0001596771-18-000028.txt : 20180312
0001596771-18-000028.hdr.sgml : 20180312
20180312163312
ACCESSION NUMBER: 0001596771-18-000028
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20180309
FILED AS OF DATE: 20180312
DATE AS OF CHANGE: 20180312
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Hagerman Philip R
CENTRAL INDEX KEY: 0001618897
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36677
FILM NUMBER: 18683776
MAIL ADDRESS:
STREET 1: 4100 S. SAGINAW STREET
CITY: FLINT
STATE: MI
ZIP: 48507
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Diplomat Pharmacy, Inc.
CENTRAL INDEX KEY: 0001610092
STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-DRUG STORES AND PROPRIETARY STORES [5912]
IRS NUMBER: 382063100
STATE OF INCORPORATION: MI
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 4100 S. SAGINAW ST.
CITY: FLINT
STATE: MI
ZIP: 48507
BUSINESS PHONE: 888-720-4450
MAIL ADDRESS:
STREET 1: 4100 S. SAGINAW ST.
CITY: FLINT
STATE: MI
ZIP: 48507
4
1
primary_doc.xml
PRIMARY DOCUMENT
X0306
4
2018-03-09
0
0001610092
Diplomat Pharmacy, Inc.
DPLO
0001618897
Hagerman Philip R
4100 S. SAGINAW STREET
FLINT
MI
48507
1
0
1
0
Common Stock
7519
D
Common Stock
2018-03-09
4
S
0
169657
20.65
D
1330099
I
Philip R. Hagerman Revocable Trust
Common Stock
2018-03-09
4
S
0
500000
20.65
D
3391609
I
2007 Hagerman Family GST
Common Stock
2018-03-09
4
S
0
550000
20.65
D
3900091
I
The JH GST Trust
Common Stock
2018-03-09
4
S
0
75000
20.65
D
1475876
I
2013 Irrev. Exempt Trust for Daughter
Common Stock
2018-03-09
4
S
0
75000
20.65
D
1475876
I
2013 Irrev. Exempt Trust for Son
Common Stock
2018-03-09
4
S
0
140000
20.65
D
1075293
I
2013 Irrev. Exempt Trust for Daughter
Common Stock
2018-03-09
4
S
0
60000
20.65
D
1311292
I
2013 Irrev. Exempt Trust for Daughter
Common Stock
313337
I
2014 Irrev. Exempt Trust for Son
Common Stock
313337
I
2014 Irrev. Exempt Trust for Daughter
Common Stock
313337
I
2014 Irrev. Exempt Trust for Daughter
Common Stock
313337
I
2014 Irrev. Exempt Trust for Daughter
Common Stock
2018-03-09
4
S
0
279131
20.65
D
417528
I
Jocelyn Hagerman Living Trust
Common Stock
2018-03-09
4
S
0
301212
20.65
D
0
I
Philip R. Hagerman Living Trust
Common Stock
263500
I
JH Marital Trust
Common Stock
272000
I
PH Marital Trust
Common Stock
394910
I
Irrevocable Trust for Son
Common Stock
394910
I
Irrevocable Trust for Daughter
Common Stock
367256
I
Irrevocable Non-Exempt Trust for Son
Common Stock
367256
I
Irrevocable Non-Exempt Trust for Daughter
Represents restricted stock units ("RSUs") granted in connection with the Issuer's equity incentive plan.
These shares are indirectly owned by Mr. Hagerman as the trustee of the Philip R. Hagerman Revocable Trust, the Philip R. Hagerman Living Trust, The JH GST Trust, the 2013 Irrevocable Exempt Trusts and 2014 Irrevocable Exempt Trusts for two daughters, and the JH Marital Trust.
Jocelyn Hagerman is Mr. Hagerman's wife. These shares are indirectly owned by her as a trustee of the 2007 Hagerman Family GST Trust, the 2013 Irrevocable Exempt Trusts and 2014 Irrevocable Exempt Trusts for a son and daughter, the Jocelyn Hagerman Living Trust, and the PH Marital Trust.
/s/ Christina Flint, by Power of Attorney
2018-03-12