0001474590-17-000010.txt : 20170214
0001474590-17-000010.hdr.sgml : 20170214
20170214164421
ACCESSION NUMBER: 0001474590-17-000010
CONFORMED SUBMISSION TYPE: SC 13G/A
PUBLIC DOCUMENT COUNT: 2
FILED AS OF DATE: 20170214
DATE AS OF CHANGE: 20170214
SUBJECT COMPANY:
COMPANY DATA:
COMPANY CONFORMED NAME: UNITED FIRE GROUP INC
CENTRAL INDEX KEY: 0000101199
STANDARD INDUSTRIAL CLASSIFICATION: FIRE, MARINE & CASUALTY INSURANCE [6331]
IRS NUMBER: 452302834
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: SC 13G/A
SEC ACT: 1934 Act
SEC FILE NUMBER: 005-03291
FILM NUMBER: 17609748
BUSINESS ADDRESS:
STREET 1: 118 SECOND AVE SE
CITY: CEDAR RAPIDS
STATE: IA
ZIP: 52401
BUSINESS PHONE: 3193995700
MAIL ADDRESS:
STREET 1: P O BOX 73909
CITY: CEDAR RAPIDS
STATE: IA
ZIP: 52407
FORMER COMPANY:
FORMER CONFORMED NAME: UNITED FIRE GROUP, INC.
DATE OF NAME CHANGE: 20120202
FORMER COMPANY:
FORMER CONFORMED NAME: UNITED FIRE & CASUALTY CO
DATE OF NAME CHANGE: 19920703
FILED BY:
COMPANY DATA:
COMPANY CONFORMED NAME: McIntyre Dee Ann
CENTRAL INDEX KEY: 0001474590
FILING VALUES:
FORM TYPE: SC 13G/A
MAIL ADDRESS:
STREET 1: 2007 FIRST AVENUE SE
CITY: CEDAR RAPIDS
STATE: IA
ZIP: 52406-2804
SC 13G/A
1
document-2.htm
OMB APPROVAL
OMB Number: 3235-0145
Expires: February 28, 2009
Estimated average burden hours per response. . . . . . . . 10.4
UNITED STATES
SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549
SCHEDULE 13G
Under the Securities Exchange Act of 1934 (Amendment No. )*
(Name of Issuer)
OMB APPROVAL
OMB Number: 3235-0145
Expires: February 28, 2009
Estimated average burden hours per response. . . . . . . . 10.4
(Title of Class of Securities)
(CUSIP Number)
(Date of Event Which Requires Filing of this Statement) Check the appropriate box to designate the rule pursuant to which this Schedule is filed:
Rule 13d-1(b)
Rule 13d-1(c) Rule 13d-1(d)
*The remainder of this cover page shall be filled out for a reporting persons initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter the disclosures provided in a prior cover page.
The information required in the remainder of this cover page shall not be deemed to be filed for the purpose of Section 18 of the Securities Exchange Act of 1934 (Act) or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act (however, see the Notes).
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number.
SEC 1745 (3-06)
Page 1 of 6 pages
CUSIP No. .......................................
1. Names of Reporting Persons.
I.R.S. Identification Nos. of above persons (entities only).
................................................................................................................................................................................................
2. Check the Appropriate Box if a Member of a Group (See Instructions)
(a) ............................................................................................................................................................................ (b) ............................................................................................................................................................................
3. SEC Use Only ...........................................................................................................................................................
4. Citizenship or Place of Organization .........................................................................................................................
Number of 5. Sole Voting Power ................................................................................................................................... Shares Bene-
ficially by 6. Shared Voting Power .............................................................................................................................. Owned by Each
Reporting 7. Sole Dispositive Power............................................................................................................................. Person With:
8. Shared Dispositive Power ........................................................................................................................
9. Aggregate Amount Beneficially Owned by Each Reporting Person.............................................................................
10. Check if the Aggregate Amount in Row (9) Excludes Certain Shares (See Instructions)...........................................
11. Percent of Class Represented by Amount in Row (9) ...............................................................................................
12. Type of Reporting Person (See Instructions)
.........................................................................................................................................................................................
.........................................................................................................................................................................................
.........................................................................................................................................................................................
.........................................................................................................................................................................................
.........................................................................................................................................................................................
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Page 2 of 6 pages
CUSIP No. .......................................
1. Names of Reporting Persons.
I.R.S. Identification Nos. of above persons (entities only).
................................................................................................................................................................................................
2. Check the Appropriate Box if a Member of a Group (See Instructions)
(a) ............................................................................................................................................................................ (b) ............................................................................................................................................................................
3. SEC Use Only ...........................................................................................................................................................
4. Citizenship or Place of Organization .........................................................................................................................
Number of 5. Sole Voting Power ................................................................................................................................... Shares Bene-
ficially by 6. Shared Voting Power .............................................................................................................................. Owned by Each
Reporting 7. Sole Dispositive Power............................................................................................................................. Person With:
8. Shared Dispositive Power ........................................................................................................................
9. Aggregate Amount Beneficially Owned by Each Reporting Person.............................................................................
10. Check if the Aggregate Amount in Row (9) Excludes Certain Shares (See Instructions)...........................................
11. Percent of Class Represented by Amount in Row (9) ...............................................................................................
12. Type of Reporting Person (See Instructions)
.........................................................................................................................................................................................
.........................................................................................................................................................................................
.........................................................................................................................................................................................
.........................................................................................................................................................................................
.........................................................................................................................................................................................
.........................................................................................................................................................................................
CUSIP No. .......................................
1. Names of Reporting Persons.
I.R.S. Identification Nos. of above persons (entities only).
................................................................................................................................................................................................
2. Check the Appropriate Box if a Member of a Group (See Instructions)
(a) ............................................................................................................................................................................ (b) ............................................................................................................................................................................
3. SEC Use Only ...........................................................................................................................................................
4. Citizenship or Place of Organization .........................................................................................................................
Number of 5. Sole Voting Power ................................................................................................................................... Shares Bene-
ficially by 6. Shared Voting Power .............................................................................................................................. Owned by Each
Reporting 7. Sole Dispositive Power............................................................................................................................. Person With:
8. Shared Dispositive Power ........................................................................................................................
9. Aggregate Amount Beneficially Owned by Each Reporting Person.............................................................................
10. Check if the Aggregate Amount in Row (9) Excludes Certain Shares (See Instructions)...........................................
11. Percent of Class Represented by Amount in Row (9) ...............................................................................................
12. Type of Reporting Person (See Instructions)
.........................................................................................................................................................................................
.........................................................................................................................................................................................
.........................................................................................................................................................................................
.........................................................................................................................................................................................
.........................................................................................................................................................................................
.........................................................................................................................................................................................
CUSIP No. .......................................
1. Names of Reporting Persons.
I.R.S. Identification Nos. of above persons (entities only).
................................................................................................................................................................................................
2. Check the Appropriate Box if a Member of a Group (See Instructions)
(a) ............................................................................................................................................................................ (b) ............................................................................................................................................................................
3. SEC Use Only ...........................................................................................................................................................
4. Citizenship or Place of Organization .........................................................................................................................
Number of 5. Sole Voting Power ................................................................................................................................... Shares Bene-
ficially by 6. Shared Voting Power .............................................................................................................................. Owned by Each
Reporting 7. Sole Dispositive Power............................................................................................................................. Person With:
8. Shared Dispositive Power ........................................................................................................................
9. Aggregate Amount Beneficially Owned by Each Reporting Person.............................................................................
10. Check if the Aggregate Amount in Row (9) Excludes Certain Shares (See Instructions)...........................................
11. Percent of Class Represented by Amount in Row (9) ...............................................................................................
12. Type of Reporting Person (See Instructions)
.........................................................................................................................................................................................
.........................................................................................................................................................................................
.........................................................................................................................................................................................
.........................................................................................................................................................................................
.........................................................................................................................................................................................
.........................................................................................................................................................................................
(2) The Dee Ann McIntyre Marital Election Trust dated October 6, 2009 is
the beneficial owner of 2,426,533, shares of $.001 par value common stock of the
Company, consisting of:
i. 2,421,533 shares held by the Dee Ann McIntyre Marital Election Trust dated October 6, 2009 for which Mrs. McIntyre serves as trustee;
ii. 5,000 shares held in the brokerage account of the Dee Ann McIntyre
Marital Election Trust;
(b) Percent of class
(1) The 2,996,832 shares reported as beneficially owned by Dee Ann
McIntyre represented 11.82% of the issued and outstanding shares of
$.001 par value common stock of the Company on December 31, 2016.
(2) The 2,426,533 shares held by the Dee Ann McIntyre Marital Election Trust dated October 6, 2009 represented 9.57% of the issued and outstanding shares of $.001 par value common stock of the Company on December 31, 2016.
(c) Number of shares to which the person has:
(1)
Dee Ann McIntyre
i.Sole Power to vote or to direct the vote:2,524,969
ii.
Shared power to vote or to direct the vote:
471,533
iii.
Sole power to dispose or to direct the disposition of:
2,524,969
iv.
Shared power to dispose or to direct the disposition of:
471,533(2) The Dee Ann McIntyre Marital Election Trust dated October 6, 2009
i.
Sole Power to vote or to direct the vote:
2,421,533
ii.
Shared power to vote or to direct the vote:
0
iii.
Sole power to dispose or to direct the disposition of:
2,421,533
iv.
Shared power to dispose or to direct the disposition of:
0
Item 5 Ownership of Five Percent or Less of a Class
If this statement is being filed to report the fact that as of the date hereof the reporting person has ceased to be the beneficial owner of more than five percent of the class of securities, check the following .
Not Applicable.
Item 6 Ownership of More than Five Percent on Behalf of Another Person.
Not Applicable.
Item 7 Identification and Classification of the Subsidiary Which Acquired the
Security Being Reported By the Parent Holding Company
Not Applicable.
Item 8 Identification and Classification of Members of the Group
Not Applicable.
Item 9 Notice of Dissolution of Group
Not Applicable.
Item 10 Certification
Not Applicable.
SIGNATURE
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.
February 13, 2017 /s/ Mark R. Van Heukelom Dated Dee Ann McIntyre
By Mark R. Van Heukelom
Attorney-in-Fact
DEE ANN MCINTYRE MARITAL ELECTION TRUST
Dated October 6, 2009
February 13, 2017 /s/ Mark R. Van Heukelom Dated Dee Ann McIntyre, Trustee
By Mark R. Van Heukelom
Attorney-in-Fact
EXHIBIT A TO SCHEDULE 13G JOINT FILING AGREEMENT
Dee Ann McIntyre, individually, and the Dee Ann McIntyre Marital Election Trust dated October 6, 2009, hereby agree and consent to the joint filing on their behalf of the foregoing Schedule 13G related to their beneficial ownership of the common stock of United Fire Group, Inc.
February 13, 2017 /s/ Mark R. Van Heukelom Dated Dee Ann McIntyre
By Mark R. Van Heukelom
Attorney-in-Fact
DEE ANN MCINTYRE MARITAL ELECTION TRUST
Dated October 6, 2009
February 13, 2017 /s/ Mark R. Van Heukelom Dated Dee Ann McIntyre, Trustee
By Mark R. Van Heukelom
Attorney-in-Fact
SC 13G/A
2
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