-----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, FpYLtKdZ6/RMGnbf5GUsR81kcbbRXGZv+GrJ+scilzYwUkh/LSgfmgJS7bigtb1p qyTzIouW/i+7L6QouZNaTQ== 0001209191-09-009101.txt : 20090213 0001209191-09-009101.hdr.sgml : 20090213 20090213172403 ACCESSION NUMBER: 0001209191-09-009101 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20081231 FILED AS OF DATE: 20090213 DATE AS OF CHANGE: 20090213 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Smith Richard H CENTRAL INDEX KEY: 0001378132 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 001-33077 FILM NUMBER: 09605448 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 5 1 doc5.xml FORM 5 SUBMISSION X0303 5 2008-12-31 0 0 0 0000929186 FIRST MERCURY FINANCIAL CORP FMR 0001378132 Smith Richard H 29621 NORTHWESTERN HWY SOUTHFIELD MI 48034 1 1 0 0 Chairman & CEO Option 17.00 2008-07-16 5 G 0 100000 D 2016-10-17 Common Stock 100000 0 D Option 20.75 2008-07-16 5 G 0 55188 D 2017-03-08 Common Stock 55188 0 D 66% (i.e., 66,000 shares) exercisable on Transaction Date with remaining 34% (34,000 shares) exercisable 10/17/2009. Security was gifted for no consideration. 33% (i.e., 18,212 shares) exercisable on Transaction Date with an additional 33% (18,212 shares) exercisable on 03/08/2009 and the final 34% (18,764 shares) exercisable on 03/08/2010. /s/ John A. Marazza, as Attorney-In-Fact 2009-02-13 -----END PRIVACY-ENHANCED MESSAGE-----