SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person*
Crusinberry Jeffrey

(Last) (First) (Middle)
15303 VENTURA BLVD.
SUITE 1600

(Street)
SHERMAN OAKS CA 91403

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
05/08/2012
3. Issuer Name and Ticker or Trading Symbol
SIGNATURE GROUP HOLDINGS, INC. [ SGGH ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Sr. V.P. and Treasurer
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
SGGH Common Stock(1) 11,002 D
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Options(2) 05/08/2012 05/08/2017 SGGH Common Stock 25,000 $0.3 D
Options(2) 01/01/2013 01/01/2018 SGGH Common Stock 25,000 $0.3 D
Options(2) 01/01/2014 01/01/2018 SGGH Common Stock 25,000 $0.3 D
Options(2) 01/01/2015 01/01/2020 SGGH Common Stock 25,000 $0.3 D
Explanation of Responses:
1. On May 18, 2012, Mr. Crusinberry purchased 1,002 shares at $0.35 per share and on May 21, 2012 he purchased through his individual retirement account 10,000 shares at $0.34 per share.
2. As a result of 2011 performance awards, Mr. Crusinberry received 100,000 options that vest in four equal installments, with the first tranche vesting immediately and the remaining tranches vesting on January 1, 2013, January 1, 2014 and January 1, 2015 respectively. The award expires May 8, 2020 if unexercised.
Remarks:
Jeffrey Crusinberry 05/22/2012
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.