Sec Form 4 Filing - Hyer Raymond T @ Heritage Insurance Holdings, Inc. - 2023-12-19

Insider filing report for Changes in Beneficial Ownership
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FORM 4
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
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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1. Name and Address of Reporting Person
Hyer Raymond T
2. Issuer Name and Ticker or Trading Symbol
Heritage Insurance Holdings, Inc. [ HRTG]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director X __ 10% Owner
_____ Officer (give title below) _____ Other (specify below)
(Last) (First) (Middle)
3919 E 7TH AVENUE
3. Date of Earliest Transaction (MM/DD/YY)
12/19/2023
(Street)
TAMPA, FL33605
4. If Amendment, Date Original Filed (MM/DD/YY)
6. Individual or Joint/Group Filing (Check Applicable Line)
_____ Form filed by One Reporting Person
__ X __ Form filed by More than One Reporting Person
(City) (State) (Zip)
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1.Title of Security
(Instr. 3)
2. Transaction Date (MM/DD/YY) 2A. Deemed Execution Date, if any (MM/DD/YY) 3. Transaction Code
(Instr. 8)
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
6. Ownership Form: Direct (D) or Indirect (I)
(Instr. 4)
7. Nature of Indirect Beneficial Ownership
(Instr. 4)
Code V Amount (A) or (D) Price
COMMON STOCK 12/19/2023 P 148,148 A $ 6.75 2,959,263 ( 1 ) D
COMMON STOCK 100,000 ( 2 ) D
COMMON STOCK 50,000 ( 3 ) D
COMMON STOCK 22,000 ( 4 ) D
COMMON STOCK 460,000 ( 5 ) I See Footnote
COMMON STOCK 120,000 ( 6 ) I See Footnote
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
( e.g. , puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security
(Instr. 3)
2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (MM/DD/YY) 3A. Deemed Execution Date, if any (MM/DD/YY) 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
(MM/DD/YY)
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)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Hyer Raymond T
3919 E 7TH AVENUE
TAMPA, FL33605
X
HYER KATHLEEN A
3919 E 7TH AVENUE
TAMPA, FL33605
MEMBER OF GROUP
TIRA TARA K
3919 E 7TH AVENUE
TAMPA, FL33605
MEMBER OF GROUP
POOLE SEAN W
3919 E 7TH AVE
TAMPA, FL33605
MEMBER OF GROUP
FUTURA CIRCUITS CORP.
3919 E 7TH AVE
TAMPA, FL33605
MEMBER OF GROUP
HYER FAMILY PARTNERSHIP, LLC
3919 E 7TH AVE
TAMPA, FL33605
MEMBER OF GROUP
Signatures
/s/ Raymond T. Hyer 02/20/2024
Signature of Reporting Person Date
/s/ Kathleen Hyer Revocable Trust, by Raymond T. Hyer as Co-Trustee 02/20/2024
Signature of Reporting Person Date
Tara K. Tira 02/20/2024
Signature of Reporting Person Date
/s/ Sean W. Poole 02/20/2024
Signature of Reporting Person Date
/s/ Raymond T. Hyer (P of Futura Circuits Corp.) 02/20/2024
Signature of Reporting Person Date
/s/ Sean Poole, Manager of Hyer Family Partnership, LLC 02/20/2024
Signature of Reporting Person Date
Explanation of Responses:
( 1 )These securities are owned solely by Raymond T. Hyer, who is a member of a group with the other Reporting Persons for purposes of Section 13(d) of the Exchange Act.
( 2 )These securities are owned solely by The Kathleen Hyer Revocable Trust.
( 3 )These securities are owned solely by Tara Tira.
( 4 )These securities are owned solely by Sean W. Poole.
( 5 )These securities are owned solely by Futura Circuits Corp.
( 6 )These securities are owned solely by Hyer Family Partnership, LLC.

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 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).

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