Statement of Changes in Beneficial Ownership (4)
March 23 2023 - 3:47PM
Edgar (US Regulatory)
FORM 4
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0287
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Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
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Hannon Gregory Paul |
2. Issuer Name and Ticker or Trading Symbol
KINGSWAY FINANCIAL SERVICES INC
[
KFS
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__X__ Director _____ 10% Owner _____ Officer (give title below) _____ Other (specify below)
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(Last)
(First)
(Middle)
OAKMONT CAPITAL INC., 45 ST. CLAIR AVENUE WEST, SUITE 400 |
3. Date of Earliest Transaction
(MM/DD/YYYY)
3/21/2023 |
(Street)
TORONTO, A6 M4V 1K9 |
4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
_X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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(City)
(State)
(Zip)
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Rule 10b5-1(c) Transaction Indication
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Check this box to indicate that a transaction was made pursuant to a contract, instruction or written plan that is intended to
satisfy the affirmative defense conditions of Rule 10b5-1(c). See Instruction 10.
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1.Title of Security (Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code (Instr. 8)
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4. Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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Common Stock | 3/21/2023 | | C | | 82144 | A | $0 (1) | 2113301 (2) | I | By Oakmont Capital Inc |
Common Stock | | | | | | | | 3000 | I | By 1272562 Ontario Inc. |
Common Stock | | | | | | | | 4000 | I | By Gilter Inc. |
Common Stock | | | | | | | | 1250 | I | By Retirement Plan (C) |
Common Stock | | | | | | | | 7500 | I | By Retirement Plan (R) |
Common Stock | | | | | | | | 13750 | I | By Retirement Plan (T) |
Common Stock | | | | | | | | 13750 | I | By Spouse |
Common Stock | | | | | | | | 4500 | I | By Trust |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Trans. Date | 3A. Deemed Execution Date, if any | 4. Trans. Code (Instr. 8) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) | 6. Date Exercisable and Expiration Date | 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) | 8. Price of Derivative Security (Instr. 5) | 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) | 10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) |
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Class A convertible preferred share, series 1 | $0 (1) | 3/21/2023 | | C | | | 13143 | 2/3/2014 | 3/22/2023 | Common Stock | 82143.75 (1) | $0 | 0 | I | By Oakmont Capital Inc. |
Explanation of Responses: |
(1) | The Class A Preferred Stock ("Preferred Stock") was convertible at a rate of one (1) share of Preferred Stock for six and 25/100th shares of Common Stock: Oakmont Capital Inc. converted 13,143 shares of Preferred Stock into 82,144 shares of Common Stock (rounded to the next whole share). |
(2) | The reporting person's previous Form 4 filings incorrectly listed the number of securities beneficially owned due to an administrative error which has been corrected in calculating the number of securities beneficially owned following the transaction reported herein. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Hannon Gregory Paul OAKMONT CAPITAL INC. 45 ST. CLAIR AVENUE WEST, SUITE 400 TORONTO, A6 M4V 1K9 | X |
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Signatures
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/s/ Debra S. Rouse, attorney-in-fact for Gregory Paul Hannon | | 3/23/2023 |
**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 4(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 control number. |
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