0000899243-17-012324.txt : 20170508 0000899243-17-012324.hdr.sgml : 20170508 20170508190545 ACCESSION NUMBER: 0000899243-17-012324 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170508 FILED AS OF DATE: 20170508 DATE AS OF CHANGE: 20170508 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Heritage Insurance Holdings, Inc. CENTRAL INDEX KEY: 0001598665 STANDARD INDUSTRIAL CLASSIFICATION: FIRE, MARINE & CASUALTY INSURANCE [6331] IRS NUMBER: 455338504 BUSINESS ADDRESS: STREET 1: 2600 MCCORMICK DRIVE STREET 2: SUITE 300 CITY: CLEARWATER STATE: FL ZIP: 33759 BUSINESS PHONE: 7273627202 MAIL ADDRESS: STREET 1: 2600 MCCORMICK DRIVE STREET 2: SUITE 300 CITY: CLEARWATER STATE: FL ZIP: 33759 FORMER COMPANY: FORMER CONFORMED NAME: Heritage Insurance Holdings, LLC DATE OF NAME CHANGE: 20140130 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Lucas Bruce CENTRAL INDEX KEY: 0001552968 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36462 FILM NUMBER: 17823969 MAIL ADDRESS: STREET 1: 2109 E. PALM AVENUE CITY: TAMPA STATE: FL ZIP: 33605 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2017-05-08 0 0001598665 Heritage Insurance Holdings, Inc. HRTG 0001552968 Lucas Bruce C/O HERITAGE INSURANCE HOLDINGS, INC. 2600 MCCORMICK DRIVE SUITE 300 CLEARWATER FL 33759 1 1 0 0 Chairman & CEO Common Stock 2017-05-08 4 P 0 83262 12.06 A 681071 D Common Stock 122020 I See Footnote Common Stock 494612 I See Footnote Shares of common stock reported on this line are held by IIM Holdings, LLC and IIM Holdings II, LLC, entities controlled by Mr. Lucas. Shares of common stock reported on this line are held by the Alec Lucas Trust. /s/ Bruce Lucas 2017-05-08