-----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, MqX63VkbHigxpfFf3557wAwEuFGRAo65OJ8uZFuDkszPGHXk8nauzjj0yzCDWfFx 3ycR8oG+RuJ+yEDsUp8gUA== 0000902561-00-000004.txt : 20000105 0000902561-00-000004.hdr.sgml : 20000105 ACCESSION NUMBER: 0000902561-00-000004 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 19991231 FILED AS OF DATE: 20000104 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: LASALLE RE HOLDINGS LTD CENTRAL INDEX KEY: 0001001384 STANDARD INDUSTRIAL CLASSIFICATION: FIRE, MARINE & CASUALTY INSURANCE [6331] IRS NUMBER: 000000000 FISCAL YEAR END: 0930 FILING VALUES: FORM TYPE: 4 SEC ACT: SEC FILE NUMBER: 001-12823 FILM NUMBER: 500779 BUSINESS ADDRESS: STREET 1: 25 CHURCH ST STREET 2: PO BOX HM 1502 CITY: HAMILTON HM FX BERMU STATE: D0 BUSINESS PHONE: 4412923339 MAIL ADDRESS: STREET 1: 25 CHURCH ST STREET 2: PO BOX HM 1502 CITY: HAMILTON HM FX STATE: D0 COMPANY DATA: COMPANY CONFORMED NAME: DWYER CLEMENT S JR CENTRAL INDEX KEY: 0001098817 STANDARD INDUSTRIAL CLASSIFICATION: [] DIRECTOR FILING VALUES: FORM TYPE: 4 BUSINESS ADDRESS: STREET 1: URSA ADVISORS LLC STREET 2: 4 INDIAN LN CITY: CALIFON STATE: NJ ZIP: 07830 BUSINESS PHONE: 9088321188 MAIL ADDRESS: STREET 1: URSA ADVISORS LLC STREET 2: 4 INDIAN LN CITY: CALIFON STATE: NJ ZIP: 07830 4 1 ------------------------------ OMB APPROVAL ------------------------------ OMB Number Expires: Estimated average burden hours per response ....... 0.5 ------------------------------ U.S. SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 FORM 4 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(f) of the Investment Company Act of 1940 [ ] Check box if no longer subject of Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). _______________________________________________________________________________ 1. Name and Address of Reporting Person* DWYER Clement S. - ------------------------------------------------------------------------------- (Last) (First) (Middle) 4 Indian Lane - ------------------------------------------------------------------------------- (Street) Califon NJ 07830 - ------------------------------------------------------------------------------- (City) (State) (Zip) _______________________________________________________________________________ 2. Issuer Name and Ticker or Trading Symbol LaSalle Re Holdings Limited (NYSE: LSH) _______________________________________________________________________________ 3. IRS Identification Number of Reporting Person, if an Entity (Voluntary) _______________________________________________________________________________ 4. Statement for Month/Year December 1999 _______________________________________________________________________________ 5. If Amendment, Date of Original (Month/Year) =============================================================================== 6. Relationship of Reporting Person to Issuer (Check all applicable) [x] Director [ ] 10% Owner [ ] Officer (give title below) [ ] Other (specify below) ---------------------------------------------------- _______________________________________________________________________________ 7. 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 Acquired, Disposed of, or Beneficially Owned ===============================================================================
6. 4. 5. Owner- Securities Acquired (A) or Amount of ship 3. Disposed of (D) Securities Form: 7. Transaction (Instr. 3, 4 and 5) Beneficially Direct Nature of 2. Code ------------------------------- Owned at End (D) or Indirect 1. Transaction (Instr. 8) (A) of Month Indirect Beneficial Title of Security Date ------------ Amount or Price (Instr. 3 (I) Ownership (Instr. 3) (mm/dd/yy) Code V (D) and 4) (Instr.4) (Instr. 4) - ----------------------------------------------------------------------------------------------------------------------------------- Common Shares 12/6/99 S (1) 3,500 D $12.50 7,800 D - ----------------------------------------------------------------------------------------------------------------------------------- Common Shares 9,500 I By spouse - ----------------------------------------------------------------------------------------------------------------------------------- Common Shares 800 (2) I By trusts - ----------------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------------- ===================================================================================================================================
* If the Form is filed by more than one Reporting Person, see Instruction 4(b)(v). Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. (Print or Type Responses) (Over) (Form 4-07/98) FORM 4 (continued) Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) ===============================================================================
10. 9. Owner- Number ship of Form 2. Deriv- of Conver- 5. 7. ative Deriv- 11. sion Number of Title and Amount Secur- ative Nature or Derivative 6. of Underlying 8. ities Secur- of Exer- 4. Securities Date Securities Price Bene- ity: In- cise 3. Trans- Acquired (A) Exercisable and (Instr. 3 and 4) of ficially Direct direct Price Trans- action or Disposed Expiration Date ---------------- Deriv- Owned (D) or Bene- 1. of action Code of(D) (Month/Day/Year) Amount ative at End In- ficial Title of Deriv- Date (Instr. (Instr. 3, ---------------- or Secur- of direct Owner- Derivative ative (Month/ 8) 4 and 5) Date Expira- Number ity Month (I) ship Security Secur- Day/ ------ ------------ Exer- tion of (Instr. (Instr. (Instr. (Instr. (Instr. 3) ity Year) Code V (A) (D) cisable Date Title Shares 5) 4) 4) 4) - ----------------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------------- =================================================================================================================================== Explanation of Responses: (1) Mr. Dwyer sold these common shares to another director of the Issuer in a privately negotiated transaction. (2) Certain trusts of which Mr. Dwyer is trustee own certain shares of the Issuer. As such, Mr. Dwyer may be deemed to have voting and investment power over such shares or to have a "pecuniary interest" in them as defined in Rule 16a-1(a)(2). However, Mr. Dwyer disclaims beneficial ownership of such shares.
/s/ Clement S. Dwyer, Jr. January 3, 2000 - -------------------------------------------- ----------------------- **Signature of Reporting Person Date ** 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 provided is insufficient, see Instruction 6 for procedure. Page 2 -----END PRIVACY-ENHANCED MESSAGE-----