0001140361-13-027403.txt : 20130703
0001140361-13-027403.hdr.sgml : 20130703
20130703164336
ACCESSION NUMBER: 0001140361-13-027403
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20130701
FILED AS OF DATE: 20130703
DATE AS OF CHANGE: 20130703
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: 13953408
MAIL ADDRESS:
STREET 1: C/O WARBURG PINCUS LLC
STREET 2: 450 LEXINGTON AVENUE
CITY: NEW YORK
STATE: NY
ZIP: 10017
4
1
doc1.xml
FORM 4
X0306
4
2013-07-01
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
2013-07-01
4
A
0
2282
13.58
A
172013
D
Common Stock
72078643
I
See footnotes
Shares acquired in payment of director retainer and meeting fees.
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 25,919,391 shares of Common Stock. Warrant balance reflects anti-dilution adjustment. See note 6.
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; 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; and Messrs. Charles R. Kaye and Joseph P. Landy, each a Managing General Partner of WP and Managing Member and Co-President of WP LLC, who may be deemed to control the Warburg Pincus entities.
Pursuant to Rule 16a-1(a)(4) of the Securities Exchange Act of 1934, as amended, (the "Act") each of WP X LP, WP X LLC, WP Partners, WP, WP LLC, and Messrs. Kaye and Landy disclaims beneficial ownership of the Common Stock and the warrants exercisable for Common Stock, except to the extent of its or his pecuniary interest in such shares of Common Stock or such warrants exercisable for Common Stock.
Pursuant to Rule 16a-1(a)(4) of the Act, 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.
MBIA Inc.'s issuance of warrants to Blue Ridge Investment, L.L.C., which was consummated on May 6, 2013, triggered certain anti-dilution adjustments under the terms of WP X's previously reported warrants that were previously exercisable for 25,327,646 shares of Common Stock. This anti-dilution adjustment is being voluntarily reported; no transaction has taken place with respect to these warrants.
/s/ Andrew Hughes, Attorney-in-Fact
2013-07-03