HIRT F WILLIAM 4

4 · ERIE INDEMNITY CO · Filed Apr 23, 2004

Form 4

Period: 2004-04-21

DirectorChairman of the Board10% Owner

Transactions

Other
Directors' Deferred Compensation Phantom Units
2004-04-21+5.571→ 1,098.828 total
Exercise: $0.00→ Class A Common Stock (5.571 underlying)

Holdings

Class B Common Stock
(indirect: By Trust)
Exercise: $0.00→ Class A Common Stock (2,808,000 underlying)
1,170
Class B Common Stock
Exercise: $0.00→ Class A Common Stock (48,000 underlying)
20
Class A Common Stock
888,260
Class A Common Stock
(indirect: By Partnership)
11,830,000

Footnotes (4)

[F1]Acquired under dividend reinvestment for 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

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