D.C. Mun. Regs. tit. 26, r. 26-A1499
When used in this title, the following terms and phrases shall have the meanings ascribed, in accordance with the provisions of this section:
ACT - the Act of Congress approved April 18, 1966, Public Law 89-402.
CLASS - all securities of an insurer which are of substantially similar character and the holders of which enjoy substantially similar rights and privileges.
EQUITY SECURITY - any stock or similar security; or any voting trust certificate or certificate of deposit for a security; or any security convertible, with or without consideration, into such a security, or carrying any warrant or right to subscribe to or purchase such a security; or any such warrant or right.
INSURER - a stock insurance company incorporated or organized under the laws of the District of Columbia.
MAYOR - the Mayor of the District of Columbia.
OFFICER - a president, vice president, treasurer, actuary, secretary, controller and any other person who performs for the insurer functions corresponding to those performed by the officers.
COMMISSIONER - the Commissioner of the Department of Insurance, D.C.
APPENDIX 14-1
[To be used pursuant to the provisions of § 1402.1 ]
SCHEDULE A
Initial Statements of Beneficial Ownership Instructions
An initial statement of beneficial ownership is required to be filed by every person who is directly or indirectly the beneficial owner of more than 10 per cent of any class of any equity security of a domestic stock insurance company, or who is a director or an officer of a company.
One signed copy of each statement shall be filed with the Commissioner of Insurance.
A separate statement shall be filed with respect to the securities of each company.
Indicate clearly the relationship of the reporting person to the company; for example, "Director," "Director and Vice President," "Beneficial owner of more than 10 per cent of the company's stock," etc.
The information as to beneficial ownership of securities shall be given as of December 31, 1965, or in the case of persons who subsequently assume any of the relationships specified in Instruction 1, as of the date that relationship was assumed.
The statement of the title of a security shall be written so as to clearly identify the security even though there may be only one class; for example, "Class A common Stock," "$6 Convertible Preferred Stock," "5% Debentures Due 1965," etc.
State whether ownership of the securities is "direct" or "indirect." If the ownership is indirect, i.e. 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 shall be reported on separate lines from those owned directly and also from those owned through a different type of indirect ownership.
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 or she so desires, also indicate in a footnote, or other appropriate manner, the extent of his or her interest in the partnership, corporation, trust or other entity.
A statement may include any additional information or explanation considered relevant by the person filing the statement.
If the statement is filed for a corporation, partnership, trust, etc., 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 her or specifically on his or her behalf by a person authorized to sign for him or her.
APPENDIX 14-2
[To be used pursuant to the
provisions of § 1402.2 ]
SCHEDULE B
Statement of Changes in Beneficial Ownership
(Instructions)
A statement of changes in beneficial ownership is required to be filed by every person who at any time during any calendar month was directly or indirectly the beneficial owner of more than 10 per cent of any class of equity security of a domestic stock insurance company, or a director or officer of the company which is the issuer of the securities, and who during the month had any change in his or her beneficial ownership of any class of equity security of the company.
Statements are required to be filed on or before the 10th day after the end of each month in which any change in beneficial ownership has occurred. Statements are not deemed to have been filed with the Commissioner until they have actually been received by him or her.
One signed copy of each statement shall be filed with the Commissioner of Insurance.
A separate statement shall be filed with respect to the securities of each company.
Indicate clearly the relationship of the reporting person to the company; for example, "Director," "Director and Vice President," "Beneficial owner of more than 10 per cent of the company's common stock," etc.
Every transaction shall be reported even though purchases and sales during the month are equal or the change involves only the nature of the ownership; for example, direct to indirect ownership. Beneficial ownership at the end of the month of all classes of securities required to be reported shall be shown even though there has been no change during the month in the ownership of securities of one or more classes.
The statement of the title of the security shall be clearly identified even though there may be only one class; for example; "Class A Common Stock," "$6 Convertible Preferred Stock," "5% Debentures Due 1965," etc.
The exact date (month, day and year) of each transaction shall be stated opposite the amount involved in the transaction.
In stating the amount of the securities acquired, disposed of, or 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, i.e., through a partnership, corporation, trust or other entity, the entire amount of securities involved in the transaction or owned by the partnership, corporation, trust or other entity shall be stated. The person whose ownership is reported may, if he or she so desires, also indicate in a footnote, or other appropriate manner, the extent of his or her interest in the transaction or holdings of the partnership, corporation, trust or other entity.
State whether ownership of the securities is "direct" or "indirect" If the ownership is indirect, i.e., 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 of other nominee does not, of itself, constitute indirect ownership. Securities owned indirectly shall be reported on separate lines from those owned directly and from those owned through a different type of indirect ownership.
If the transaction was the issuer of the securities, so state. If it involved the purchase of securities through the exercise of options, so state and give the exercise price per share. If any other purchase or sale as effected otherwise than in the open market, that fact shall be indicated. If the transaction was not a purchase or sale, indicate its character; for example, gift, 5% stock dividend, etc., as the case may be. The foregoing information may be appropriately set forth in the table or under "Remarks" at the end of the table.
A statement may include any additional information or explanation considered relevant by the person filing the statement.
If the statement is filed for a corporation, partnership, trust, etc., 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 her specifically on his or her behalf by a person authorized to sign for him or her.
D.C. Mun. Regs. tit. 26, r. 26-A1499