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) 04/01/2018 | 3. Issuer Name and Ticker or Trading Symbol James River Group Holdings, Ltd. [ JRVR ] | |||||||||||||
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 | 9,742(1) | D |
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 | ||||
Share Option (Right to Buy) | (2) | 12/11/2020 | Common Shares | 1,250 | 18.01 | D | |
Share Option (Right to Buy) | (3) | 12/12/2021 | Common Shares | 3,815 | 21 | D | |
Share Option (Right to Buy) | (4) | 02/16/2023 | Common Shares | 15,015 | 32.07 | D | |
Share Option (Right to Buy) | (5) | 02/14/2024 | Common Shares | 6,266 | 42.17 | D |
Explanation of Responses: |
1. These securities include 4,939 restricted share units. 4,117 of these restricted share units will vest in three equal annual installments on February 21 of each of the years of 2019, 2020 and 2021. 822 of these restricted share units will vest in two equal annual installments on February 14 of each of the years of 2019 and 2020. |
2. The share option became exercisable on December 11, 2017. |
3. The share option became exercisable on December 12, 2017. |
4. 3,003 of the share options became exercisable on February 16, 2017, 6,006 of the share options became exercisable on February 16, 2017 and 6,006 of the share options will become exercisable on February 16, 2019. |
5. The share option will become exercisable on February 14, of each of the years 2018, 2019 and 2020. |
Remarks: |
EXHIBIT LIST - Exhibit 24 - Power of Attorney for Daniel Heinlein |
/s/ Daniel Heinlein | 04/10/2018 | |
** 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. |