0000814585-23-000010.txt : 20230307 0000814585-23-000010.hdr.sgml : 20230307 20230307172933 ACCESSION NUMBER: 0000814585-23-000010 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230303 FILED AS OF DATE: 20230307 DATE AS OF CHANGE: 20230307 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: 23714044 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 2023-03-03 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 2023-03-03 4 A 0 20064 12.46 A 902818 D Common Stock 2023-03-03 4 A 0 31982 12.46 A 934800 D Time based shares that will vest in equal installments on the third, fourth and fifth anniversary of the grant date, subject to the NEO's continued employment on the vesting date (subject to certain exceptions). Balance reflects adjustment for retirement plan shares. The vesting of the March 2023 performance-based share awards will be contingent on Total Shareholder Return over a three year performance period beginning December 31, 2022 and ending on December 31, 2025. The beginning stock price is the closing share price as of 12/31/22 and ending stock price will be the average stock price over the 60 trading days preceding and including the last day of the performance period. Earned shares will vest in equal installments on the third, fourth and fifth anniversary of the grant date, subject to the NEO's continued employment subject to certain exceptions. Performance-based shares not earned will be forfeited. /s/ Jonathan C. Harris 2023-03-07