-----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, IPTkac0Sfh8ficRBgXYT+L0pOI6mHQcKL5PhMI5Jushu9G9SPQpxxxDW5OX3bjKM NNSAPdnSrnfF+svQCMP/sQ== 0001179110-08-001101.txt : 20080114 0001179110-08-001101.hdr.sgml : 20080114 20080114170109 ACCESSION NUMBER: 0001179110-08-001101 CONFORMED SUBMISSION TYPE: 3/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20061017 FILED AS OF DATE: 20080114 DATE AS OF CHANGE: 20080114 ISSUER: 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 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 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Shaw Jerome M CENTRAL INDEX KEY: 0001378133 FILING VALUES: FORM TYPE: 3/A SEC ACT: 1934 Act SEC FILE NUMBER: 001-33077 FILM NUMBER: 08529079 BUSINESS ADDRESS: BUSINESS PHONE: 800-762-6837 MAIL ADDRESS: STREET 1: 29621 NORTHWESTERN HIGHWAY CITY: SOUTHFIELD STATE: MI ZIP: 48034 3/A 1 edgar.xml FORM 3/A - X0202 3/A 2006-10-17 2006-10-17 0 0000929186 FIRST MERCURY FINANCIAL CORP FMR 0001378133 Shaw Jerome M 29110 INKSTER ROAD, SUITE 100 SOUTHFIELD MI 48034 1 0 1 0 Common Stock 2610954 I By trust Common Stock 555879 I See footnote Stock Option (right to buy) 1.66 2008-07-15 Common Stock 52540 D Stock Option (right to buy) 1.78 2008-07-15 Common Stock 48840 D Stock Option (right to buy) 1.90 2008-07-15 Common Stock 45880 D Stock Option (right to buy) 2.14 2008-07-15 Common Stock 40700 D As of October 17, 2006, the date of Mr. Shaw's initial Form 3 filing with respect to First Mercury Corporation, Mr. Shaw owned 53.2% of the membership interests in 4SFW, L.L.C., which as of October 17, 2006 owned 1,044,887 shares of First Mercury Financial Corporation's common stock. Mr. Shaw disclaims any beneficial ownership in these shares, except to the extent of his pecuniary interest therein. All options fully vested and exercisable as of October 17, 2006. /s/ Eric Orsic, as Attorney-In-Fact 2008-01-14 -----END PRIVACY-ENHANCED MESSAGE-----