0000814585-11-000017.txt : 20110505
0000814585-11-000017.hdr.sgml : 20110505
20110505180346
ACCESSION NUMBER: 0000814585-11-000017
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20110504
FILED AS OF DATE: 20110505
DATE AS OF CHANGE: 20110505
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: MBIA INC
CENTRAL INDEX KEY: 0000814585
STANDARD INDUSTRIAL CLASSIFICATION: SURETY INSURANCE [6351]
IRS NUMBER: 061185706
STATE OF INCORPORATION: CT
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 113 KING ST
CITY: ARMONK
STATE: NY
ZIP: 10504
BUSINESS PHONE: 914-273-4545
MAIL ADDRESS:
STREET 1: 113 KING ST
CITY: ARMONK
STATE: NY
ZIP: 10504
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: COULTER DAVID A
CENTRAL INDEX KEY: 0001179577
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-09583
FILM NUMBER: 11816104
MAIL ADDRESS:
STREET 1: 6855 PACIFIC STREET, AK-310
CITY: OMAHA
STATE: NE
ZIP: 68106
4
1
primary_doc.xml
PRIMARY DOCUMENT
X0303
4
2011-05-04
0
0000814585
MBIA INC
MBI
0001179577
COULTER DAVID A
C/O MBIA INC.
113 KING STREET
ARMONK
NY
10504
1
0
0
0
Common Stock
2011-05-04
4
A
0
10450
9.57
A
120147
D
Common Stock
71486898
I
see footnotes
Restricted stock granted on May 4, 2011 at a price of $9.57 per share subject to 10 year cliff vesting; no vesting until 10 year anniversary of grant. On May 4, 2021, entire grant of restricted stock vests.
Warburg Pincus Private Equity X, L.P., a Delaware limited partnership (together with an affiliated limited partnership, "WP X") is the holder of (a) 46,159,252 shares of Common Stock and (b) warrants exercisable for 25,327,646 shares of Common Stock.
Warburg Pincus X L.P., a Delaware limited partnership ("WP X LP") is the general partner of WP X; Warburg Pincus X LLC, a Delaware limited liability company ("WP X LLC") is the general partner of WP X LP; Warburg Pincus Partners, LLC, a New York limited liability company ("WP Partners") is the sole member of WP X LLC; and Warburg Pincus & Co., a New York general partnership ("WP") is the managing member of WP Partners. Warburg Pincus LLC, a New York limited liability company ("WP LLC") manages WP X. As a Partner of WP and a Member and Managing Director of WP LLC, Mr. David A. Coulter may be deemed to be the beneficial owner of the Common Stock held by WP X and the warrants exercisable for Common Stock held by WP X.
Pursuant to Rule 16a-1(a)(4) of the Securities Exchange Act of 1934, as amended, Mr. David A. Coulter, herein states that this filing shall not be deemed an admission that he is the beneficial owner of any of the shares of Common Stock held by WP X or of any of the warrants exercisable for Common Stock held by WP X. Mr. Coulter disclaims beneficial ownership of such Common Stock and such warrants exercisable for Common Stock, except to the extent of his pecuniary interest in such shares of Common Stock and in such warrants exercisable for Common Stock.
/s/Andrew Hughes, Attorney-in-Fact
2011-05-05