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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 | |
KARFUNKEL MICHAEL C/O AMTRUST FINANCIAL SERVICES, INC. 59 MAIDEN LANE, 6TH FLOOR NEW YORK, NY 10038 |
X | X |
/s/ Michael Karfunkel | 11/26/2007 | |
**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) | AmTrust Financial Group, Inc. ("AFG") owned 24,089,286 shares of common stock of the Issuer. The Reporting Person owned 37.5% of AFG, and shared voting and investment power with Barry D. Zyskind and George Karfunkel. In an effort to simplify the stock ownership and pursuant to an Agreement of Merger among AFG, AFG Acquisition Corp. and the Issuer, the Reporting Person, Barry D. Zyskind and George Karfunkel received their approximate individual pro rata portion of shares of common stock formerly held by AFG. |
(2) | These shares are owned by New Gulf Holdings, Inc. (NGH), which is a wholly owned subsidiary of Gulf USA Corporation (Gulf). The Reporting Person owns 50.0% of Gulf. With respect to the shares owned by NGH, the Reporting Person shares voting and investment power with George Karfunkel. This does not include shares held by the Hod Foundation, a charitable foundation controlled by the Reporting Person, which owns 669,643 shares of common stock. The Reporting Person does not have a beneficial interest in the shares owned by Hod Foundation and, therefore, disclaims beneficial ownership of these shares of common stock. |