-----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, WoNgjXlYH4i/7JuDnmojNUHGtneWVmVxhXWdE1K58R6LZo8n4lvCfs8jlrQW3TUB mSvgzxPx9VWUy78uPClCMQ== 0001362310-09-002042.txt : 20090213 0001362310-09-002042.hdr.sgml : 20090213 20090213172612 ACCESSION NUMBER: 0001362310-09-002042 CONFORMED SUBMISSION TYPE: SC 13G/A PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20090213 DATE AS OF CHANGE: 20090213 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: Shaw Jerome M CENTRAL INDEX KEY: 0001378133 FILING VALUES: FORM TYPE: SC 13G/A BUSINESS ADDRESS: BUSINESS PHONE: 800-762-6837 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: 09605486 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 c81122sc13gza.htm SCHEDULE 13G/A Filed by Bowne Pure Compliance
     
 
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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

SCHEDULE 13G

Under the Securities Exchange Act of 1934
(Amendment No. 2)*

FIRST MERCURY FINANCIAL CORPORATION
(Name of Issuer)
Common Stock
(Title of Class of Securities)
320841 10 9
(CUSIP Number)
December 31, 2008
(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)

     þ 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   2,004,559
       
SHARES 6   SHARED VOTING POWER
BENEFICIALLY    
OWNED BY   None
       
EACH 7   SOLE DISPOSITIVE POWER
REPORTING    
PERSON   2,004,559
       
WITH: 8   SHARED DISPOSITIVE POWER
     
    None
     
9   AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
   
  2,004,559
     
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)
   
  11.1%based on Common Stock outstanding as of September 30, 2008.
     
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) 2,000,937 shares of common stock held by the Jerome M. Shaw Revocable Trust, which is controlled by Mr. Shaw, and (ii) 3,622 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 11, 2009
  By:    
 
        
 
  By:   /s/ Jerome M. Shaw
 
  Name:   Jerome M. Shaw
 
  Title:    

 

 

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