0001140361-17-007714.txt : 20170215 0001140361-17-007714.hdr.sgml : 20170215 20170215163359 ACCESSION NUMBER: 0001140361-17-007714 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170214 FILED AS OF DATE: 20170215 DATE AS OF CHANGE: 20170215 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: 17615023 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 2017-02-14 0 0000033992 KINGSTONE COMPANIES, INC. KINS 0001186619 Seibald Jack D 1336 BOXWOOD DRIVE WEST HEWLETT NY 11557 1 0 0 0 Common Stock 2017-02-14 4 S 0 38116 11.31 D 71668 D Common Stock 2017-02-14 4 S 0 43838 11.31 D 88731 I Retirement Trust Common Stock 2017-02-14 4 S 0 1226 11.31 D 2334 I See footnote This amount represents the $12.00 per share public offering price less the underwriting discount of $0.69 per share. 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 57,353 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 27 of the shares sold 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 1,199 of the shares sold by the limited partnership based upon his wife's status as a limited partner of the limited partnership. Mr. Seibald may be deemed to have an indirect pecuniary interest in 51 of the shares owned by the limited partnership based upon his general partner status and may be deemed to have an indirect pecuniary interest in an additional 2,283 of the shares owned by the limited partnership based upon his wife's limited partnership status. 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 2017-02-14