SEC Form 3
FORM 3 | UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
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1. Name and Address of Reporting Person*
(Street)
| 2. Date of Event Requiring Statement (Month/Day/Year) 07/06/2017 | 3. Issuer Name and Ticker or Trading Symbol Allied World Assurance Co Holdings, AG [ AWH ] | |||||||||||||
4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
| 5. If Amendment, Date of Original Filed (Month/Day/Year) | ||||||||||||||
6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Beneficially Owned | |||
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1. Title of Security (Instr. 4) | 2. Amount of Securities Beneficially Owned (Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 4. Nature of Indirect Beneficial Ownership (Instr. 5) |
Common Shares | 82,845,778(1) | I | See Footnote(2) |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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1. Title of Derivative Security (Instr. 4) | 2. Date Exercisable and Expiration Date (Month/Day/Year) | 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 6. Nature of Indirect Beneficial Ownership (Instr. 5) | ||
Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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Explanation of Responses: |
1. Acquired pursuant to the exchange offer effected pursuant to the Agreement and Plan of Merger, dated December 18, 2016, between Fairfax Financial Holdings Limited ("FFHL") and the Issuer, and the tender offer statement on Schedule TO, filed May 8, 2017, as amended. |
2. Held by a wholly-owned subsidiary of Fairfax Financial Holdings (Switzerland) GmbH ("FFH Switzerland"). FFH Switzerland is a limited liability company organized under the laws of Switzerland, and an indirect subsidiary of FFHL. V. Prem Watsa is the CEO and controlling person of FFHL through the other Reporting Persons other than FFH Switzerland. Each of the Reporting Persons disclaims beneficial ownership of the common shares reported herein for purposes of Rule 16a-1(a) under the Securities Exchange Act of 1934, as amended (the "Exchange Act"), except to the extent of its or his pecuniary interest therein, if any. This report shall not be deemed an admission that any of the Reporting Persons is a beneficial owner for the purpose of Section 16 of the Exchange Act, or for any other purpose. |
/s/ Paul Rivett, President, on behalf of Fairfax Financial Holdings Limited | 07/12/2017 | |
/s/ V. Prem Watsa | 07/12/2017 | |
/s/ V. Prem Watsa, President, on behalf of 1109519 Ontario Limited | 07/12/2017 | |
/s/ V. Prem Watsa, President, on behalf of The Sixty Two Investment Company Limited | 07/12/2017 | |
/s/ V. Prem Watsa, President, on behalf of 810679 Ontario Limited | 07/12/2017 | |
/s/ Ronald Schokking, Director, on behalf of Fairfax Financial Holdings (Switzerland) GmbH | 07/12/2017 | |
** Signature of Reporting Person | Date | |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | ||
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v). | ||
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). | ||
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. | ||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |