FORM 5 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP 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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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). | |||||||||||||||||
Form 3 Holdings Reported. | |||||||||||||||||
Form 4 Transactions Reported. |
1. Name and Address of Reporting Person*
(Street)
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2. Issuer Name and Ticker or Trading Symbol
UNITED FIRE GROUP INC [ UFCS ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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3. Statement for Issuer's Fiscal Year Ended
(Month/Day/Year) 12/31/2014 | ||||||||||||||||||||||||||
4. 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 Acquired, Disposed of, or Beneficially Owned | |||||||||||||||
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1. Title of Security (Instr. 3) | 2. Transaction Date (Month/Day/Year) | 2A. Deemed Execution Date, if any (Month/Day/Year) | 3. Transaction Code (Instr. 8) | 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) | 5. Amount of Securities Beneficially Owned at end of Issuer's Fiscal Year (Instr. 3 and 4) | 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 7. Nature of Indirect Beneficial Ownership (Instr. 4) | ||||||||
Amount | (A) or (D) | Price | |||||||||||||
Common Stock | 24,448(1) | D | |||||||||||||
Common Stock | 8,392(2) | I | See footnote #1 |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | ||||||||||||||
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1. Title of Derivative Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) | 6. Date Exercisable and Expiration Date (Month/Day/Year) | 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) | 8. Price of Derivative Security (Instr. 5) | 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) | 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) | |||
(A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | |||||||||
Phantom Stock | (3) | (3) | (3) | Common Stock | 2,042.0387 | 2,042.0387 | D | |||||||
Stock Option (right to buy) | $32.39 | (4) | 02/18/2015 | Common Stock | 20,000 | 20,000 | D | |||||||
Stock Option (right to buy) | $39.13 | (4) | 02/17/2016 | Common Stock | 20,000 | 20,000 | D | |||||||
Stock Option (right to buy) | $35.23 | (4) | 02/16/2017 | Common Stock | 20,000 | 20,000 | D | |||||||
Stock Option (right to buy) | $34.39 | (4) | 02/15/2018 | Common Stock | 3,000 | 3,000 | D | |||||||
Stock Option (right to buy) | $22.46 | (5) | 05/19/2020 | Common Stock | 2,727 | 2,727 | D | |||||||
Stock Option (right to buy) | $20.4 | (6) | 02/18/2021 | Common Stock | 2,727 | 2,727 | D | |||||||
Stock Option (right to buy) | $21.095 | (7) | 05/16/2022 | Common Stock | 2,145 | 2,145 | D | |||||||
Stock Option (right to buy) | $28.925 | (8) | 05/15/2023 | Common Stock | 1,755 | 1,755 | D |
Explanation of Responses: |
1. The number of shares (excluding fractionals) beneficially held directly by the Reporting Person includes: 22,160 shares held jointly by Mr. Rife and his wife, 1,002 shares held directly by Mr. Rife; and 1,286 shares of restricted stock issued to Mr. Rife under the Issuer's Non-Qualified Non-Employee Stock Option and Restricted Stock Plan which vest, subject to certain conditions, on May 21, 2017. |
2. The number of shares (excluding frationals) beneficially held indirectly by the Reporting Person includes: 6,591 shares held in an individual retirement account for Mr. Rife's benefit; 1,370 shares held individually by Mr. Rife's spouse; and 431 shares held in a SEP individual retirement account for Mr. Rife's benefit. |
3. Each share of phantom stock is the economic equivalent of one share of the Issuer's common stock. The shares of phantom stock become payable, in cash, in one lump sum or prorated over five years, at the election of the Reporting Person, upon the Reporting Person's termination of service as a director. |
4. All options currently exercisable. |
5. 2,182 options currently exercisable. Remaining options vest and become exercisable on 05/19/2015. |
6. 1,636 options currently exercisable. Remaining options become vested and exercisable in equal installments on 02/18/2015 and 02/18/2016, respectively. |
7. 858 options currently exercisable. Remaining options become vested and exercisable in equal installments on 05/16/2015, 05/16/2016 and 05/16/2017, respectively. |
8. 351 options currently exercisable. Remaining options become vested and exercisable in equal installments on 05/15/2015, 05/15/2016, 05/15/2017 and 05/15/2018, respectively. |
Remarks: |
/s/ John A. Rife by Michael T. Wilkins, Attorney-in-Fact | 02/13/2015 | |
** 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 4 (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. |