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Share Name | Share Symbol | Market | Type |
---|---|---|---|
Independence Holding Company | NYSE:IHC | NYSE | Common Stock |
Price Change | % Change | Share Price | High Price | Low Price | Open Price | Shares Traded | Last Trade | |
---|---|---|---|---|---|---|---|---|
0.00 | 0.00% | 57.01 | 0 | 00:00:00 |
FORM 3
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Washington, D.C. 20549 |
OMB APPROVAL
OMB Number: 3235-0104 Expires: November 30, 2011 Estimated average burden hours per response... 0.5 |
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1. Name and Address of Reporting Person * Balzofiore Gary |
2. Date of Event Requiring Statement (MM/DD/YYYY)
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3. Issuer Name and Ticker or Trading Symbol INDEPENDENCE HOLDING CO [IHC] |
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4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
_____ Director
_____ 10% Owner
___ X ___ Officer (give title below) _____ Other (specify below) Corporate Vice President / |
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5. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
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X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person |
Table I - Non-Derivative Securities Beneficially Owned |
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1.Title of Security
(Instr. 4) |
2. Amount of Securities Beneficially Owned
(Instr. 4) |
3. Ownership Form: Direct (D) or Indirect (I)
(Instr. 5) |
4. Nature of Indirect Beneficial Ownership
(Instr. 5) |
Common Stock | 25473 | D |
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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. 4) |
2. Date Exercisable and Expiration Date
(MM/DD/YYYY) |
3. Title and Amount of Securities Underlying Derivative Security
(Instr. 4) |
4. Conversion or Exercise Price of Derivative Security |
5. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
(Instr. 5) |
6. Nature of Indirect Beneficial Ownership
(Instr. 5) |
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Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
Stock Option (right to buy) | 1/5/2011 | 1/4/2015 | Common Stock | 14666 | $9.09 | D |
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Stock Option (right to buy) | 1/5/2012 | 1/4/2015 | Common Stock | 14666 | $9.09 | D |
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Stock Option (right to buy) | 1/5/2013 | 1/4/2015 | Common Stock | 14666 | $9.09 | D |
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Stock Appreciation Right | 3/16/2011 | 3/15/2016 | Common Stock | 8800 | $7.11 | D |
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Explanation of Responses: |
Reporting Owners
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Reporting Owner Name / Address |
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Director | 10% Owner | Officer | Other | ||
Balzofiore Gary
485 MADISON AVENUE NEW YORK, NY 10022 |
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Corporate Vice President |
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Signatures
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Gary Balzofiore | 3/20/2012 | |
** Signature of Reporting Person | Date |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |
* | If the form is filed by more than one reporting person, see Instruction 5(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). |
Note: | File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. |
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. |
1 Year Independence Chart |
1 Month Independence Chart |
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