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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 |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Pollett William C/O MONTPELIER RE HOLDINGS LTD. MONTPELIER HOUSE, 94 PITTS BAY ROAD PEMBROKE, D0 HM 08 |
X | President and CEO |
/s/ Jonathan B. Kim, attorney in fact | 06/16/2014 | |
**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) | Represents an award of restricted share units made on June 15, 2014 by the Company to Mr. Pollett. This award will vest in three equal tranches on June 15, 2015, 2016 and 2017, subject to the Director remaining actively engaged as a Director in good standing on such dates. |
(2) | In accordance with a letter agreement between Montpelier Re Holdings Ltd. ("MRH") and Mr. Pollett, all remuneration, including cash fees, restricted share units, any other equity-based awards and other compensation, to which Mr. Pollett is or will become entitled for his service as a Director of the Company will be assigned or paid directly to MRH. Mr. Pollett disclaims beneficial ownership of all such restricted share units, except to the extent of his pecuniary interest in such restricted share units by virtue of his ownership of MRH common shares. |