-----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, IzCC0Mfikwh75+vUwmHmP+KSUVjh/wNWUgLnFOLgj0MFTO3tPeRrRE3aMKS7JNaY 6tEw0HM1c+SpErdjD5MGQg== 0001209191-09-027008.txt : 20090515 0001209191-09-027008.hdr.sgml : 20090515 20090515175631 ACCESSION NUMBER: 0001209191-09-027008 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20090513 FILED AS OF DATE: 20090515 DATE AS OF CHANGE: 20090515 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Tyler William CENTRAL INDEX KEY: 0001382517 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-33077 FILM NUMBER: 09834868 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 X0303 4 2009-05-13 0 0000929186 FIRST MERCURY FINANCIAL CORP FMR 0001382517 Tyler William 29621 NORTHWESTERN HWY SOUTHFIELD MI 48034 1 0 0 0 Common Stock 2009-05-13 2009-05-13 4 A 0 2463 A 7085 D Common Stock 1000 I Held by investment trust Common Stock 500 I Held by LLC Common Stock 500 I Held by LLC Common Stock 500 I Held by LLC Common Stock 500 I Held by LLC Transaction represents the grant of restricted stock to the reporting person under the Company's Omnibus Plan. The shares vest immediately, but will not be transferable for one year after the date of grant. Includes 6,085 shares of restricted stock issued under the Company's Omnibus Plan (including 2,463 shares acquired under the Reported Transaction). Consists of shares held by investment trust, to which Mr. Tyler is trustee. Consists of shares held by the 1st of 4 LLCs holding shares for the benefit of the registrant's children. Consists of shares held by the 2nd of 4 LLCs holding shares for the benefit of the registrant's children. Consists of shares held by the 3rd of 4 LLCs holding shares for the benefit of the registrant's children. Consists of shares held by the 4th of 4 LLCs holding shares for the benefit of the registrant's children. /s/ John A. Marazza, as Attorney-in-Fact 2009-05-15 -----END PRIVACY-ENHANCED MESSAGE-----