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Smith Michael R. – ‘4’ for 4/1/24 re: ICC Holdings, Inc.

On:  Tuesday, 4/2/24, at 1:40pm ET   ·   For:  4/1/24   ·   As:  Officer   ·   Accession #:  1593968-24-539   ·   File #:  1-38046

Previous ‘4’:  ‘4’ on / for 3/4/24   ·   Latest ‘4’:  This Filing

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  As Of               Filer                 Filing    For·On·As Docs:Size             Issuer                      Filing Agent

 4/02/24  Smith Michael R.                  4          Officer     2:23K  ICC Holdings, Inc.                Equity Administr… Inc/FA

Statement of Changes in Beneficial Ownership of Securities by an Insider   —   Form 4   —   SEA’34

Filing Table of Contents

Document/Exhibit                   Description                      Pages   Size 

 1: 4           Statement of Changes in Beneficial Ownership of     HTML     20K 
                Securities by an Insider -- primary_01.xml/5.8                   
 2: EX-24       EX-24 Document                                      HTML      7K

‘4’   —   Statement of Changes in Beneficial Ownership of Securities by an Insider — primary_01.xml/5.8



        

This ‘4’ Document is an XML Data File that may be rendered in various formats:

  Form 4    –   Plain Text   –  SEC Website  –  EDGAR System  –    XML Data    –  <?xml?> File
 
 
SEC Info℠ rendering:  Statement of Changes in Beneficial Ownership of Securities by an Insider
 

The SEC has not released XSLT Stylesheets needed to render this File’s XML Data as a Form.

This is our “Plain Text” rendering:
 
                                                                                                                                                                                
Ownership Document
 
Schema Version:  X0508
Document Type:  4
Period of Report:  4/1/24
Issuer:
Issuer CIK:  1681903
Issuer Name:  ICC Holdings, Inc.
Issuer Trading Symbol:  ICCH
Reporting Owner:
Reporting Owner ID:
Owner CIK:  1699809
Owner Name:  Smith Michael R.
Reporting Owner Address:
Owner Street 1:  225 20TH ST
Owner Street 2:
Owner City:  ROCK ISLAND
Owner State:  IL
Owner ZIP Code:  61201-8810
Owner State Description:
Reporting Owner Relationship:
Is Director?  No
Is Officer?  Yes
Is Ten Percent Owner?  No
Is Other?  No
Officer Title:  Chief Financial Officer
Other Text:
Aff 10b5 One?  No
Non-Derivative Table:
Non-Derivative Transaction:
Security Title:
Value:  Common Stock
Footnote ID:  F1
Transaction Date:
Value:  4/1/24
Transaction Coding:
Transaction Form Type:  4
Transaction Code:  M
Equity Swap Involved?  No
Transaction Amounts:
Transaction Shares:
Value:  834
Transaction Price Per Share:
Value:  16
Transaction Acquired-Disposed Code:
Value:  A
Post-Transaction Amounts:
Shares Owned Following Transaction:
Value:  6,931
Ownership Nature:
Direct or Indirect Ownership:
Value:  D
Non-Derivative Transaction:
Security Title:
Value:  Common Stock
Footnote ID:  F1
Transaction Date:
Value:  4/1/24
Transaction Coding:
Transaction Form Type:  4
Transaction Code:  M
Equity Swap Involved?  No
Transaction Amounts:
Transaction Shares:
Value:  500
Transaction Price Per Share:
Value:  16
Transaction Acquired-Disposed Code:
Value:  A
Post-Transaction Amounts:
Shares Owned Following Transaction:
Value:  7,431
Ownership Nature:
Direct or Indirect Ownership:
Value:  D
Non-Derivative Transaction:
Security Title:
Value:  Common Stock
Footnote ID:  F1
Transaction Date:
Value:  4/1/24
Transaction Coding:
Transaction Form Type:  4
Transaction Code:  M
Equity Swap Involved?  No
Transaction Amounts:
Transaction Shares:
Value:  700
Transaction Price Per Share:
Value:  16
Transaction Acquired-Disposed Code:
Value:  A
Post-Transaction Amounts:
Shares Owned Following Transaction:
Value:  8,131
Ownership Nature:
Direct or Indirect Ownership:
Value:  D
Non-Derivative Holding:
Security Title:
Value:  Common Stock
Post-Transaction Amounts:
Shares Owned Following Transaction:
Value:  10,500
Ownership Nature:
Direct or Indirect Ownership:
Value:  I
Nature of Ownership:
Value:  401(k)
Non-Derivative Holding:
Security Title:
Value:  Common Stock
Post-Transaction Amounts:
Shares Owned Following Transaction:
Value:  8,300
Ownership Nature:
Direct or Indirect Ownership:
Value:  I
Nature of Ownership:
Value:  IRA
Non-Derivative Holding:
Security Title:
Value:  Common Stock
Post-Transaction Amounts:
Shares Owned Following Transaction:
Value:  709.784
Ownership Nature:
Direct or Indirect Ownership:
Value:  I
Nature of Ownership:
Value:  By ESOP
Non-Derivative Holding:
Security Title:
Value:  Common Stock
Post-Transaction Amounts:
Shares Owned Following Transaction:
Value:  1,400
Ownership Nature:
Direct or Indirect Ownership:
Value:  I
Nature of Ownership:
Value:  401(k)
Non-Derivative Holding:
Security Title:
Value:  Common Stock
Post-Transaction Amounts:
Shares Owned Following Transaction:
Value:  795.1674
Ownership Nature:
Direct or Indirect Ownership:
Value:  I
Nature of Ownership:
Value:  By ESOP
Non-Derivative Holding:
Security Title:
Value:  Common Stock
Post-Transaction Amounts:
Shares Owned Following Transaction:
Value:  351
Ownership Nature:
Direct or Indirect Ownership:
Value:  I
Nature of Ownership:
Value:  401(k)
Non-Derivative Holding:
Security Title:
Value:  Common Stock
Post-Transaction Amounts:
Shares Owned Following Transaction:
Value:  202
Ownership Nature:
Direct or Indirect Ownership:
Value:  I
Nature of Ownership:
Value:  401(k)
Non-Derivative Holding:
Security Title:
Value:  Common Stock
Post-Transaction Amounts:
Shares Owned Following Transaction:
Value:  9,971
Ownership Nature:
Direct or Indirect Ownership:
Value:  I
Nature of Ownership:
Value:  IRA
Non-Derivative Holding:
Security Title:
Value:  Common Stock
Post-Transaction Amounts:
Shares Owned Following Transaction:
Value:  5,000
Ownership Nature:
Direct or Indirect Ownership:
Value:  I
Nature of Ownership:
Value:  IRA
Non-Derivative Holding:
Security Title:
Value:  Common Stock
Post-Transaction Amounts:
Shares Owned Following Transaction:
Value:  727.2373
Ownership Nature:
Direct or Indirect Ownership:
Value:  I
Nature of Ownership:
Value:  By ESOP
Non-Derivative Holding:
Security Title:
Value:  Common Stock
Post-Transaction Amounts:
Shares Owned Following Transaction:
Value:  9
Ownership Nature:
Direct or Indirect Ownership:
Value:  I
Nature of Ownership:
Value:  IRA
Non-Derivative Holding:
Security Title:
Value:  Common Stock
Post-Transaction Amounts:
Shares Owned Following Transaction:
Value:  866
Ownership Nature:
Direct or Indirect Ownership:
Value:  I
Nature of Ownership:
Value:  By ESOP
Non-Derivative Holding:
Security Title:
Value:  Common Stock
Post-Transaction Amounts:
Shares Owned Following Transaction:
Value:  1,000
Ownership Nature:
Direct or Indirect Ownership:
Value:  I
Nature of Ownership:
Value:  IRA
Non-Derivative Holding:
Security Title:
Value:  Common Stock
Post-Transaction Amounts:
Shares Owned Following Transaction:
Value:  211
Ownership Nature:
Direct or Indirect Ownership:
Value:  I
Nature of Ownership:
Value:  IRA
Non-Derivative Holding:
Security Title:
Value:  Common Stock
Post-Transaction Amounts:
Shares Owned Following Transaction:
Value:  2,789
Ownership Nature:
Direct or Indirect Ownership:
Value:  I
Nature of Ownership:
Value:  IRA
Non-Derivative Holding:
Security Title:
Value:  Common Stock
Post-Transaction Amounts:
Shares Owned Following Transaction:
Value:  1,000
Ownership Nature:
Direct or Indirect Ownership:
Value:  I
Nature of Ownership:
Value:  401(k)
Non-Derivative Holding:
Security Title:
Value:  Common Stock
Post-Transaction Amounts:
Shares Owned Following Transaction:
Value:  824
Ownership Nature:
Direct or Indirect Ownership:
Value:  I
Nature of Ownership:
Value:  By ESOP
Non-Derivative Holding:
Security Title:
Value:  Common Stock
Post-Transaction Amounts:
Shares Owned Following Transaction:
Value:  1,092
Ownership Nature:
Direct or Indirect Ownership:
Value:  I
Nature of Ownership:
Value:  By ESOP
Non-Derivative Holding:
Security Title:
Value:  Common Stock
Post-Transaction Amounts:
Shares Owned Following Transaction:
Value:  2000
Ownership Nature:
Direct or Indirect Ownership:
Value:  I
Nature of Ownership:
Value:  By 401K
Non-Derivative Holding:
Security Title:
Value:  Common Stock
Post-Transaction Amounts:
Shares Owned Following Transaction:
Value:  931
Ownership Nature:
Direct or Indirect Ownership:
Value:  I
Nature of Ownership:
Value:  By ESOP
Derivative Table:
Derivative Transaction:
Security Title:
Value:  Restricted Stock Unit
Conversion or Exercise Price:
Value:  0
Footnote ID:  F2
Transaction Date:
Value:  4/1/24
Transaction Coding:
Transaction Form Type:  4
Transaction Code:  M
Equity Swap Involved?  No
Transaction Amounts:
Transaction Shares:
Value:  834
Transaction Price Per Share:
Value:  16
Transaction Acquired-Disposed Code:
Value:  D
Exercise Date:
Footnote ID:  F3
Expiration Date:
Footnote ID:  F4
Underlying Security:
Underlying Security Title:
Value:  ICC Holdings, Inc. Common Stock
Underlying Security Shares:
Value:  834
Post-Transaction Amounts:
Shares Owned Following Transaction:
Value:  0
Ownership Nature:
Direct or Indirect Ownership:
Value:  D
Derivative Transaction:
Security Title:
Value:  Restricted Stock Unit
Conversion or Exercise Price:
Value:  0
Footnote ID:  F2
Transaction Date:
Value:  4/1/24
Transaction Coding:
Transaction Form Type:  4
Transaction Code:  M
Equity Swap Involved?  No
Transaction Amounts:
Transaction Shares:
Value:  500
Transaction Price Per Share:
Value:  16
Transaction Acquired-Disposed Code:
Value:  D
Exercise Date:
Footnote ID:  F3
Expiration Date:
Footnote ID:  F4
Underlying Security:
Underlying Security Title:
Value:  ICC Holdings, Inc. Common Stock
Underlying Security Shares:
Value:  500
Post-Transaction Amounts:
Shares Owned Following Transaction:
Value:  500
Ownership Nature:
Direct or Indirect Ownership:
Value:  D
Derivative Transaction:
Security Title:
Value:  Restricted Stock Unit
Conversion or Exercise Price:
Value:  0
Footnote ID:  F2
Transaction Date:
Value:  4/1/24
Transaction Coding:
Transaction Form Type:  4
Transaction Code:  M
Equity Swap Involved?  No
Transaction Amounts:
Transaction Shares:
Value:  700
Transaction Price Per Share:
Value:  16
Transaction Acquired-Disposed Code:
Value:  D
Exercise Date:
Footnote ID:  F3
Expiration Date:
Footnote ID:  F4
Underlying Security:
Underlying Security Title:
Value:  ICC Holdings, Inc. Common Stock
Underlying Security Shares:
Value:  700
Post-Transaction Amounts:
Shares Owned Following Transaction:
Value:  1,400
Ownership Nature:
Direct or Indirect Ownership:
Value:  D
Derivative Transaction:
Security Title:
Value:  Restricted Stock Unit
Conversion or Exercise Price:
Value:  0
Footnote ID:  F2
Transaction Date:
Value:  4/1/24
Transaction Coding:
Transaction Form Type:  4
Transaction Code:  A
Equity Swap Involved?  No
Transaction Amounts:
Transaction Shares:
Value:  3,100
Transaction Price Per Share:
Value:  0
Transaction Acquired-Disposed Code:
Value:  A
Exercise Date:
Footnote ID:  F3
Expiration Date:
Footnote ID:  F4
Underlying Security:
Underlying Security Title:
Value:  ICC Holdings, Inc. Common Stock
Underlying Security Shares:
Value:  3,100
Post-Transaction Amounts:
Shares Owned Following Transaction:
Value:  3,100
Ownership Nature:
Direct or Indirect Ownership:
Value:  D
Footnotes:
Footnote - F1:  RSU with 3 Year Periodic vesting schedule
Footnote - F2:  No exercise price for this type of award
Footnote - F3:  No exercisable date for this type of award
Footnote - F4:  No expiration date for this type of award
Remarks:
Owner Signature:
Signature Name:  /s/Kathleen S. Springer, Attorney in Fact
Signature Date:  4/2/24


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