.

29110 Inkster Road, Southfield, MI 48034

 

 

 

Item 2(a)

 

Name of Person Filing.

Jerome Shaw

 

 

 

Item 2(b)

 

Address of Principal Business Office.

29110 Inkster Road, Southfield, MI 48034

 

 

 

Item 2(c)

 

Citizenship.

U.S.A.

 

 

 

Item 2(d)

 

Title of Class of Securities.

Common Stock

 

 

 

Item 2(e)

 

CUSIP Number.

320841 10 9

 

 

 

 

 

Item 3

 

Reporting Person.

Not Applicable

 

 

 

Item 4

 

Ownership.

See cover page. Shares consist of (i) 1,929,137 shares of common stock held by the Jerome M. Shaw Revocable Trust, which is controlled by Mr. Shaw, and (ii) 6,085 shares of common stock held directly by Mr. Shaw.

 

 

 

Item 5

 

Ownership of Five Percent or Less of a Class.

Not Applicable

 

 

 

Item 6

 

Ownership of More Than Five Percent on Behalf of Another Person.

Not Applicable

 

 

 

Item 7

 

Identification and Classification of the Subsidiary which Acquired the Security Being Reported On by the Parent Holding Company.

Not Applicable

 

 

 

Item 8

 

Identification and Classification of Members of the Group.

Not Applicable

 

 

 

Item 9

 

Notice of Dissolution of Group.

Not Applicable

 

 

 

Item 10

 

Certifications.

Not Applicable

 

 

 

 

SIGNATURE

After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct.

 

 

 

 

 

Date: February 16, 2010

 

 

 

 

 

 

 

 

 

 

 

By:

 

/s/ Jerome M. Shaw

 

 

Name:

 

Jerome M. Shaw

 

 

 

 

 

 

 

 

 

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