0001301106-16-000215.txt : 20161114 0001301106-16-000215.hdr.sgml : 20161111 20161114184213 ACCESSION NUMBER: 0001301106-16-000215 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20161110 FILED AS OF DATE: 20161114 DATE AS OF CHANGE: 20161114 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: National Interstate CORP CENTRAL INDEX KEY: 0001301106 STANDARD INDUSTRIAL CLASSIFICATION: FIRE, MARINE & CASUALTY INSURANCE [6331] IRS NUMBER: 341607394 STATE OF INCORPORATION: OH FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 3250 INTERSTATE DRIVE CITY: RICHFIELD STATE: OH ZIP: 44286 BUSINESS PHONE: (330) 659-8900 MAIL ADDRESS: STREET 1: 3250 INTERSTATE DRIVE CITY: RICHFIELD STATE: OH ZIP: 44286 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Michelson David W CENTRAL INDEX KEY: 0001306400 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-51130 FILM NUMBER: 161997224 MAIL ADDRESS: STREET 1: 3250 INTERSTATE DRIVE CITY: RICHFIELD STATE: OH ZIP: 44286 4 1 wf-form4_147916691552483.xml FORM 4 X0306 4 2016-11-10 1 0001301106 National Interstate CORP NATL 0001306400 Michelson David W 3250 INTERSTATE DRIVE RICHFIELD OH 44286 1 0 0 0 Common Shares ($0.01 par value) 2016-11-10 4 D 0 12000 32 D 0 D Common Shares ($.01 par value) 2016-11-10 4 D 0 195542 32 D 0 D Represents Restricted Shares. Disposed of pursuant to the Agreement and Plan of Merger, dated as of July 25, 2016, by and among Great American Insurance Company, GAIC Alloy, Inc., and National Interstate Corporation (the "Company"), as amended by Amendment No. 1, dated as of August 15, 2016 (the "Agreement and Plan of Merger"). Pursuant to the Agreement and Plan of Merger, effective as of November 10, 2016, these shares, whether vested or unvested, were automatically cancelled and converted into the the right to receive $32.00 per share in cash, less any required withholding taxes. In addition, the Company declared a special cash dividend of $0.50 per common share payable to shareholders of record immediately prior to the effective time of the merger. Disposed of pursuant to the Agreement and Plan of Merger, effective as of November 10, 2016, the Company's common shares were automatically cancelled and converted into the right to receive $32 per share in cash. In addition, the Company declared a special dividend of $0.50 per common share payable to shareholders of record immediately prior to the effective time of the merger. /s/ David W. Michelson 2016-11-14