UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549INITIAL STATEMENT OF 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 |
|
| ||||||||||||||||||||||||||||||
|
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | SEC 1473 (7-02) | ||
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. |
1. Title of Derivative Security (Instr. 4) |
2. Date Exercisable and Expiration Date (Month/Day/Year) |
3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) |
4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 5) |
6. Nature of Indirect Beneficial Ownership (Instr. 5) |
||
Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Bergonzi Adam T. C/O MBIA INC. 1 MANHATTANVILLE ROAD, SUITE 301 PURCHASE, NY 10577 |
 |  |  AVP & Chief Portfolio Officer |  |
/s/ Jonathan C. Harris, Attorney-in-fact | 09/25/2017 | |
**Signature of Reporting Person | Date |
* | If the form is filed by more than one reporting person, see Instruction 5(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) | Shares acquired prior to status as Reporting Person including a) 17,675 shares held in the Reporting Person's accounts; b) 3,193 shares of restricted stock granted at $12.78 per share and vesting entirely in March 2018, 5,444 shares of restricted stock granted at $14.99 per share and vesting 50% in March 2018 and 50% in March 2019, 13,063 shares of restricted stock granted at $9.37 per share and vesting in one-third increments in each of March 2018, 2019 and 2020, 20,427 shares of restricted stock granted at $8.44 per share and vesting in one-third increments in March 2019, 2020 and 2021, and 12,777 shares of restricted stock granted at $9.58 per share and vesting in one-third increments in March 2020, 2021 and 2022 and c) 15,010 shares held in the Amended and Restated MBIA Inc. Deferred Compensation and Excess Benefit Plan. |
(2) | Shares acquired by spouse prior to designation as Reporting Person includes 429 shares held privately with personal Fidelity 401(k) retirement account. |