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