0001593968-21-001085.txt : 20210406 0001593968-21-001085.hdr.sgml : 20210406 20210406095725 ACCESSION NUMBER: 0001593968-21-001085 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20210401 FILED AS OF DATE: 20210406 DATE AS OF CHANGE: 20210406 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Beck Howard J. CENTRAL INDEX KEY: 0001699897 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38046 FILM NUMBER: 21808314 MAIL ADDRESS: STREET 1: 225 20TH STREET CITY: ROCK ISLAND STATE: IL ZIP: 61201 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: ICC Holdings, Inc. CENTRAL INDEX KEY: 0001681903 STANDARD INDUSTRIAL CLASSIFICATION: FIRE, MARINE & CASUALTY INSURANCE [6331] IRS NUMBER: 813359409 STATE OF INCORPORATION: PA FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 225 20TH STREET CITY: ROCK ISLAND STATE: IL ZIP: 61201 BUSINESS PHONE: 309-793-1700 MAIL ADDRESS: STREET 1: 225 20TH STREET CITY: ROCK ISLAND STATE: IL ZIP: 61201 4 1 primary_01.xml PRIMARY DOCUMENT X0306 4 2021-04-01 0001681903 ICC Holdings, Inc. ICCH 0001699897 Beck Howard J. 225 20TH ST ROCK ISLAND IL 61201-8810 false true false false Chief Underwriting Officer Common Stock 2021-04-01 4 M false 719 14.7836 A 2867 D Common Stock 2021-04-01 4 F false 248 14.7836 D 2619 D Common Stock 16000 I 401(k) Common Stock 9900 I IRA Common Stock 611.1215 I By ESOP Common Stock 667.9980 I By ESOP Common Stock 680.0839 I By ESOP Common Stock 125 I By Spouse Common Stock 842 I By ESOP Restricted Stock Unit 0 2021-04-01 4 M false 719 14.7836 D ICC Holdings, Inc. Common Stock 719 1439 D Restricted Stock Unit 0 2021-04-01 4 A false 2500 0 A ICC Holdings, Inc. Common Stock 2500 2500 D RSU with 3 Year Periodic vesting schedule No exercise price for this type of award No exercisable date for this type of award No expiration date for this type of award /s/Kathleen S. Springer, Attorney in Fact 2021-04-06 EX-24 2 beckpoa.htm EX-24 DOCUMENT Limited Power of Attorney

POWER OF ATTORNEY Know all by these presents, that the undersigned hereby constitutes and appoints each of Kathleen Springer, Julia B. Suiter, Sunjeet S. Gill and Stephanie R. Hager or any of them signing singly, and with full power of substitution, the undersigned's true and lawful attorney in fact to: (1) prepare, execute in the undersigned's name and on the undersigned's behalf, and submit to the U.S. Securities and Exchange Commission (the "SEC") a Form ID, including amendments thereto, and any other documents necessary or appropriate to obtain codes and passwords enabling the undersigned to make electronic filings with the SEC of reports required by Section 16(a) of the Securities Exchange Act of 1934 or any rule or regulation of the SEC; (2) execute for and on behalf of the undersigned, in the undersigned's capacity as a director of ICC Holdings, Inc. (the "Company"), Forms 3, 4, and 5 in accordance with Section 16(a) of the Securities Exchange Act of 1934 and the rules thereunder; (3) do and perform any and all acts for and on behalf of the undersigned which may be necessary or desirable to complete and execute any such Form 3, 4, or 5, complete and execute any amendment or amendments thereto, and timely file such form with the SEC and any stock exchange or similar authority; and (4) take any other action of any type whatsoever in connection with the foregoing which, in the opinion of such attorney in fact, may be of benefit to, in the best interest of, or legally required by, the undersigned, it being understood that the documents executed by such attorney in fact on behalf of the undersigned pursuant to this Power of Attorney shall be in such form and shall contain such terms and conditions as such attorney in fact may approve in such attorney in fact's discretion. The undersigned hereby grants to each such attorney in fact full power and authority to do and perform any and every act and thing whatsoever requisite, necessary, or proper to be done in the exercise of any of the rights and powers herein granted, as fully to all intents and purposes as the undersigned might or could do if personally present, with full power of substitution or revocation, hereby ratifying and confirming all that such attorney in fact, or such attorney in fact's substitute or substitutes, shall lawfully do or cause to be done by virtue of this power of attorney and the rights and powers herein granted. The undersigned acknowledges that the foregoing attorneys in fact, in serving in such capacity at the request of the undersigned, are not assuming, nor is the Company assuming, any of the undersigned's responsibilities to comply with Section 16 of the Securities Exchange Act of 1934. This Power of Attorney shall remain in full force and effect until the undersigned is no longer required to file Forms 3, 4, and 5 with respect to the undersigned's holdings of and transactions in securities issued by the Company, unless earlier revoked by the undersigned in a signed writing delivered to the foregoing attorneys in fact. IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be executed as of this 1st day of March 2017. /s/ Howard J. Beck