SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
OMB APPROVAL
OMB Number: 3235-0104
Estimated average burden
hours per response: 0.5
1. Name and Address of Reporting Person*
Page Russell Andrew

(Last) (First) (Middle)
121 DRIVERS EDGE

(Street)
TRAVERSE CITY MI 49684

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
04/16/2024
3. Issuer Name and Ticker or Trading Symbol
Hagerty, Inc. [ HGTY ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Chief Information Officer
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Class A Common Stock 26,639(1) D
Class A Common Stock 55,778(2) D
Class A Common Stock 22,246(3) D
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Explanation of Responses:
1. Represents shares of Class A Common Stock of Hagerty, Inc. ("Class A Common Stock") underlying restricted stock units ("RSUs") acquired by the Reporting Person under the Hagerty, Inc. (the "Issuer") 2021 Equity Incentive Plan (the "Plan"). The RSUs vest in equal amounts on each annual-anniversary of the grant date ending on April 1, 2027, subject to the Reporting Person's continued service with the Issuer, with exceptions for death, disability, or retirement terminations, or a change of control of the Issuer.
2. Represents shares of Class A Common Stock underlying RSUs acquired by the Reporting Person under the Issuer's Plan. The RSUs vest in equal amounts on each annual-anniversary of the grant date ending on April 1, 2026, subject to the Reporting Person's continued service with the Issuer, with exceptions for death, disability, or retirement.
3. Represents shares of Class A Common Stock underlying RSUs acquired by the Reporting Person under the Issuer's Plan. The RSUs vest in equal amounts on each annual-anniversary of the grant date ending on October 1, 2025, subject to the Reporting Person's continued service with the Issuer, with exceptions for death, disability, or retirement.
Remarks:
Exhibit List: Exhibit 24 - Confirmation Statement.
/s/ Diana M. Chafey, Power of Attorney 04/26/2024
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.