-----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, Re/ecHd5UkhhCxYAGUNzRcFbeXh7fc+5nCZ5yVrg2CK58dA7sN39oWufolgi8Iem TSo9fFrCdkNxIv5+hSJnxQ== 0001209191-08-007304.txt : 20080204 0001209191-08-007304.hdr.sgml : 20080204 20080204152941 ACCESSION NUMBER: 0001209191-08-007304 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20080131 FILED AS OF DATE: 20080204 DATE AS OF CHANGE: 20080204 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Shaw Jerome M CENTRAL INDEX KEY: 0001378133 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-33077 FILM NUMBER: 08572151 BUSINESS ADDRESS: BUSINESS PHONE: 800-762-6837 MAIL ADDRESS: STREET 1: 29621 NORTHWESTERN HIGHWAY CITY: SOUTHFIELD STATE: MI ZIP: 48034 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 4 1 doc4.xml FORM 4 SUBMISSION X0202 4 2008-01-31 0 0000929186 FIRST MERCURY FINANCIAL CORP FMR 0001378133 Shaw Jerome M 29621 NORTHWESTERN HWY SOUTHFIELD MI 48034 1 0 1 0 Common Stock 2008-01-31 4 M 0 52540 1.66 A 1919108 I By trust Common Stock 2008-01-31 4 M 0 48840 1.78 A 1967948 I By trust Common Stock 2008-01-31 4 M 0 45880 1.90 A 2013828 I By trust Common Stock 2008-01-31 4 M 0 40700 2.14 A 2054528 I By trust Common Stock 1890 D Stock Option (right to buy) 1.66 2008-01-31 4 M 0 52540 0.00 D 2006-10-17 2008-07-15 Common Stock 52540 0 D Stock Option (right to buy) 1.78 2008-01-31 4 M 0 48840 0.00 D 2006-10-17 2008-07-15 Common Stock 48840 0 D Stock Option (right to buy) 1.90 2008-01-31 4 M 0 45880 0.00 D 2006-10-17 2008-07-15 Common Stock 45880 0 D Stock Option (right to buy) 2.14 2008-01-31 4 M 0 40700 0.00 D 2006-10-17 2008-07-15 Common Stock 40700 0 D Consists of shares held by the Jerome M. Shaw Revocable Trust, which is controlled by Mr. Shaw. Consists of restricted stock issued under the Company's Omnibus Plan. Options became fully vested and exercisable on October 17, 2006 in connection with First Mercury Financial Corporation's initial public offering. /s/ John A. Marazza, as Attorney-In-Fact 2008-02-01 -----END PRIVACY-ENHANCED MESSAGE-----