0001596771-19-000011.txt : 20190214
0001596771-19-000011.hdr.sgml : 20190214
20190214155836
ACCESSION NUMBER: 0001596771-19-000011
CONFORMED SUBMISSION TYPE: 5
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20181231
FILED AS OF DATE: 20190214
DATE AS OF CHANGE: 20190214
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Hagerman Philip R
CENTRAL INDEX KEY: 0001618897
FILING VALUES:
FORM TYPE: 5
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36677
FILM NUMBER: 19605715
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
5
1
primary_doc.xml
PRIMARY DOCUMENT
X0306
5
2018-12-31
0
0
0
0001610092
Diplomat Pharmacy, Inc.
DPLO
0001618897
Hagerman Philip R
4100 S. SAGINAW STREET
FLINT
MI
48507
1
0
1
0
Common Stock
5222
D
Common Stock
2018-05-30
5
G
0
50000
0
D
1280099
I
Philip R. Hagerman Revocable Trust
Common Stock
3391609
I
2007 Hagerman Family GST
Common Stock
3600091
I
The JH GST Trust
Common Stock
1475876
I
2013 Irrev. Exempt Trust for Daughter
Common Stock
1475876
I
2013 Irrev. Exempt Trust for Son
Common Stock
1075293
I
2013 Irrev. Exempt Trust for Daughter
Common Stock
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
2018-05-30
5
G
0
50000
0
D
367528
I
Jocelyn 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
On May 30, 2018, 50,000 shares held by the Philip R. Hagerman Revocable Trust were donated to The Hagerman Foundation, an unaffiliated, nonprofit corporation.
These shares are indirectly owned by Mr. Hagerman as trustee of the Philip R. Hagerman Revocable 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.
On May 30, 2018, 50,000 shares held by the Jocelyn Hagerman Living Trust were donated to The Hagerman Foundation, an unaffiliated, nonprofit corporation.
/s/ Christina Flint, by Power of Attorney
2019-02-14