0001209191-20-016781.txt : 20200305 0001209191-20-016781.hdr.sgml : 20200305 20200305192145 ACCESSION NUMBER: 0001209191-20-016781 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20200303 FILED AS OF DATE: 20200305 DATE AS OF CHANGE: 20200305 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: del Amo Mojica Jose CENTRAL INDEX KEY: 0001699407 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-33865 FILM NUMBER: 20692210 MAIL ADDRESS: STREET 1: 1441 F.D. ROOSEVELT AVE., 6TH FLOOR CITY: SAN JUAN STATE: PR ZIP: 00936 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: TRIPLE-S MANAGEMENT CORP CENTRAL INDEX KEY: 0001171662 STANDARD INDUSTRIAL CLASSIFICATION: ACCIDENT & HEALTH INSURANCE [6321] IRS NUMBER: 660555678 STATE OF INCORPORATION: PR FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1441 F.D. ROOSEVELT AVE. CITY: SAN JUAN STATE: PR ZIP: 00920 BUSINESS PHONE: 7877494949 MAIL ADDRESS: STREET 1: 1441 F.D. ROOSEVELT AVE. CITY: SAN JUAN STATE: PR ZIP: 00920 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2020-03-03 0 0001171662 TRIPLE-S MANAGEMENT CORP GTS 0001699407 del Amo Mojica Jose 1441 F.D. ROOSEVELT AVE., 6TH FLOOR SAN JUAN PR 00936 PUERTO RICO 0 1 0 0 President, TSP and TIA Class B Common Stock 2020-03-03 4 A 0 5619 0.00 A 23842 D Class B Common Stock 2020-03-03 4 A 0 15650 0.00 A 39492 D Shares acquired represent grant of restricted stock that will vest in equal installments on each of March 3, 2021, 2022 and 2023. The amount of securities beneficially owned reported in Column 5 includes 885 Class B Common Stock shares received by the reporting person pursuant to a share dividend issued by Triple-S Management Corporation ("TSM") to all Class B Common Stock shareholders on August 6, 2019. Shares acquired represent common stock earned pursuant to a grant of Performance Shares on March 7, 2017. The Performance Shares resulting in the issuance of these shares of common stock did not constitute derivative securities. As a result, such Performance Shares were not required to be reported and were not reported on a Form 4 at the time of the award. /s/ Manuel Rodriguez-Boissen, Attorney-in-fact 2020-03-05