0000905729-19-000212.txt : 20191108 0000905729-19-000212.hdr.sgml : 20191108 20191108144144 ACCESSION NUMBER: 0000905729-19-000212 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20191106 FILED AS OF DATE: 20191108 DATE AS OF CHANGE: 20191108 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Clarkston Ventures, LLC CENTRAL INDEX KEY: 0001718951 STATE OF INCORPORATION: MI FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37536 FILM NUMBER: 191203644 BUSINESS ADDRESS: STREET 1: 81 WEST LONG LAKE ROAD CITY: BLOOMFIELD HILLS STATE: MI ZIP: 48304 BUSINESS PHONE: (248) 723-8000 MAIL ADDRESS: STREET 1: 91 WEST LONG LAKE ROAD CITY: BLOOMFIELD HILLS STATE: MI ZIP: 48304 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 ownership.xml X0306 4 2019-11-06 0 0001502292 Conifer Holdings, Inc. CNFR 0001718951 Clarkston Ventures, LLC 91 WEST LONG LAKE ROAD BLOOMFIELD HILLS MI 48304 0 0 1 0 Common Stock 2019-11-06 4 P 0 321782 4.50 A 2107425 D /s/ Jeffrey A. Hakala 2019-11-08