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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549ANNUAL STATEMENT 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 2270 (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 at End of Issuer's Fiscal Year (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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(A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Karfunkel Leah C/O AMTRUST FINANCIAL SERVICES, INC. 59 MAIDEN LANE, 43RD FLOOR NEW YORK, NY 10038 |
 X |  X |  |  |
/s/ Leah Karfunkel | 06/20/2016 | |
**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) | Shares distributed from the Michael Karfunkel 2005 Grantor Retained Annuity Trust to Michael Karfunkel. |
(2) | On February 2, 2016, the common stock of AmTrust Financial Services, Inc. split two-for-one, resulting in the ownership of 9,864,781 additional shares of common stock. This is not reflected in this Form 5, which reports the transaction as of March 31, 2015 and the ownership as of the end of the Issuer's 2015 fiscal year. |
(3) | At the time of this transaction, shares were held indirectly by the reporting owner as sole trustee and beneficiary of the Michael Karfunkel 2005 Grantor Retained Annuity Trust. On July 28, 2015, the Michael Karfunkel 2005 Grantor Retained Annuity Trust distributed all of its shares of Common Stock by its terms to the Michael Karfunkel Family 2005 Trust. The reporting person is co-trustee and a beneficiary of the Michael Karfunkel Family 2005 Trust. |