-----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, UIL71q1M8Ilp29dOS0v+UAMo77/Lmlt3KxiPLfK7/ncB/7Om/jhX3ICk6kT4OkJ3 YUQgfhQIQI2FVABIRy04Gg== 0001209191-10-059302.txt : 20101209 0001209191-10-059302.hdr.sgml : 20101209 20101209132021 ACCESSION NUMBER: 0001209191-10-059302 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20101208 FILED AS OF DATE: 20101209 DATE AS OF CHANGE: 20101209 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: WALTER MATTHEW D CENTRAL INDEX KEY: 0001183442 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-08738 FILM NUMBER: 101241818 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: BANCINSURANCE CORP CENTRAL INDEX KEY: 0000276400 STANDARD INDUSTRIAL CLASSIFICATION: FIRE, MARINE & CASUALTY INSURANCE [6331] IRS NUMBER: 310790882 STATE OF INCORPORATION: OH FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 250 EAST BROAD STREET STREET 2: 7TH FLOOR CITY: COLUMBUS STATE: OH ZIP: 43215 BUSINESS PHONE: 614-220-5200 MAIL ADDRESS: STREET 1: 250 EAST BROAD STREET STREET 2: 7TH FLOOR CITY: COLUMBUS STATE: OH ZIP: 43215 4 1 doc4.xml FORM 4 SUBMISSION X0303 4 2010-12-08 1 0000276400 BANCINSURANCE CORP BCIS 0001183442 WALTER MATTHEW D 330 W. SPRING STREET SUITE 400 COLUMBUS OH 43215 1 0 0 0 Common Shares 282411 I By Fenist, LLC Common Shares 2010-12-09 4 J 0 282411 D 0 I By Fenist, LLC Option to Purchase Common Shares 4.82 2010-12-08 4 D 0 2000 3.68 D 2002-05-31 2011-05-30 Common Shares 2000 0 D Option to Purchase Common Shares 5.30 2010-12-08 4 D 0 2000 3.20 D 2003-06-04 2012-06-03 Common Shares 2000 0 D Option to Purchase Common Shares 6.00 2010-12-08 4 D 0 2000 2.50 D 2004-06-03 2013-06-02 Common Shares 2000 0 D Option to Purchase Common Shares 6.00 2010-12-08 4 D 0 2000 2.50 D 2007-07-19 2016-07-18 Common Shares 2000 0 D Option to Purchase Common Shares 6.40 2010-12-08 4 D 0 2000 2.10 D 2008-05-30 2017-05-29 Common Shares 2000 0 D Option to Purchase Common Shares 4.75 2010-12-08 4 D 0 2000 3.75 D 2009-07-31 2018-07-30 Common Shares 2000 0 D Option to Purchase Common Shares 3.40 2010-12-08 4 D 0 2000 5.10 D 2010-07-27 2019-07-26 Common Shares 2000 0 D In connection with the merger of Fenist Acquistion Sub, Inc. ("Merger Sub") with and into the Issuer (the "Merger"), the Reporting Person contributed these shares of the Issuer's common stock to Fenist, LLC ("Parent") in exchange for equity interests in Parent. This contribution did not alter the Reporting Person's ultimate pecuniary interest in the common stock of the Issuer. In connection with the Merger, all shares of the Issuer's common stock held by Parent were cancelled and ceased to exist. In connection with the Merger, all outstanding options to purchase common stock of the Issuer were cancelled. The Issuer paid holders of the options an amount per share equal to the excess, if any, of (a) $8.50 over (b) the exercise price of such options. Matthew D. Walter /s/ Matthew C. Nolan, as Attorney-in-Fact 2010-12-09 -----END PRIVACY-ENHANCED MESSAGE-----