0001174947-19-000716.txt : 20190523
0001174947-19-000716.hdr.sgml : 20190523
20190523093533
ACCESSION NUMBER: 0001174947-19-000716
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: Espegard Duaine
CENTRAL INDEX KEY: 0001699502
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37973
FILM NUMBER: 19848173
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
c522292_4.xml
OWNERSHIP DOCUMENT
X0306
4
2019-05-21
0
0001681206
NI Holdings, Inc.
NODK
0001699502
Espegard Duaine
1101 FIRST AVENUE NORTH
FARGO
ND
58102
1
0
0
0
Common Stock
2019-05-21
4
A
0
3100
0.00
A
16000
D
These shares are represented by restricted stock units, and will be deferred issuance until after separation from service.
Includes restricted stock units.
These shares include 4,600 restricted stock units that will be deferred issuance until after separation from service.
/s/ Timothy J. Milius
2019-05-23