BLACK SAMUEL P III 4

4 · ERIE INDEMNITY CO · Filed Nov 3, 2003

Form 4

Period: 2003-11-03

10% Owner

Transactions

Other
Directors' Deferred Compensation Phantom Units
2003-11-03+167.246→ 919.643 total
Exercise: $0.00→ Class A Common Stock (167.246 underlying)

Holdings

Class A Common Stock
(indirect: By Partnership)
5,709,240
Class A Common Stock
(indirect: Samuel P. Black & Associates, Inc.)
24,000
Class A Common Stock
129,750
Class B Common Stock
Exercise: $0.00→ Class A Common Stock (24,000 underlying)
10
Class B Common Stock
(indirect: By Partnership)
Exercise: $0.00→ Class A Common Stock (936,000 underlying)
390

Footnotes (4)

[F1]Acquired under Directors' Deferred Compensation Plan
[F2]The shares subject to this reporting are phantom Share Credits which are periodically credited to the accounts of certain Directors of Erie Indemnity Company pursuant to its Outside Directors Stock Plan. These Credit Shares are actually paid to the reporting individual in shares of Erie Indemnity Company Class A Common Stock when their service as a Director of Erie Indemnity Company ends. There is no exercisable date for these securities.
[F3]The shares subject to this reporting are phantom Share Credits which are periodically credited to the accounts of certain Directors of Erie Indemnity Company pursuant to its Outside Directors Stock Plan. These Credit Shares are actually paid to the reporting individual in shares of Erie Indemnity Company Class A Common Stock when their service as a Director of Erie Indemnity Company ends. There is no expiration date for these securities.
[F4]Market value at the date of conversion at the rate of 2,400 shares of Class A for each share of Class B.

Documents

1 file