R.C.S.A. § 38a-147 Schedule A
Information Required in Proxy Statement
Cite as Conn. Agencies Regs. § 38a-147 Schedule A
1. Revocability of proxy. State whether or not the person giving the proxy has the power
to revoke it. If the right of revocation before the proxy is exercised is limited
or is subject to compliance with any formal procedure, briefly describe such limitation
or procedure.
2. Dissenters’ rights of appraisal. Outline briefly the rights of appraisal or similar
rights of dissenting security holders with respect to any matter to be acted upon
and indicate any statutory procedure required to be followed by such security holders
in order to perfect their rights. Where such rights may be exercised only within a
limited time after the date of the adoption of a proposal, the filing of a charter
amendment, or other similar act, state whether the person solicited will be notified
of such date.
3. Persons making solicitations not subject to section 38a-147-10. (a) If the solicitation
is made by the management of the insurer, so state. Give the name of any director
of the insurer who has informed the management in writing that he intends to oppose
any action intended to be taken by the management and indicate the action which he
intends to oppose.
(b) If the solicitation is made otherwise than by the management of the insurer, state
the names and addresses of the persons by whom and on whose behalf it is made and
the names and addresses of the persons by whom the cost of solicitation has been or
will be borne, directly or indirectly.
(c) If the solicitation is to be made by specially engaged employees or paid solicitors,
state (1) the material features of any contract or arrangement for such solicitation
and identify the parties, and (2) the cost or anticipated cost thereof.
4. Interest of certain persons in matters to be acted upon. Describe briefly any substantial
interest, direct or indirect, by security holdings or otherwise, of any director,
nominee for election for director, officer and, if the solicitation is made otherwise
than on behalf of management, each person on whose behalf the solicitation is made,
in any matter to be acted upon other than elections to office.
5. Voting securities and principal holders thereof. (a) State, as to each class of voting
securities of the insurer entitled to be voted at the meeting, the number of shares
outstanding and the number of votes to which each class is entitled.
(b) Give the date as of which the record list of security holders entitled to vote
at the meeting will be determined. If the right to vote is not limited to security
holders of record on that date, indicate the conditions under which other security
holders may be entitled to vote.
(c) If action is to be taken with respect to the election of directors and if the
persons solicited have cumulative voting rights, make a statement that they have such
rights and state briefly the conditions precedent to the exercise thereof.
6. Nominees and directors. If action is to be taken with respect to the election of directors,
furnish the following information, in tabular form to the extent practicable, with
respect to each person nominated for election as a director and each other person
whose term of office as a director will continue after the meeting:
(a) Name each such person, state when his term of office or the term of office for
which he is a nominee will expire, and all other positions and offices with the insurer
presently held by him, and indicate which persons are nominees for election as directors
at the meeting.
(b) State his present principal occupation or employment and give the name and principal
business of any corporation or other organization in which such employment is carried
on. Furnish similar information as to all of his principal occupations or employments
during the last five years, unless he is now a director and was elected to his present
term of office by a vote of security holders at a meeting for which proxies were solicited
under this regulation.
(c) If he is or has previously been a director of the insurer, state the period or
periods during which he has served as such.
(d) State, as of the most recent practicable date, the approximate amount of each
class of equity securities of the insurer or any of its parents, subsidiaries or affiliates
other than directors’ qualifying shares, benefically owned directly or indirectly
by him. If he is not the beneficial owner of any such securities, make a statement
to that effect.
7. Remuneration and other transactions with management and others. Furnish the information
reported or required in item One of Schedule SIS under the heading "Information Regarding
Management and Directors" if action is to be taken with respect to (1) the election
of directors, (2) any remuneration plan, contract or arrangement in which any director,
nominee for election as a director, or officer of the insurer will participate, (3)
any pension or retirement plan in which any such person will participate, or (4) the
granting or extension to any such person of any options, warrants or rights to purchase
any securities, other than warrants or rights issued to security holders, as such,
on a pro rata basis. If the solicitation is made on behalf of persons other than the
management, information shall be furnished only as to Item One-A of the aforesaid
heading of Schedule SIS.
8. Bonus, profit sharing and other remuneration plans. If action is to be taken with
respect to any bonus, profit sharing or other remuneration plan of the insurer, furnish
the following information:
(a) A brief description of the material features of the plan, each class of persons
who will participate therein, the approximate number of persons in each such class
and the basis of such participation.
(b) The amounts which would have been distributable under the plan during the last
calendar year to (1) each person named in item 7 of this schedule, (2) directors and
officers as a group and (3) all other employees as a group, if the plan had been in
effect.
(c) If the plan to be acted upon may be amended, other than by a vote of security
holders, in a manner which would materially increase the cost thereof to the insurer
or materially alter the allocation of the benefits as between the groups specified
in paragraph (b) of this item, the nature of such amendments should be specified.
9. Pension and retirement plan. If action is to be taken with respect to any pension
or retirement plan of the insurer, furnish the following information:
(a) A brief description of the material features of the plan, each class of persons
who will participate therein, the approximate number of persons in each such class
and the basis of such participation.
(b) State (1) the approximate total amount necessary to fund the plan with respect
to past services, the period over which such amount is to be paid and the estimated
annual payments necessary to pay the total amount over such period; (2) the estimated
annual payment to be made with respect to current services; and (3) the amount of
such annual payments to be made for the benefit of (a) each person named in item 7
of this schedule, (b) directors and officers as a group and (c) employees as a group.
(c) If the plan to be acted upon may be amended, other than by a vote of security
holders, in a manner which would materially increase the cost thereof to the insurer
or materially alter the allocation of the benefits as between the groups specified
in subparagraph (b) (3) of this item, the nature of such amendments should be specified.
10. Options, warrants or rights. If action is to be taken with respect to the granting
or extension of any options, warrants or rights, all referred to herein as "warrants,"
to purchase securities of the insurer or any subsidiary or affiliate, other than warrants
issued to all security holders on a pro rata basis, furnish the following information:
(a) The title and amount of securities called for or to be called for, the prices,
expiration dates and other material conditions upon which the warrants may be exercised,
the consideration received or to be received by the insurer, subsidiary or affiliate
for the granting or extension of the warrants and the market value of the securities
called for or to be called for by the warrants, as of the latest practicable date.
(b) If known, state separately the amount of securities called for or to be called
for by warrants received or to be received by the following persons, naming each such
person: (1) each person named in item 7 of this schedule and (2) each other person
who will be entitled to acquire five per cent or more of the securities called for
or to be called for by such warrants.
(c) If known, state also the total amount of securities called for or to be called
for by such warrants, received or to be received by all directors and officers of
the company as a group and all employees, without naming them.
11. Authorization or issuance of securities.
(a) If action is to be taken with respect to the authorization or issuance of any
securities of the insurer, furnish the title, amount and description of the securities
to be authorized or issued.
(b) If the shares of securities are other than additional shares of common stock of
a class outstanding, furnish a brief summary of the following, if applicable: Dividend,
voting, liquidation, pre-emptive and conversion rights, redemption and sinking fund
provisions, interest rate and date of maturity.
(c) If the shares of securities to be authorized or issued are other than additional
shares of common stock of a class outstanding, the commissioner may require financial
statements comparable to those contained in the annual report.
12. Mergers, consolidations, acquisitions and similar matters. (a) If action is to be
taken with respect to a merger, consolidation, acquisition or similar matter, furnish
in brief outline the following information: (1) The rights of appraisal or similar
rights of dissenters with respect to any matters to be acted upon. Indicate any procedure
required to be followed by dissenting security holders in order to perfect such rights;
(2) the material features of the plan or agreement; (3) the business done by the company
to be acquired or whose assets are being acquired; (4) if available, the high and
low sales prices for each quarterly period within two years; (5) the percentage of
outstanding shares which must approve the transaction before it is consummated.
(b) For each company involved in a merger, consolidation or acquisition, the following
financial statements should be furnished: (1) A comparative balance sheet as of the
close of the last two fiscal years; (2) a comparative statement of operating income
and expenses for each of the last two fiscal years and, as a continuation of each
statement, a statement of earnings per share after related taxes and cash dividends
paid per share; (3) a pro forma combined balance sheet and income and expenses statement
for the last fiscal year giving effect to the necessary adjustments with respect to
the resulting company.
13. Restatement of accounts. If action is to be taken with respect to the restatement
of any asset, capital or surplus of the insurer, furnish the following information:
(a) State the nature of the restatement and the date as of which it is to be effective;
(b) outline briefly the reasons for the restatement and for the selection of the particular
effective date; (c) state the name and amount of each account affected by the restatement
and the effect of the restatement thereon.
14. Matters not required to be submitted. If action is to be taken with respect to any
matter which is not required to be submitted to a vote of security holders, state
the nature of such matter, the reason for submitting it to a vote of security holders
and what action is intended to be taken by the management in the event of a negative
vote on the matter by the security holders.
15. Amendment of charter, bylaws or other documents. If action is to be taken with respect
to any amendment of the insurer’s charter, bylaws or other documents as to which information
is not required above, state briefly the reasons for and general effect of such amendment
and the vote needed for its approval.