0001760617-19-000001.txt : 20190214 0001760617-19-000001.hdr.sgml : 20190214 20190214145938 ACCESSION NUMBER: 0001760617-19-000001 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20181231 FILED AS OF DATE: 20190214 DATE AS OF CHANGE: 20190214 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Popoli Matthew T. CENTRAL INDEX KEY: 0001760617 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38718 FILM NUMBER: 19605031 MAIL ADDRESS: STREET 1: 3750 WEST DEERFIELD ROAD CITY: RIVERWOODS STATE: IL ZIP: 60015 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Federal Life Group, Inc. CENTRAL INDEX KEY: 0001743886 STANDARD INDUSTRIAL CLASSIFICATION: LIFE INSURANCE [6311] IRS NUMBER: 824944172 STATE OF INCORPORATION: PA FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 3750 DEERFIELD ROAD CITY: RIVERWOODS STATE: IL ZIP: 60015 BUSINESS PHONE: (847) 520-1900 MAIL ADDRESS: STREET 1: 3750 DEERFIELD ROAD CITY: RIVERWOODS STATE: IL ZIP: 60015 5 1 primary_doc.xml PRIMARY DOCUMENT X0306 5 2018-12-31 0 0 1 0001743886 Federal Life Group, Inc. FLF 0001760617 Popoli Matthew T. 3750 WEST DEERFIELD ROAD RIVERWOODS IL 60015 1 0 1 0 common stock 2018-12-18 4 P 0 L 160000 10.5 A 2825500 I Held by Insurance Capital Group, LLC common stock 2018-12-19 4 P 0 L 1160000 10.5 A 2825500 I Held by Insurance Capital Group, LLC common stock 2018-12-20 4 P 0 L 500 10 A 2825500 I Held by Insurance Capital Group, LLC The securities held by Insurance Capital Group, LLC ("ICG") may be deemed to be beneficially owned by Matthew T. Popoli (the "Reporting Person"), who is the controlling owner of ICG. The Reporting Person disclaims beneficial ownership of the reported securities except to the extent of his pecuniary interest therein. /s/ Matthew T. Popoli 2019-02-14