0001339147-17-000002.txt : 20171002
0001339147-17-000002.hdr.sgml : 20171002
20171002165807
ACCESSION NUMBER: 0001339147-17-000002
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20170929
FILED AS OF DATE: 20171002
DATE AS OF CHANGE: 20171002
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: MELOCHE HAROLD J
CENTRAL INDEX KEY: 0001339147
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37536
FILM NUMBER: 171115131
MAIL ADDRESS:
STREET 1: 28819 FRANKLIN ROAD
CITY: SOUTHFIELD
STATE: MI
ZIP: 48034
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Conifer Holdings, Inc.
CENTRAL INDEX KEY: 0001502292
STANDARD INDUSTRIAL CLASSIFICATION: FIRE, MARINE & CASUALTY INSURANCE [6331]
IRS NUMBER: 271298795
STATE OF INCORPORATION: MI
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 550 WEST MERRILL STREET
STREET 2: SUITE 200
CITY: BIRMINGHAM
STATE: MI
ZIP: 48009
BUSINESS PHONE: (248) 559-0840
MAIL ADDRESS:
STREET 1: 550 WEST MERRILL STREET
STREET 2: SUITE 200
CITY: BIRMINGHAM
STATE: MI
ZIP: 48009
4
1
wf-form4_150697787415531.xml
FORM 4
X0306
4
2017-09-29
0
0001502292
Conifer Holdings, Inc.
CNFR
0001339147
MELOCHE HAROLD J
550 W. MERRILL STREET
SUITE 200
BIRMINGHAM
MI
48009
0
1
0
0
CFO, Treasurer
Common Stock
2017-09-29
4
P
0
4000
6.25
A
45448
D
Brian J. Roney, by Power of Attorney
2017-10-02