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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
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. | SEC 1474 (9-02) |
1. Title of Derivative Security (Instr. 3) |
2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction 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 (Month/Day/Year) |
7. Title and Amount of Underlying Securities (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) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Restricted Stock Units | (2) | 01/23/2019 | A | 134,409 | (3) | (3) | Class A Common Stock | 134,409 | $ 0 | 134,409 | D | ||||
Restricted Stock Units | (2) | 01/23/2019 | M | 134,409 | (3) | (3) | Class A Common Stock | 134,409 | $ 0 | 0 | D | ||||
Restricted Stock Units | (1) | (4) | (4) | Class A Common Stock | 68,150 | 68,150 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Kolander Geoffrey Martin 2900 ESPERANZA CROSSING, 2ND FL AUSTIN, TX 78758 |
CEO |
/s/ Geoffrey M. Kolander | 01/25/2019 | |
**Signature of Reporting Person | Date |
* | 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). |
(1) | Restricted stock units convert into Citizens, Inc. Class A common stock on a one-for-one basis. |
(2) | Each restricted stock unit represents a contingent right to receive one share of Citizens, Inc. Class A common stock. |
(3) | Pursuant to the reporting person's employment agreement dated January 23, 2019, the reporting person was granted 134,409 restricted stock units on January 23, 2019 that vest immediately. |
(4) | Vesting is 50% on the first anniversary of the date of the grant (February 15, 2019, and 50% on the second anniversary of the date of the grant (February 15, 2020) |