1 | NAME OF REPORTING PERSON: | |
Michael Karfunkel | ||
SS
OR IRS IDENTIFICATION NOS. OF ABOVE PERSONS: NA
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2 | CHECK THE APPROPRIATE BOX IF A MEMBER OF GROUP (See Instructions) | |
(a)
o
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(b)
o
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3 | SEC USE ONLY | |
4 | SOURCE OF FUNDS: | |
PF | ||
5 | CHECK BOX IF DISCLOSURE OF LEGAL PROCEEDINGS IS REQUIRED PURSUANT TO ITEMS 2(d) OR 2(e) | |
o
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6 | CITIZENSHIP OR PLACE OF ORGANIZATION: | |
United States of America |
Number
of
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7 | SOLE VOTING POWER: | |
Shares
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|||
Beneficially
|
3,950,000 | ||
Owned
by
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8 | SHARED VOTING POWER: | |
Each
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|||
Trustee
|
2,862,130 (1) | ||
With:
|
9 | SOLE DISPOSITIVE POWER: | |
3,950,000 | |||
10 | SHARED DISPOSITIVE POWER: | ||
2,862,130 (1) |
11 | AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON: | |
6,812,130 (1) | ||
12 | CHECK IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDE CERTAIN SHARES (See Instructions) | |
o
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13 | PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (11): | |
11.37% (1) | ||
14 | TYPE OF REPORTING PERSON (See Instructions): | |
IN |
(1) |
The
Reporting Person disclaims beneficial ownership of 1,292,130 of these
shares held HOD
Foundation.
|
(a) |
As
of
November 25, 2008, the Reporting Person beneficially
owned 5,462,130 Common Shares as follows: (i) 2,600,000 Common Shares
held
directly by the Reporting Person, (ii) warrants to purchase 1,350,000
Common Shares held directly by the Reporting Person, (iii) 1,292,130
Common Shares held by HOD and
(iv) 1,570,000 Common Shares held indirectly by the Reporting Person
as a trustee of the Trust. The Reporting Person disclaims beneficial
ownership of the 1,292,130 Common Shares that he holds indirectly
as a
trustee
of
HOD.
|
(b) |
As
of
November 25, 2008, the Reporting Person had sole voting and dispositive
power with respect to (i)
the 2,600,000 Common Shares held directly by the Reporting Person,
(ii)
assuming exercise of the warrants at the discretion of the Reporting
Person, the 1,350,000 Common Shares issuable upon the exercise of
warrants
to purchase Common Shares held directly by the Reporting Person and
shared
voting and dispositive power with respect to, (iii) the 1,292,130
Common
Shares held indirectly by the Reporting Person as a
trustee of
HOD and (iv) the 1,570,000 Common Shares held indirectly by the Reporting
Person as a trustee of the
Trust.
|
(c)
|
Except
for the following transactions, the Reporting Person has not had
any other
transactions in the Common Shares that were effected during the past
60
days:
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Date
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Number
of Common Shares
|
Price
Per Share
|
|
||
November
13, 2008
|
325,000
|
$2.90
|
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November
14, 2008
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450,000
|
$3.15
|
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||
November
18, 2008
|
795,000
|
$3.40
|
(d)
|
Not
applicable.
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(e)
|
Not
applicable.
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Exhibit
A
|
Registration
Rights Agreement between Maiden Holdings, Ltd., Barry D. Zyskind,
George
Karfunkel and Michael Karfunkel dated as of July 3, 2007 (incorporated
by
reference to Exhibit 4.6 to the Registration Statement on Form
S-1 of Maiden Holdings, Ltd. filed on September 17,
2007).
|
Exhibit
B
|
Warrant
granted by Maiden Holdings, Ltd. to Michael Karfunkel, effective
June 14,
2007 (incorporated by reference to Exhibit 4.3 to the Registration
Statement on Form S-1 of Maiden Holdings, Ltd. filed on September
17,
2007).
|
MICHAEL KARFUNKEL | ||
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By: | /s/ Michael Karfunkel | |
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Exhibit
A
|
Registration
Rights Agreement between Maiden Holdings, Ltd., Barry D. Zyskind,
George
Karfunkel and Michael Karfunkel dated as of July 3, 2007 (incorporated
by
reference to Exhibit 4.6 to the Registration Statement on Form
S-1 of Maiden Holdings, Ltd. filed on September 17,
2007).
|
Exhibit
B
|
Warrant
granted by Maiden Holdings, Ltd. to Michael Karfunkel, effective
June 14,
2007 (incorporated by reference to Exhibit 4.3 to the Registration
Statement on Form S-1 of Maiden Holdings, Ltd. filed on September
17,
2007).
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