0001174947-17-001773.txt : 20171212 0001174947-17-001773.hdr.sgml : 20171212 20171212130258 ACCESSION NUMBER: 0001174947-17-001773 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20171211 FILED AS OF DATE: 20171212 DATE AS OF CHANGE: 20171212 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Marlow Stephen V. CENTRAL INDEX KEY: 0001699509 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37973 FILM NUMBER: 171251357 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 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 formfour.xml OWNERSHIP DOCUMENT X0306 4 2017-12-11 0 0001681206 NI Holdings, Inc. NODK 0001699509 Marlow Stephen V. 1101 FIRST AVENUE NORTH FARGO ND 58102 1 0 0 0 Common Stock 2017-12-11 4 A 0 1400 0.00 A 3900 D These shares are represented by restricted stock units. Includes restricted stock units. /s/ Stephen V. Marlow 2017-12-11