-----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, AtghOysEfBvus0AKHZUdTmp+mVX8Dd5QncyflQnIQLkz3mPD+lUgiLY8aTBUq9rW 2opxSmeQzqkpwSWBdMDGgQ== 0000913355-98-000065.txt : 19980709 0000913355-98-000065.hdr.sgml : 19980709 ACCESSION NUMBER: 0000913355-98-000065 CONFORMED SUBMISSION TYPE: SC 13D PUBLIC DOCUMENT COUNT: 2 FILED AS OF DATE: 19980708 SROS: NYSE SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: NYMAGIC INC CENTRAL INDEX KEY: 0000847431 STANDARD INDUSTRIAL CLASSIFICATION: SURETY INSURANCE [6351] IRS NUMBER: 133534162 STATE OF INCORPORATION: NY FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13D SEC ACT: SEC FILE NUMBER: 005-43571 FILM NUMBER: 98661792 BUSINESS ADDRESS: STREET 1: 330 MADISON AVE CITY: NEW YORK STATE: NY ZIP: 10017 BUSINESS PHONE: 2125510600 MAIL ADDRESS: STREET 1: 330 MADISON AVE CITY: NEW YORK STATE: NY ZIP: 10017 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: TOLLEFSON LOUISE B CENTRAL INDEX KEY: 0001065048 STANDARD INDUSTRIAL CLASSIFICATION: [] IRS NUMBER: 243209191 FILING VALUES: FORM TYPE: SC 13D BUSINESS ADDRESS: STREET 1: 18665 S E VILLAGE CIRCLE CITY: TEQUESTA STATE: FL ZIP: 33469 MAIL ADDRESS: STREET 1: 18665 S E VILLAGE CIRCLE CITY: TEQUESTA STATE: FL ZIP: 33469 SC 13D 1 SCHEDULE 13D WITH ATTACHED EXHIBIT UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington D.C. 20549 SCHEDULE 13D Under the Securities Exchange Act of 1934 NYMAGIC, INC. ------------- (Name of Issuer) Common Stock, $1.00 Par Value ----------------------------- (Title of Class of Securities) 629484 10 6 ----------- (CUSIP Number) Robert G. Simses Cummings & Lockwood 140 Royal Palm Way, Suite 205 Palm Beach, FL 33480 (561) 659-1250 -------------- (Name, Address and Telephone Number of Person Authorized to Receive Notices and Communications) June 16, 1998 ------------- (Date of Event which Requires Filing of this Statement) If the filing person has previously filed a statement on Schedule 13G to report the acquisition which is the subject of this Schedule 13D, and is filing this Schedule because of Rule 13d-1(b)(3) or (4), check the following box. [ ] Page 1 of 7 pages - -------------------------------------------------------------------------------- CUSIP NO. 629484 10 6 Page 2 of 7 Pages - -------------------------------------------------------------------------------- 1 NAME OF REPORTING PERSON I.R.S. IDENTIFICATION NOS. OF ABOVE PERSONS (ENTITIES ONLY) Louise B. Tollefson Revocable Trust dated 12/23/97 - ------------ ------------------------------------------------------------------- 2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (See Instructions) (a) [_] (b) [_] - ------------ ------------------------------------------------------------------- 3 SEC USE ONLY - ------------ ------------------------------------------------------------------- 4 SOURCE OF FUNDS (See Instructions) OO - ------------ ------------------------------------------------------------------- 5 CHECK BOX IF DISCLOSURE OF LEGAL PROCEEDINGS IS REQUIRED PURSUANT TO ITEMS 2(D) OR 2(E) [_] - ------------ ------------------------------------------------------------------- 6 CITIZENSHIP OR PLACE OF ORGANIZATION Florida - ------------------------- -------- --------------------------------------------- 7 SOLE VOTING POWER 1,814,611 NUMBER OF SHARES 8 SHARED VOTING POWER BENEFICIALLY 0 OWNED BY EACH 9 SOLE DISPOSITIVE POWER REPORTING 1,814,611 PERSON WITH 10 SHARED DISPOSITIVE POWER 0 - ------------ ------------------------------------------------------------------- 11 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 1,814,611 - ------------ ------------------------------------------------------------------- 12 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES CERTAIN SHARES (See Instructions) [_] - ------------ ------------------------------------------------------------------- 13 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (11) 18.8% - ------------ ------------------------------------------------------------------- 14 TYPE OF REPORTING PERSON (See Instructions) OO - ------------ ------------------------------------------------------------------- - -------------------------------------------------------------------------------- CUSIP NO. 629484 10 6 Page 3 of 7 Pages - -------------------------------------------------------------------------------- 1 NAME OF REPORTING PERSON I.R.S. IDENTIFICATION NOS. OF ABOVE PERSONS (ENTITIES ONLY) Louise B. Tollefson - ------------ ------------------------------------------------------------------- 2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (See Instructions) (a) [_] - ------------ ------------------------------------------------------------------- 3 SEC USE ONLY - ------------ ------------------------------------------------------------------- 4 SOURCE OF FUNDS (See Instructions) OO - ------------ ------------------------------------------------------------------- 5 CHECK BOX IF DISCLOSURE OF LEGAL PROCEEDINGS IS REQUIRED PURSUANT TO ITEMS 2(d) OR 2(e) [_] - ------------ ------------------------------------------------------------------- 6 CITIZENSHIP OR PLACE OF ORGANIZATION United States - ------------------------- -------- --------------------------------------------- 7 SOLE VOTING POWER 1,818,117 NUMBER OF SHARES 8 SHARED VOTING POWER BENEFICIALLY 0 OWNED BY EACH 9 SOLE DISPOSITIVE POWER REPORTING 1,818,117 PERSON WITH 10 SHARED DISPOSITIVE POWER 0 - ------------ ------------------------------------------------------------------- 11 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 1,818,117 - ------------ ------------------------------------------------------------------- 12 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES CERTAIN SHARES (See Instructions) [_] - ------------ ------------------------------------------------------------------- 13 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (11) 18.8% - ------------ ------------------------------------------------------------------- 14 TYPE OF REPORTING PERSON (See Instructions) IN - ------------ ------------------------------------------------------------------- Page 4 of 7 Pages INTRODUCTION This Schedule is being filed in order to report the transfer of an aggregate of 1,814,611 shares of common stock, $1.00 par value (the "Common Stock"), of NYMAGIC, Inc., a New York corporation (the "Issuer"), from the Louise B. Tollefson Florida Intangible Tax Trust u/a 12/23/97 (the "FIT Trust") to the Louise B. Tollefson Revocable Trust dated 12/23/97 (the "Revocable Trust"). Louise B. Tollefson ("Tollefson") is a beneficiary of the FIT Trust and is both the sole Trustee and a beneficiary of the Revocable Trust. ITEM 1. SECURITY AND ISSUER. The class of equity securities to which this Schedule relates is the Issuer's Common Stock, $1.00 par value. The Issuer is NYMAGIC, Inc., a New York corporation, and its principal executive offices are located at 330 Madison Avenue, New York, New York 10017. ITEM 2. IDENTITY AND BACKGROUND This Schedule is being filed by the Revocable Trust and by Tollefson in her capacity as a direct owner of shares of Common Stock and as both the sole Trustee and a beneficiary of the Revocable Trust. The principal business address for the Revocable Trust is c/o Cummings & Lockwood, 140 Royal Palm Way, Suite 205, Palm Beach, Florida 33480. Tollefson is retired and her residence is located at 18665 S.E. Village Circle, Tequesta, Florida 33469. During the last five years, neither the Revocable Trust nor Tollefson has been convicted in a criminal proceeding (excluding traffic violations or similar misdemeanors) nor been the subject of a judgment, decree or final order enjoining future violations of, or prohibiting or mandating activities subject to, federal or state securities laws or finding any violation with respect to such laws. ITEM 3. SOURCE AND AMOUNT OF FUNDS OR OTHER CONSIDERATION The transactions which require the filing of this Schedule were transfers which were effected without consideration. On June 16, 1998 and June 19, 1998, the FIT Trust effected transfers of an aggregate of 1,814,611 shares of Common Stock to the Revocable Trust. Page 5 of 7 Pages ITEM 4. PURPOSE OF TRANSACTION The purpose of the transfers of 1,814,611 shares of Common Stock from the FIT Trust to the Revocable Trust was to implement certain aspects of Tollefson's estate and tax planning. Neither the Revocable Trust nor Tollefson currently has any plan or proposal which would result in any of the consequences listed in paragraphs (a) - - (j) of Item 4 of Schedule 13D. If any such plan or proposal were decided upon by the Revocable Trust or Tollefson, an appropriate amendment to this Schedule 13D would be prepared and filed promptly. ITEM 5. INTEREST IN SECURITIES OF THE ISSUER (a) and (b) Set forth in the table below are the number and percentage of shares of Common Stock of the Issuer beneficially owned by each of the Revocable Trust and Tollefson as of the date hereof:
Number of Shares Number of Shares Beneficially Owned Beneficially Owned Aggregate Number Percentage of With Sole Voting and With Shared Voting and of Shares Shares Name Dispositive Power Dispositive Power Beneficially Owned Beneficially Owned - ---------------------------------------------------------------------------------------------------------------------- Louise B. Tollefson Revocable Trust dated 12/23/97 1,814,611 0 1,814,611 18.8% Louise B. Tollefson 1,818,117 0 1,818,117 18.8%
(c) On June 16, 1998, 1,788,806 shares of Common Stock were transferred from the FIT Trust to the Revocable Trust. On June 19, 1998, 25,805 shares of Common Stock were transferred from the FIT Trust to the Revocable Trust. No consideration was given for these transfers. (d) None. (e) Not applicable ITEM 6. CONTRACTS, ARRANGEMENTS, UNDERSTANDINGS OR RELATIONSHIPS WITH RESPECT TO SECURITIES OF THE ISSUER None. ITEM 7. MATERIAL TO BE FILED AS EXHIBITS Exhibit Number Description - ------ ----------- 1 Agreement, dated as of June 30, 1998, between the Revocable Trust and Tollefson relating to the filing of a joint Schedule 13D. Page 6 of 7 Pages SIGNATURES 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: June 30, 1998 LOUISE B. TOLLEFSON REVOCABLE TRUST DATED 12/23/97 By: /s/ Louise B. Tollefson --------------------------------- Louise B. Tollefson Trustee /s/ Louise B. Tollefson --------------------------------- Louise B. Tollefson Page 7 of 7 Pages EXHIBIT INDEX ------------- Exhibit Number Description - ------ ----------- 1 Agreement, dated as of June 30, 1998, between the Revocable Trust and Tollefson relating to the filing of a joint Schedule 13D. EX-1 2 AGREEMENT EXHIBIT 1 AGREEMENT --------- This Agreement is made as of the 30th day of June, 1998 between the Louise B. Tollefson Revocable Trust dated 12/23/1997 (the "Trust") and Louise B. Tollefson ("Tollefson"). The Parties hereto hereby agree that a single, joint statement containing the information required by Schedule 13D under the Securities Exchange Act of 1934 with respect to the beneficial ownership of shares of Common Stock of NYMAGIC, Inc., a New York corporation, may be filed with the Securities and Exchange Commission on behalf of each of the Trust and Tollefson. IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of the date first written above. LOUISE B. TOLLEFSON REVOCABLE TRUST DATED 12/23/97 By: /s/ Louise B. Tollefson --------------------------------- Louise B. Tollefson Trustee /s/ Louise B. Tollefson --------------------------------- Louise B. Tollefson -----END PRIVACY-ENHANCED MESSAGE-----