0000814585-19-000003.txt : 20190305 0000814585-19-000003.hdr.sgml : 20190305 20190305161606 ACCESSION NUMBER: 0000814585-19-000003 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190303 FILED AS OF DATE: 20190305 DATE AS OF CHANGE: 20190305 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Bergonzi Adam T. CENTRAL INDEX KEY: 0001717578 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-09583 FILM NUMBER: 19658522 MAIL ADDRESS: STREET 1: C/O MBIA INC. STREET 2: 1 MANHATTANVILLE ROAD CITY: PURCHASE STATE: NY ZIP: 10577 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: MBIA INC CENTRAL INDEX KEY: 0000814585 STANDARD INDUSTRIAL CLASSIFICATION: SURETY INSURANCE [6351] IRS NUMBER: 061185706 STATE OF INCORPORATION: CT FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1 MANHATTANVILLE ROAD STREET 2: SUITE 301 CITY: PURCHASE STATE: NY ZIP: 10577 BUSINESS PHONE: 914-273-4545 MAIL ADDRESS: STREET 1: 1 MANHATTANVILLE ROAD STREET 2: SUITE 301 CITY: PURCHASE STATE: NY ZIP: 10577 4 1 primary_doc.xml PRIMARY DOCUMENT X0306 4 2019-03-03 0 0000814585 MBIA INC MBI 0001717578 Bergonzi Adam T. C/O MBIA INC. 1 MANHATTANVILLE ROAD PURCHASE NY 10577 0 1 0 0 Assistant Vice President Common Stock 2019-03-03 4 F 0 2313 10.61 D 641291 D Represents shares surrendered to Issuer for payment of tax liability upon vesting of restricted stock. Balance reflects adjustment for retirement plan shares. /s/ Jonathan C. Harris, Attorney-in-Fact 2019-03-05