New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 2 - INSURANCE GROUP › Subchapter 9 - INSIDER TRADING OF DOMESTIC STOCK INSURANCE COMPANY EQUITY SECURITIES › Section 11:2-9.23 - Instructions for Form A

Current through Register Vol. 56, No. 14, July 15, 2024
(a) A statement on this form is required to be filed by every person who is directly or indirectly the beneficial owner of more than ten per cent of any class of any equity security of a New Jersey stock insurance company, or who is a director or an officer of such a company.
(b) Persons who hold any of the relationships specified in (a) above are required to file a statement by January 31, 1966, or within 10 days after assuming such relationship, whichever date is later.
(c) Statements are not deemed to have been filed with the Commissioner until they have actually been received by him.
(d) One signed copy of each statement shall be filed with the Commissioner of Banking and Insurance, State House Annex, Trenton, New Jersey 08625.
(e) A separate statement shall be filed with respect to the securities of each company.
(f) Indicate clearly the relationship of the reporting person to the Company; for example, "Director", "Director and Vice President", "Beneficial owner of more than ten per cent of the company's common stock", and so forth.
(g) The information as to beneficial ownership of securities shall be given as of January 31, 1966, or, in the case of persons who subsequently assume any of the relationships specified in (a) above, as of the date that relationship was assumed.
(h) The statement of the title of a security shall be such as clearly to identify the security even though there may be only one class; for example, "Class A common stock", "$ 6 convertible preferred stock", "5 per cent debentures due 1965", and so forth.
(i) Under "Nature of ownership", state whether ownership of the securities is "direct" or "indirect". If the ownership is indirect, that is, through a partnership, corporation, trust or other entity, indicate, in a footnote or other appropriate manner, the name or identity of the medium through which the securities are indirectly owned. The fact that securities are held in the name of a broker or other nominee does not, of itself, constitute indirect ownership. Securities owned indirectly shall be reported on separate lines from those owned directly and also from those owned through a different type of indirect ownership.
(j) In stating the amount of securities beneficially owned, give the face amount of debt securities or the number of shares or other units of other securities. In the case of securities owned indirectly, the entire amount of securities owned by the partnership, corporation, trust or other entity shall be stated. The person whose ownership is reported may, if he so desires, also indicate in a footnote, or other appropriate manner, the extent of his interest in the partnership, corporation, trust or other entity.
(k) A statement may include any additional information or explanation deemed relevant by the person filing the statement.
(l) If the statement is filed for a corporation, partnership, trust, and so forth, the name of the organization shall appear over the signature of the officer or other person authorized to sign the statement. If the statement is filed for an individual, it shall be signed by him or specifically on his behalf by a person authorized to sign for him.