Rule 120-2-7-.13 - Information to be Included in Statements Filed by or on Behalf of a Participant (Other Than the Insurer) in a Proxy Solicitation in an Election Contest(1) Insurer. State the name and address of the insurer.(2) Identity and Background. (a) state the following: 1. participant's name and business address.2. participant's present principal occupation or employment and the name, principal business and address of any corporation or other organization in which such employment is carried on.(b) state the following:1. participant's residence address.2. information as to all material occupations, positions, offices or employments during the last ten years, giving starting and ending dates of each and the name, principal business and address of any business corporation or other business organization in which each such occupation, position, office or employment was carried on.(c) state whether or not participant is or has been a participant in any other proxy contest involving this company or other companies within the past ten years. If so, identify the principals, the subject matter and participant's relationship to the parties and the outcome.(d) state whether or not, during the past ten years, participant has been convicted in a criminal proceeding (excluding traffic violations or similar misdemeanors) and, if so, give dates, nature of conviction, name and location of court, and penalty imposed or other disposition of the case. A negative answer to this requirement need not be included in the proxy statement or other proxy soliciting material.(3) Interest in stock of the insurer.(a) state the amount of each class of securities of the insurer which participant owns beneficially, directly or indirectly.(b) state the amount of each class of securities of the insurer which participant owns of record but not beneficially.(c) state, with respect to all securities of the insurer, the amounts acquired or sold within the past two years, the dates on which they were purchased or sold and the amount purchased or sold on each date.(d) if any part of the purchase price or market value of any of the securities specified in (c) is represented by funds borrowed or otherwise obtained for the purpose of acquiring or holding such securities, so state and indicate the amount of the indebtedness as of the latest practicable date. If such funds were borrowed or obtained otherwise than pursuant to a margin account or bank loan in the regular course of business of a bank, broker or dealer, briefly describe the transaction, and state the names of the parties.(e) state whether or not participant is a party to any contracts, arrangements or understandings with any persons with respect to any securities of the insurer, including but not limited to joint ventures, loan or option arrangements, puts or calls, guarantees against loss or guarantees of profits, division of losses or profits, or the giving or withholding of proxies. If so, name the persons with whom such contracts, arrangements, or understandings exist and give the details thereof.(f) state the amount of securities of the insurer owned beneficially, directly or indirectly, by each of participant's associates and the name and address of each such associate.(g) state the amount of each class of securities of any parent, subsidiary or affiliate of the insurer which participant owns beneficially, directly or indirectly.(4) Further Matters. (a) describe the time and circumstances under which participant became a participant in the solicitation and state the nature and extent of participant's activities or proposed activities as a participant.(b) describe briefly, and where practicable state the approximate amount of, any material interest, direct or indirect, of participant and of each of participant's associates in any material transactions since the beginning of the company's last fiscal year, or in any material proposed transactions, to which the company or any of its subsidiaries or affiliates was or is to be a party.(c) state whether or not participant or any of participant's associates have any arrangements or understanding with any person:1. with respect to any future employment by the insurer or its subsidiaries or affiliates; or2. with respect to any future transactions to which the insurer or any of its subsidiaries or affiliates will or may be a party. If so, describe such arrangement or understanding and state the names of the parties thereto.(5) Certification, Signature. The participant or his authorized representative shall certify as to the truthfulness, completeness and correctness, to the best of their knowledge and belief and shall date and sign such statement.Ga. Comp. R. & Regs. R. 120-2-7-.13
Ga. L. 1960, pp. 289, 305, 1965, pp. 378 to 380.
Original Rule entitled "Information to Be Included in Statements Filed by or on Behalf of a Participant (Other Than the Insurer) in a Proxy Solicitation in an Election Contest" adopted. F. and eff. July 20, 1965.Amended: F. Dec. 3, 1965; eff. Dec. 22, 1965.Amended: F. Jan. 28, 1970; eff. Jan. 1, 1970, as specified by the Agency.Submitted for Publishing: Mar. 6, 2007.