0001174947-19-000714.txt : 20190523
0001174947-19-000714.hdr.sgml : 20190523
20190523093058
ACCESSION NUMBER: 0001174947-19-000714
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20190521
FILED AS OF DATE: 20190523
DATE AS OF CHANGE: 20190523
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Aasmundstad Eric K.
CENTRAL INDEX KEY: 0001700267
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37973
FILM NUMBER: 19848159
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
c522291_4.xml
OWNERSHIP DOCUMENT
X0306
4
2019-05-21
0
0001681206
NI Holdings, Inc.
NODK
0001700267
Aasmundstad Eric K.
1101 FIRST AVENUE NORTH
FARGO
ND
58102
1
0
0
0
Common Stock
2019-05-21
4
A
0
3100
0.00
A
15414
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
2019-05-23