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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 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) | The Michael Karfunkel 2005 Grantor Retained Annuity Trust distributed 9,864,781 shares of Common Stock by its terms to the Michael Karfunkel Family 2005 Trust (the "Family Trust"). |
| (2) | The reporting person was the sole trustee and a beneficiary of the Michael Karfunkel 2005 Grantor Retained Annuity Trust |
| (3) | On February 2, 2016, the common stock of AmTrust Financial Services, Inc. split two-for-one, resulting in the reporting person's indirect ownership as co-trustee of the Family Trust of 9,864,781 additional shares of Common Stock. This is not reflected in this Form 4/A, which reports the amount of shares impacted by the transaction and the resulting beneficial ownership as of the date of the original Form 4 filing. |
| (4) | The reporting person is co-trustee and a beneficiary of the Family Trust, shares voting and dispositive power over 3,814,781 of the shares of Common Stock held by the Family Trust, and has sole voting and dispositive power over the remaining 6,050,000 shares of Common Stock held by the Family Trust. |
| Remarks: This amended Form 4 is being filed to correct the amount of securities impacted by and beneficially owned following the reported transaction. The original Form 4 stated 10,029,637 shares of Common Stock were distributed, acquired and beneficially owned, and that the reporting person shared voting and dispositive power over 3,979,637 shares of Common Stock held by the Family Trust. These amounts did not take into account a March 31, 2015 distribution of 164,856 shares of Common Stock from the Michael Karfunkel 2005 Grantor Retained Annuity Trust to Michael Karfunkel, as reported on a Form 5 filed by the reporting person on June 20, 2016 | |