Sec Form 4 Filing - Springer Kathleen @ ICC Holdings, Inc. - 2022-04-01

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
Springer Kathleen
2. Issuer Name and Ticker or Trading Symbol
ICC Holdings, Inc. [ ICCH]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director _____ 10% Owner
X __ Officer (give title below) _____ Other (specify below)
Chief Human Resources Officer
(Last) (First) (Middle)
225 20TH ST
3. Date of Earliest Transaction (MM/DD/YY)
04/01/2022
(Street)
ROCK ISLAND, IL61201-8810
4. If Amendment, Date Original Filed (MM/DD/YY)
6. Individual or Joint/Group Filing (Check Applicable Line)
__ X __ Form filed by One Reporting Person
_____ 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( 1 ) 04/01/2022 M 626 A $ 17.05 2,652 D
Common Stock( 1 ) 04/01/2022 F 245 D $ 17.05 2,407 D
Common Stock( 1 ) 04/01/2022 M 833 A $ 17.05 3,240 D
Common Stock( 1 ) 04/01/2022 F 296 D $ 17.05 2,944 D
Common Stock 3,000 I 401(k)
Common Stock 500.4518 I By ESOP
Common Stock 587.3193 I By ESOP
Common Stock 595.5675 I By ESOP
Common Stock 737 I By ESOP
Common Stock 687 I By ESOP
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
Restricted Stock Unit $ 0( 2 ) 04/01/2022 M 626 ( 3 ) ( 4 ) ICC Holdings, Inc. Common Stock 626 $ 17.05 0 D
Restricted Stock Unit $ 0( 2 ) 04/01/2022 A 1,500 ( 3 ) ( 4 ) ICC Holdings, Inc. Common Stock 1,500 $ 0 1,500 D
Restricted Stock Unit $ 0( 2 ) 04/01/2022 M 833 ( 3 ) ( 4 ) ICC Holdings, Inc. Common Stock 833 $ 17.05 0 D
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Springer Kathleen
225 20TH ST
ROCK ISLAND, IL61201-8810
Chief Human Resources Officer
Signatures
/s/ Springer, Kathleen 04/05/2022
Signature of Reporting Person Date
Explanation of Responses:
( 1 )RSU with 3 Year Periodic vesting schedule
( 2 )No exercise price for this type of award
( 3 )No exercisable date for this type of award
( 4 )No expiration date for this type of award

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).
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