U.S. SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 4
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(f) of the Investment Company Act of 1940
[_] Check box if no longer subject of 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*
Tollefson Louise B.
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(Last) (First) (Middle)
18665 S.E. Village Circle
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(Street)
Tequesta FL 33469
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(City) (State) (Zip)
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2. Issuer Name and Ticker or Trading Symbol
NYMAGIC, Inc. ("NYM")
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3. IRS Identification Number of Reporting Person, if an Entity (Voluntary)
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4. Statement for Month/Year
March/2000
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5. If Amendment, Date of Original (Month/Year)
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6. Relationship of Reporting Person to Issuer
(Check all applicable)
[X] Director [X] 10% Owner
[_] Officer (give title below) [_] Other (specify below)
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7. Individual or Joint/Group Filing (Check applicable line)
[X] Form filed by one Reporting Person
[_] Form filed by more than one Reporting Person
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Table I -- Non-Derivative Securities Acquired, Disposed of,
or Beneficially Owned
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<TABLE>
<CAPTION>
6.
4. 5. Owner-
Securities Acquired (A) or Amount of ship
3. Disposed of (D) Securities Form: 7.
Transaction (Instr. 3, 4 and 5) Beneficially Direct Nature of
2. Code ------------------------------ Owned at End (D) or Indirect
1. Transaction (Instr. 8) (A) of Month Indirect Beneficial
Title of Security Date ------------ Amount or Price (Instr. 3 (I) Ownership
(Instr. 3) (mm/dd/yy) Code V (D) and 4) (Instr.4) (Instr. 4)
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<S> <C> <C> <C> <C> <C> <C> <C> <C> <C>
Common Stock, par value $1.00
per share 3/31/00 J(1) 366,972 A N/A D
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Common Stock, par value $1.00
per share 3/31/00 J(2) 366,972 D N/A D
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Common Stock, par value $1.00
per share 3/31/00 J(3) 366,972 A N/A I By Spouse
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Common Stock, par value $1.00
per share 3/31/00 J(4) 366,972 D N/A I By Spouse
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Common Stock, par value $1.00 As life bene-
per share 1,080,667 I ficiary under
Louise B.
Tollefson
Florida In-
tangible Tax
Trust dated
12/9/98
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Common Stock, par value $1.00 As life bene-
per share 96,600 I ficiary under
Louise B.
Tollefson
Charitable
Remainder
Unitrust
dated 3/24/98
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Common Stock, par value $1.00
per share 4,564 D
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</TABLE>
* If the Form is filed by more than one Reporting Person, see Instruction
4(b)(v).
Reminder: Report on a separate line for each class of securities beneficially
owned directly or indirectly.
(Print or Type Responses)
(Over)
(Form 4-07/99)
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FORM 4 (continued)
Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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<TABLE>
<CAPTION>
10.
9. Owner-
Number ship
of Form
2. Deriv- of
Conver- 5. 7. ative Deriv- 11.
sion Number of Title and Amount Secur- ative Nature
or Derivative 6. of Underlying 8. ities Secur- of
Exer- 4. Securities Date Securities Price Bene- ity: In-
cise 3. Trans- Acquired (A) Exercisable and (Instr. 3 and 4) of ficially Direct direct
Price Trans- action or Disposed Expiration Date ---------------- Deriv- Owned (D) or Bene-
1. of action Code of(D) (Month/Day/Year) Amount ative at End In- ficial
Title of Deriv- Date (Instr. (Instr. 3, ---------------- or Secur- of direct Owner-
Derivative ative (Month/ 8) 4 and 5) Date Expira- Number ity Month (I) ship
Security Secur- Day/ ------ ------------ Exer- tion of (Instr. (Instr. (Instr. (Instr.
(Instr. 3) ity Year) Code V (A) (D) cisable Date Title Shares 5) 4) 4) 4)
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<S> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C>
No derivative
securities owned.
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</TABLE>
Explanation of Responses:
(1) This transaction consisted of a transfer from the Louise B. Tollefson
Florida Intangible Tax Trust dated 12/9/98 of 366,972 shares to the
Reporting Person.
(2) This transaction consisted of a transfer from the Reporting Person of
366,972 shares to the Louise B. Tollefson Charitable Lead Annuity Trust
dated 3/30/00, Robert G. Simses and First Union National Bank, co-trustees.
(3) This transaction consisted of a transfer from the Louise B. Tollefson
Florida Intangible Tax Trust dated 12/9/98 of 366,972 shares to the spouse
of the Reporting Person.
(4) This Transaction consisted of a transfer from the spouse of the Reporting
Person of 366,972 shares to the Bennett H. Tollefson Charitable Lead
Unitrust dated 3/30/00, Robert G. Simses and First Union National Bank,
co-trustees.
/s/ LOUISE B. TOLLEFSON April 10, 2000
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**Signature of Reporting Person Date
** 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 provided is insufficient, see Instruction 6 for procedure.
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