SEC FORM
3
SEC Form 3
FORM 3 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
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 |
OMB Number: |
3235-0104 |
Estimated average burden |
hours per response: |
0.5 |
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1. Name and Address of Reporting Person*
C/O MGIC INVESTMENT CORPORATION |
250 E. KILBOURN AVE. |
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 04/28/2022
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3. Issuer Name and Ticker or Trading Symbol
MGIC INVESTMENT CORP
[ MTG ]
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X |
Director |
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10% Owner |
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Officer (give title below) |
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Other (specify below) |
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5. 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 Beneficially Owned |
1. Title of Security (Instr.
4)
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2.
Amount of Securities Beneficially Owned (Instr.
4)
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3. Ownership Form: Direct (D) or Indirect (I) (Instr.
5)
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4. Nature of Indirect Beneficial Ownership (Instr.
5)
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Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivative Security (Instr.
4)
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2. Date Exercisable and Expiration Date
(Month/Day/Year) |
3. Title and Amount of Securities Underlying Derivative Security (Instr.
4)
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4. Conversion or Exercise Price of Derivative Security
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5. Ownership Form: Direct (D) or Indirect (I) (Instr.
5)
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6. Nature of Indirect Beneficial Ownership (Instr.
5)
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Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
Explanation of Responses: |
Remarks: |
No securities are beneficially owned. |
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Leslie A. Schunk, Attorney-in-Fact |
04/28/2022 |
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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
5
(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. |
LIMITED POWER OF ATTORNEY
KNOW ALL BY THESE PRESENTS, that the undersigned is required, or may
be required in the future, to file reports of changes in beneficial
ownership of equity securities of MGIC Investment Corporation (the
"Company").
To facilitate the filing of these reports, the undersigned hereby
appoints each of Timothy A. Chrapko, Shelby E. Heinrich, Heidi A.
Heyrman, Paula C. Maggio, Brian M. Remington, Leslie A. Schunk, and
Martha F. Tsuchihashi as the undersigned's attorney-in-fact and agent
to: (i) apply on behalf of the undersigned for access codes (if
necessary) for the EDGAR System, and (ii) sign on behalf of the
undersigned and file any Form 3, Form 4, or Form 5 for the
undersigned with the Securities and Exchange Commission or any
securities exchange.
Each of the persons authorized to act as such attorney-in-fact and
agent above may do so separately without the concurrence of the other
persons. The authority granted hereunder is granted to the person
occupying the position specified at the time such authority is
exercised.
Dated: March 1, 2022
Signature: /s/ Teresita M. Lowman
Please print or type name: Teresita M. Lowman
ACKNOWLEDGMENT
STATE OF CALIFORNIA )
COUNTY OF SAN DIEGO )
Before me, a Notary Public in and for the State of California, on this
day personally appeared Teresita M. Lowman, known to me to be the person
whose name is subscribed to the foregoing Limited Power of Attorney,
and acknowledged to me that he/she executed the same for the purposes
and consideration therein expressed.
Given under my hand and official seal this 1st day of March 2022.
(SEAL)
By: /s/ Raj Wilfred Disouza
Notary Public, State of California
Print Name: Raj Wilfred Disouza
My commission expires: April 5, 2023