Sec Form 13D Filing - Clinton Richard Kevin filing for ICC Holdings Inc. (ICCH) - 2018-09-12

UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549



SCHEDULE 13D/A

Under  the  Securities Exchange  Act of 1934  (Amendment No.  1)*





ICC Holdings, Inc.

(Name of Issuer)



Common Stock, $0.01 par value per share

(Title of Class of Securities)



44931Q104

(CUSIP Number)





R. Kevin Clinton

6410 Oakencliffe Lane

East Lansing, Michigan 48823

Telephone: 517-204-2857

(Name, Address and Telephone Number of Person Authorized to Receive Notices and Communications)



September 7, 2018

(Date of Event which Requires Filing of this Statement)







If the filing person has previously filed a statement on Schedule 13G  to report the acquisition that is  the subject of this Schedule 13D, and is  filing this  schedule because of §§240.13d-1(e), 240.13d-1(f) or 240.13d-1(g), check the following box. ☐







Note:  Schedules filed in  paper format shall include a signed original and five copies of the schedule, including all exhibits. See §240.13d-7 for other  parties  to whom copies are  to  be sent.





* The remainder of this cover page shall be filled out for a reporting person’s initial filing on this form with respect to the subject class of securities, and  for any subsequent amendment containing information which would alter disclosures provided in a prior cover page.



The information required on the remainder of this cover page shall not  be deemed to  be “filed” for the purpose of Section 18 of the Securities Exchange  Act of 1934 (“Act”) or otherwise subject to the liabilities of that section of the Act but shall be subject to all other  provisions of the Act (however, see the  Notes).







The Reporting Persons are filing this Amendment No. 1 to the Schedule 13D (“Amendment No. 1”) to amend and supplement the original Schedule 13D filed on April 17, 2017 (the “13D Filing”).  The purpose of this Amendment No. 1 is to expand and supplement the Reporting Persons’ disclosures under Items 3, 5 and 7 to reflect the sale of shares of common stock on September 7, 2018 pursuant to a stock purchase agreement, dated August 31, 2018 (the “Stock Purchase Agreement”), with ICC Holdings, Inc.  Capitalized terms used and not defined in this Amendment No. 1 have the meanings ascribed to such terms in the 13D Filing.  Except as specifically amended and supplemented by this Amendment No. 1, the 13D Filing remains in full force and effect.



Item  3.         Source or Amount of Funds  or Other Consideration.



Item 3 is hereby amended to add the following paragraph:



The Reporting Persons sold 147,541 shares of Common Stock to the Issuer for an aggregate purchase price of $2,250,000.25 ($15.25 per share) pursuant to the Stock Purchase Agreement.  As of the date hereof, the Reporting Persons hold 452,459 shares of Common Stock.



Item  5.         Interest in Securities of  the Issuer.



Items 5 (a) - (c) are hereby amended and restated to read as follows:



(a) - (c)



The Reporting Persons may be deemed to  beneficially own, in the aggregate, 452,459 shares of Common Stock, representing approximately 12.9% of the  Issuer’s issued and outstanding shares of Common Stock, based on 3,500,000 shares of Common Stock of the Issuer issued and outstanding as of August 9,2018, as set forth in the Issuer’s Quarterly Report on Form 10-Q  for the period ended June 30, 2018, filed with the SEC on August 14, 2018.