Statement of Changes in Beneficial Ownership (4)
May 26 2021 - 7:23PM
Edgar (US Regulatory)
FORM 4
[X]
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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3235-0287
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Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
*
Juffer Paul A. |
2. Issuer Name and Ticker or Trading Symbol
FBL FINANCIAL GROUP INC
[
FFG
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__X__ Director _____ 10% Owner
_____ Officer (give title below) _____ Other (specify below)
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(Last)
(First)
(Middle)
5400 UNIVERSITY AVENUE |
3. Date of Earliest Transaction
(MM/DD/YYYY)
5/25/2021 |
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(Street)
WEST DES MOINES, IA 50266
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
_X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1.Title of Security
(Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code
(Instr. 8)
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4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security
(Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Trans. Date | 3A. Deemed Execution Date, if any | 4. Trans. 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 | 7. Title and Amount of Securities Underlying Derivative Security
(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) |
| Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
| Restricted Stock Units (Cash Settled) | (1) | 5/25/2021 | | D | | | 4437.35 | (1) | (1) | Class A Common Stock | 4437.35 | $61 | 0 | D | |
| Explanation of Responses: |
| (1) | Each unit of cash settled RSUs represented the economic equivalent of one share of FBL Financial Group, Inc. Class A common stock. The cash settled RSUs were accrued under the FBL Financial Group, Inc. Director Compensation Plan. In conjunction with the merger of FBL Financial Group, Inc. and 5400 Merger Sub, Inc., pursuant to an agreement and plan of merger dated January 11, 2021 and amended on May 2, 2021, these RSUs were cancelled and exchanged for the right to receive an amount in cash equal to $61.00 per unit, with payment subject to deferral elections made by the reporting person under the Director Compensation Plan. |
Reporting Owners
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| Reporting Owner Name / Address | Relationships |
| Director | 10% Owner | Officer | Other |
Juffer Paul A.
5400 UNIVERSITY AVENUE
WEST DES MOINES, IA 50266 | X |
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Signatures
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| By: Mark Wickham per filed confirming stmt: For: Paul Juffer | | 5/26/2021 |
| **Signature of Reporting Person | Date |
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