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*
Davis Seth Anthony

(Last) (First) (Middle)
9025 N. LINDBERGH DRIVE

(Street)
PEORIA IL 61615

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
07/01/2019
3. Issuer Name and Ticker or Trading Symbol
RLI CORP [ RLI ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Vice President, Controller
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)
Common Stock 4,077.1259 I RLI Corp. Executive Deferred Compensation Plan(1)
Common Stock 12,354.2393 I RLI Corp. Employee Stock Ownership Plan(2)
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
Stock Option 05/01/2015(3) 05/01/2022 Common Stock 9,000 $38.21(4) D
Stock Option 05/07/2016(3) 05/07/2023 Common Stock 9,000 $47.61(4) D
Stock Option 05/05/2017(3) 05/05/2024 Common Stock 6,000 $64.09 D
Stock Option 05/04/2018(3) 05/04/2025 Common Stock 9,000 $56.71 D
Stock Option 05/03/2019(3) 05/03/2026 Common Stock 7,000 $63.14 D
Stock Option 05/02/2020(3) 05/02/2027 Common Stock 6,000 $82.66 D
Restricted Stock Unit (5) (5) Common Stock 250 (6) D
Restricted Stock Unit (5) (5) Common Stock 250 (6) D
Restricted Stock Unit (5) (5) Common Stock 250 (6) D
Explanation of Responses:
1. Ownership reflects dividend reinvestment
2. Balance reflects annual company contributions and dividend reinvestment.
3. Pursuant to option schedule wherein 20% of the aggregate number of shares granted may be exercised commencing one year from grant date and each year thereafter in 20% increments.
4. Exercise price reflects prior adjustments as a result of special dividends.
5. These restricted stock units are scheduled to vest 100% on the third anniversary of the date of grant.
6. Upon vesting, each restricted stock unit represents the right to receive one share of common stock.
/s/ Seth Anthony Davis 07/05/2019
** 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.
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