0001140361-17-000806.txt : 20170105
0001140361-17-000806.hdr.sgml : 20170105
20170105174141
ACCESSION NUMBER: 0001140361-17-000806
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20170104
FILED AS OF DATE: 20170105
DATE AS OF CHANGE: 20170105
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: KINGSTONE COMPANIES, INC.
CENTRAL INDEX KEY: 0000033992
STANDARD INDUSTRIAL CLASSIFICATION: FIRE, MARINE & CASUALTY INSURANCE [6331]
IRS NUMBER: 362476480
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 15 JOYS LANE
CITY: KINGSTON
STATE: NY
ZIP: 12401
BUSINESS PHONE: 516 374-7600
MAIL ADDRESS:
STREET 1: 15 JOYS LANE
CITY: KINGSTON
STATE: NY
ZIP: 12401
FORMER COMPANY:
FORMER CONFORMED NAME: DCAP GROUP INC
DATE OF NAME CHANGE: 20050210
FORMER COMPANY:
FORMER CONFORMED NAME: DCAP GROUP INC/
DATE OF NAME CHANGE: 19990702
FORMER COMPANY:
FORMER CONFORMED NAME: EXTECH CORP
DATE OF NAME CHANGE: 19920703
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Seibald Jack D
CENTRAL INDEX KEY: 0001186619
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-01665
FILM NUMBER: 17512061
MAIL ADDRESS:
STREET 1: 1336 BOXWOOD DRIVE WEST
CITY: HEWLETT HARBOR
STATE: NY
ZIP: 11557
FORMER NAME:
FORMER CONFORMED NAME: SIEBALD JACK D
DATE OF NAME CHANGE: 20020905
4
1
doc1.xml
FORM 4
X0306
4
2017-01-04
0
0000033992
KINGSTONE COMPANIES, INC.
KINS
0001186619
Seibald Jack D
1336 BOXWOOD DRIVE WEST
HEWLETT
NY
11557
1
0
0
0
Common Stock
2017-01-04
4
A
0
2000
0
A
137323
D
Common Stock
174824
I
Retirement Trust
Common Stock
4600
I
See footnote
Received as director fees. Vests to the extent of 667 shares on each of January 4, 2018 and 2019 and 666 shares on January 4, 2020.
Includes 3,333 shares received as director fees. Vests to the extent of 1,334 shares on January 4, 2018, 1,333 shares on January 4, 2019 and 666 shares on January 4, 2020.
Includes 113,000 shares jointly owned with Mr. Seibald's wife.
Shares are owned by a limited partnership. Mr. Seibald may be deemed to have an indirect pecuniary interest in 100 shares owned by the limited partnership based upon his status as a general partner of the limited partnership and may be deemed to have an indirect pecuniary interest in an additional 4,500 shares owned by the limited partnership based upon his wife's status as a limited partner of the limited partnership. The filing of this form shall not be deemed an admission that Mr. Seibald is, for purposes of Section 16 of the Securities Exchange Act of 1934 or otherwise, the beneficial owner of any shares owned by the limited partnership.
This filing shall not be deemed an admission that the Reporting Person is, for purposes of Section 16 of the Securities Exchange Act of 1934 or otherwise, the beneficial owner of any equity securities covered by this statement.
/s/ Jack D. Seibald
2017-01-05