-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, WkpNUhLRH6x/GiQogQwhYbt+Y1Fi2uL2sSHB8wxuJRj0EEtBE5OMnMtFy784Zhuo jYnjlKPDpIhxKHHv2BzKCQ== 0000914760-07-000024.txt : 20070214 0000914760-07-000024.hdr.sgml : 20070214 20070214151544 ACCESSION NUMBER: 0000914760-07-000024 CONFORMED SUBMISSION TYPE: SC 13G PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20070214 DATE AS OF CHANGE: 20070214 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: Shaw Jerome M CENTRAL INDEX KEY: 0001378133 FILING VALUES: FORM TYPE: SC 13G BUSINESS ADDRESS: BUSINESS PHONE: 800-762-6837 MAIL ADDRESS: STREET 1: 29621 NORTHWESTERN HIGHWAY CITY: SOUTHFIELD STATE: MI ZIP: 48034 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: FIRST MERCURY FINANCIAL CORP CENTRAL INDEX KEY: 0000929186 STANDARD INDUSTRIAL CLASSIFICATION: FIRE, MARINE & CASUALTY INSURANCE [6331] IRS NUMBER: 383164336 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G SEC ACT: 1934 Act SEC FILE NUMBER: 005-82499 FILM NUMBER: 07619243 BUSINESS ADDRESS: STREET 1: 29621 NORTHWESTERN HWY STREET 2: PO BOX 5096 CITY: SOUTHFIELD STATE: MI ZIP: 48034 BUSINESS PHONE: 8103584010 MAIL ADDRESS: STREET 1: 29621 NORTHWESTERN HGWY STREET 2: PO BOX 5096 CITY: SOUTHFIELD STATE: MI ZIP: 48086 SC 13G 1 f73847_shaw13g.htm DECEMBER 31, 2006

UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

 

SCHEDULE 13G

 

Under the Securities Exchange Act of 1934

 

 

FIRST MERCURY FINANCIAL CORPORATION

(Name of Issuer)

 

Common Stock

(Title of Class of Securities)

 

320841 10 9

(CUSIP Number)

 

December 31, 2006

(Date of Event which Requires Filing of this Statement)

 

Check the appropriate box to designate the rule pursuant to which this Schedule is filed:

 

 

[

]Rule 13d-1(b)

 

[

]Rule 13d-1(c)

 

[ X ]Rule 13d-1(d)

 

 

* The remainder of this cover page shall be filled out for a reporting person's initial filing on this form with respect to the subject class of securities and for any subsequent amendment containing information which would alter the disclosures provided in a prior cover page.

 

The information required in the remainder of this cover page shall not be deemed to be "filed" for the purpose of Section 18 of the Securities Exchange Act of 1934 ("Act") or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act.

 


CUSIP No. 320841 10 9  Schedule 13G

 

 

1.

NAME OF REPORTING PERSON

IRS. IDENTIFICATION NUMBER. OF ABOVE PERSON (ENTITIES ONLY)

 

Jerome Shaw

 

 

 

2.

CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP

 

(a)         [ ]

(b)         [ ]

 

 

3.

SEC USE ONLY

 

 

 

4.

CITIZENSHIP OR PLACE OF ORGANIZATION

 

USA

 

 

 

NUMBER OF SHARES BENEFICIALLY OWNED BY EACH REPORTING PERSON WITH:

 

 

 

 

5.

SOLE VOTING POWER

 

3,843,801

 

 

6.

SHARED VOTING POWER

 

None

 

 

7.

SOLE DISPOSITIVE POWER

 

3,843,801

 

 

 

8.

SHARED DISPOSITIVE POWER

 

None

 

 

9.

AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON

 

3,843,801

 

 

10.

CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES CERTAIN SHARES                                                                                              [ ]

 

 

 

11.

PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9)

 

22.2% based on 17,306,780 shares of Common Stock outstanding as of November 14, 2006.

 

 

12.

TYPE OF REPORTING PERSON

 

IN

 

 

 


CUSIP No. 320841 10 9

Schedule 13G

 

Item 1.

 

(a)

Name of Issuer:

 

 

First Mercury Financial Corporation

 

 

(b)

Address of Issuer’s Principal Executive Offices:

 

 

29621 Northwestern Highway, Southfield, Michigan 48034

 

Item 2.

 

(a)

Name of person filing:

 

 

Jerome Shaw

 

 

(b)

Address of principal business office or, if none, residence:

 

29621 Northwestern Highway, Southfield, Michigan 48034

 

 

(c)

Citizenship:

U.S.A.

 

 

(d)

Title of Class of Securities:

Common Stock

 

 

(e)

CUSIP Number:

320841 10 9

 

Item 3.

If this statement is filed pursuant to sections 240.13d-1(b), or 240.13d-2(b) or (c), check whether the person filing is a:

 

 

Not applicable.

 

Item 4.

Ownership.

 

See cover page. Shares consist of (i) 2,610,954 shares of the common stock held by The Jerome Shaw 2005 Intangibles Trust, which is controlled by Mr. Shaw, (ii) options to purchase 187,960 shares of common stock which are exercisable within 60 days of December 31, 2006 and (iii) 1,044,887 shares of common stock held by 4SFW, L.L.C., with respect to which Mr. Shaw may be deemed to be the beneficial owner of these shares by virtue of his owning a majority of the membership interests in 4SFW, L.L.C. Mr. Shaw disclaims any beneficial ownership in these shares, except to the extent of his pecuniary interest therein.

 

Items 5 - 10.

 

 

Not applicable.

 

If this statement is being filed to report the fact that as of the date hereof the reporting person has ceased to be the beneficial owner of more than 5 percent of the class of securities, check the following: [ ]

 

 


SIGNATURE

 

After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct.

 

 

Dated as of February 14, 2007.

 

 

 

/s/ Jerome Shaw

Jerome Shaw

 

 

 

-----END PRIVACY-ENHANCED MESSAGE-----