0001768102-19-000001.txt : 20190214
0001768102-19-000001.hdr.sgml : 20190214
20190214151522
ACCESSION NUMBER: 0001768102-19-000001
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: Insurance Capital Group, LLC
CENTRAL INDEX KEY: 0001768102
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 5
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38718
FILM NUMBER: 19605215
BUSINESS ADDRESS:
STREET 1: 767 FIFTH AVENUE, 16TH FLOOR
CITY: NEW YORK
STATE: NY
ZIP: 10153
BUSINESS PHONE: 2123909403
MAIL ADDRESS:
STREET 1: 767 FIFTH AVENUE, 16TH FLOOR
CITY: NEW YORK
STATE: NY
ZIP: 10153
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
1
1
0001743886
Federal Life Group, Inc.
FLF
0001768102
Insurance Capital Group, LLC
767 FIFTH AVENUE, 16TH FLOOR
NEW YORK
NY
10153
0
0
1
0
common stock
3
2825500
D
common stock
2018-12-18
4
P
0
L
160000
10.5
A
2825500
D
common stock
2018-12-19
4
P
0
L
1160000
10.5
A
2825500
D
common stock
2018-12-20
4
P
0
L
500
10
A
2825500
D
On December 11, 2018, Insurance Capital Group, LLC became a beneficial owner of more than 10% of the issuer's common stock by purchasing 1,505,000 shares of the issuer's common stock pursuant to the issuer's initial public offering.
/s/ Matthew T. Popoli, Chief Executive Officer
2019-02-14