Amended Statement of Changes in Beneficial Ownership (4/a)
January 25 2022 - 6:07PM
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).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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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
*
Walvekar Vijay |
2. Issuer Name and Ticker or Trading Symbol
Heritage Insurance Holdings, Inc.
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HRTG
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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)
C/O HERITAGE INSURANCE HOLDINGS, INC, 2600 MCCORMICK DRIVE SUITE 300 |
3. Date of Earliest Transaction
(MM/DD/YYYY)
3/20/2017 |
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(Street)
CLEARWATER, FL 33759
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
3/28/2017 |
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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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 | 3/20/2017 (1) | | S | | 10000 | D | $12.4887 (2) | 80182 (3) | D | |
| Common Stock | 3/22/2017 (1) | | S | | 10000 | D | $12.2662 (4) | 70182 (3) | D | |
| Common Stock | 3/24/2017 | | S | | 3630 | D | $12.45 | 66552 (3) | D | |
| Common Stock | 3/27/2017 | | S | | 18370 | D | $12.4269 (5) | 48182 (3) | D | |
| Common Stock | | | | | | | | 237782 | I | See Footnote (6) |
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 |
| Explanation of Responses: |
| (1) | The filing is late due to an administrative oversight. |
| (2) | The price is the weighted average price for the transactions reported on this line. The range of prices for the transactions reported on this line is between $12.46 and $12.54 per share. Complete information regarding the number of shares purchased at each separate price will be provided upon request by the Commission Staff, the issuer or a security holder of the issuer. |
| (3) | This amendment is being filed solely to correct errors in the numbers of shares beneficially owned by the Reporting Person. |
| (4) | The price is the weighted average price for the transactions reported on this line. The range of prices for the transactions reported on this line is between $12.25 and $12.31 per share. Complete information regarding the number of shares purchased at each separate price will be provided upon request by the Commission Staff, the issuer or a security holder of the issuer. |
| (5) | The price is the weighted average price for the transactions reported on this line. The range of prices for the transactions reported on this line is between $12.41 and $12.49 per share. Complete information regarding the number of shares purchased at each separate price will be provided upon request by the Commission Staff, the issuer or a security holder of the issuer. |
| (6) | Shares of common stock reported on this line are held by Mr. Walvekar's wife. |
Reporting Owners
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| Reporting Owner Name / Address | Relationships |
| Director | 10% Owner | Officer | Other |
Walvekar Vijay
C/O HERITAGE INSURANCE HOLDINGS, INC
2600 MCCORMICK DRIVE SUITE 300
CLEARWATER, FL 33759 | X |
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Signatures
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| /s/ Vijay Walvekar | | 1/25/2022 |
| **Signature of Reporting Person | Date |
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