-----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, WuEPGlajE1VGLJbMsfisfVOLJrZpt2BnSmUBfroLxz+BwYZMXDB4/6tL1U9kl08E qkXpWLoH7oxz3rn1yRfYNw== 0001179110-04-013544.txt : 20040622 0001179110-04-013544.hdr.sgml : 20040622 20040622174257 ACCESSION NUMBER: 0001179110-04-013544 CONFORMED SUBMISSION TYPE: 4/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040616 FILED AS OF DATE: 20040622 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: FOGLER WILLIAM V R CENTRAL INDEX KEY: 0001241272 FILING VALUES: FORM TYPE: 4/A SEC ACT: 1934 Act SEC FILE NUMBER: 000-25425 FILM NUMBER: 04875634 MAIL ADDRESS: STREET 1: 10 HIGHWAY 31 STREET 2: PO BOX 278 CITY: PENNINGTON STATE: NJ ZIP: 08534 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: MERCER INSURANCE GROUP INC CENTRAL INDEX KEY: 0001050690 STANDARD INDUSTRIAL CLASSIFICATION: FIRE, MARINE & CASUALTY INSURANCE [6331] IRS NUMBER: 232939601 STATE OF INCORPORATION: PA FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 10 NORTH HIGHWAY ONE CITY: PENNINGTON STATE: NJ ZIP: 08534 BUSINESS PHONE: 6097370426 MAIL ADDRESS: STREET 1: 10 N HWY 1 CITY: PENNINGTON STATE: NJ ZIP: 08534 4/A 1 edgar.xml FORM 4/A - X0202 4/A 2004-06-16 2004-06-18 0 0001050690 MERCER INSURANCE GROUP INC MIGP 0001241272 FOGLER WILLIAM V R 10 NORTH HIGHWAY 31 PENNINGTON NJ 08534 1 0 0 0 Restricted Stock Award 12.21 2004-06-16 4 A 0 9375 12.21 A 2009-06-16 Common Stock 9375 9375 D Stock Option (right to buy) 12.21 2004-06-16 4 A 0 27400 12.21 A 2007-06-16 Common Stock 27400 36775 D The award vests over a five year period. The option vests in three annual installments beginning on June 16, 2004. This amendment is being filed solely to include the correct amount of derivative securities beneficially owned. Andrew R. Speaker, by Power of Attorney 2004-06-18 -----END PRIVACY-ENHANCED MESSAGE-----