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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 | ||||||||
Warrants | $ 1.03 | 06/11/2010 | 06/11/2010 | P | 1,100,000 (1) | 06/11/2010 | 06/11/2020 | Signature Group holdings, Inc. - Common Shares | 1,100,000 (1) | $ 0.02 | 5,500,000 (1) | I | Signature Group Holdings, LLC | ||
Warrants | $ 1.03 | 06/11/2010 | 06/11/2010 | P | 1,100,000 (1) | 06/11/2011 | 06/11/2020 | Signature Group Holdings, Inc. - Common Shares | 1,100,000 (1) | $ 0.02 | 5,500,000 (1) | I | Signature Group Holdings, LLC | ||
Warrants | $ 1.03 | 06/11/2010 | 06/11/2010 | P | 1,100,000 (1) | 06/11/2012 | 06/11/2020 | Signature Group Holdings, Inc. - Common Shares | 1,100,000 (1) | $ 0.02 | 5,500,000 (1) | I | Signature Group Holdings, LLC | ||
Warrants | $ 1.03 | 06/11/2010 | 06/11/2010 | P | 1,100,000 (1) | 06/11/2013 | 06/11/2020 | Signature Group Holdings, Inc. - Common Shares | 1,100,000 (1) | $ 0.02 | 5,500,000 (1) | I | Signature Group Holdings, Inc. | ||
Warrants | $ 1.03 | 06/11/2010 | 06/11/2010 | P | 1,100,000 (1) | 06/11/2014 | 06/11/2020 | Signature Group Holdings, Inc. - Common Shares | 1,100,000 (1) | $ 0.02 | 5,500,000 (1) | I | Signature Group Holdings, Inc. |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Noell Craig Forrest 15303 VENTURA BLVD. SUITE 1510 SHERMAN OAKS, CA 91403 |
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/s/ Craig Forrest Noell | 07/02/2010 | |
**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) | On June 11, 2010, Signature Group Holdings, LLC acquired 8,800,000 Warrants for $.02 per warrant share to purchase common shares in Signature Group Holdings, Inc. (SGGH.PK) at $1.03 per share. The Warrants vest as to shares of the underlying common stock as follows: 20% on the Effective Date June 11, 2010, and 20% each year in annual installments thereafter until the Warrants are fully vested on the fourth anniversary of the Effective Date. The amounts disclosed represent Mr. Noell's 62.5% benefical ownership share of Signature Group Holdings, LLC. |