0001104659-23-064406.txt : 20230525 0001104659-23-064406.hdr.sgml : 20230525 20230525090156 ACCESSION NUMBER: 0001104659-23-064406 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230524 FILED AS OF DATE: 20230525 DATE AS OF CHANGE: 20230525 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Missling Jeffrey R. CENTRAL INDEX KEY: 0001699863 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37973 FILM NUMBER: 23956542 MAIL ADDRESS: STREET 1: 1101 FIRST AVENUE NORTH CITY: FARGO STATE: ND ZIP: 58102 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: NI Holdings, Inc. CENTRAL INDEX KEY: 0001681206 STANDARD INDUSTRIAL CLASSIFICATION: FIRE, MARINE & CASUALTY INSURANCE [6331] IRS NUMBER: 812683619 FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1101 FIRST AVENUE NORTH CITY: FARGO STATE: ND ZIP: 58102 BUSINESS PHONE: 701-298-4200 MAIL ADDRESS: STREET 1: 1101 FIRST AVENUE NORTH CITY: FARGO STATE: ND ZIP: 58102 4 1 tm2316922-8_4seq1.xml OWNERSHIP DOCUMENT X0407 4 2023-05-24 0 0001681206 NI Holdings, Inc. NODK 0001699863 Missling Jeffrey R. 1101 FIRST AVENUE NORTH FARGO ND 58102 1 0 0 0 0 Common Stock 2023-05-24 4 A 0 3800 0.00 A 20400 D These shares are represented by restricted stock units. Includes restricted stock units. These shares include 1,500 restricted stock units that will be deferred issuance until after separation from service. /s/ Timothy J. Milius 2023-05-25