FORM
4 |
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 or Section 30(h) of the Investment Company Act of
1940
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OMB APPROVAL |
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3235-0287 |
Expires: |
December 31, 2014 |
Estimated average burden |
hours per response: |
0.5 |
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Check this box if no longer subject to Section 16. Form 4 or Form 5
obligations may continue.
See
Instruction 1(b).
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1. Name and Address of Reporting Person
*
(Street)
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2. Issuer Name
and
Ticker or Trading Symbol
FBL FINANCIAL GROUP INC
[
FFG
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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Director |
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10% Owner |
X |
Officer (give title below) |
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Other (specify below) |
Chief Administrative Officer |
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3. Date of Earliest Transaction
(Month/Day/Year) 02/01/2019
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4. If Amendment, Date of Original Filed
(Month/Day/Year)
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6. Individual or Joint/Group Filing (Check
Applicable Line)
X |
Form filed by One Reporting Person |
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Form filed by More than One Reporting
Person |
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Table I - Non-Derivative Securities Acquired, Disposed of, or
Beneficially Owned |
1.
Title of Security (Instr.
3)
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2.
Transaction Date
(Month/Day/Year) |
2A.
Deemed Execution Date, if any
(Month/Day/Year) |
3.
Transaction Code (Instr.
8)
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4.
Securities Acquired (A) or Disposed Of (D) (Instr.
3, 4 and 5)
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5.
Amount of Securities Beneficially Owned Following Reported
Transaction(s) (Instr.
3 and 4)
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6.
Ownership Form: Direct (D) or Indirect (I) (Instr.
4)
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7.
Nature of Indirect Beneficial Ownership (Instr.
4)
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Code |
V |
Amount |
(A) or (D) |
Price |
Class A Common Stock
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02/01/2019 |
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M |
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282
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A
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282
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D
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Class A Common Stock
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02/01/2019 |
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D |
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282
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D
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$
70.88
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0
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D
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Class A Common Stock
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198.874
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I
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by Trust
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Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivative Security (Instr.
3)
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2. Conversion or Exercise Price of Derivative Security
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3. Transaction Date
(Month/Day/Year) |
3A. Deemed Execution Date, if any
(Month/Day/Year) |
4. Transaction Code (Instr.
8)
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5.
Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr.
3, 4 and 5)
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6. Date Exercisable and Expiration Date
(Month/Day/Year) |
7. Title and Amount of Securities Underlying Derivative Security (Instr.
3 and 4)
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8. Price of Derivative Security (Instr.
5)
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9.
Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr.
4)
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10. Ownership Form: Direct (D) or Indirect (I) (Instr.
4)
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11. Nature of Indirect Beneficial Ownership (Instr.
4)
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Code |
V |
(A) |
(D) |
Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
Restricted Stock Units (Cash Settled)
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02/01/2019 |
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M |
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282
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02/01/2019 |
02/01/2022 |
Class A Common Stock
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282
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847
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D
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Restricted Stock Units (Cash Settled)
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02/01/2019 |
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A |
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1,474
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02/01/2020
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02/01/2024
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Class A Common Stock
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1,474
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$
0
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1,474
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D
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Explanation of Responses: |
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By: Mark Wickham per filed confirming stmt For: Nicholas Gerhart |
02/05/2019 |
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** 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
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). |
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 Number. |
CONFIRMING STATEMENT
This Statement confirms that the undersigned, Nicholas C. Gerhart,
has authorized and designated any one of Lori K. Geadelmann,
Douglas V. Shelton or Mark D. Wickham to execute and file on
the undersigned's behalf all Forms 3, 4, and 5 (including
any amendments thereto) that the undersigned may be required
to file with the U.S. Securities and Exchange Commission as a
result of the undersigned's ownership of or transactions in
securities of FBL Financial Group, Inc. The authority of
Lori K. Geadelmann, Douglas V. Shelton and Mark D. Wickham under
this Statement shall continue until the undersigned is no
longer required to file Forms 3, 4, and 5 with regard to the
undersigned's ownership of or transactions in securities of FBL
Financial Group, Inc., unless earlier revoked in writing.
The undersigned acknowledges that Lori K. Geadelmann, Douglas
V. Shelton and Mark D. Wickham are not assuming any of the
undersigned's responsibilities to comply with Section 16 of
the Securities Exchange Act of 1934.
/s/ Nicholas C. Gerhart
Date: March 1, 2018 ___________________
(sign)
Nicholas C. Gerhart