Item 1. Security and Issuer
This statement on Schedule 13D (this Schedule 13D) relates to the shares of common stock, par value $0.01 per share (the
Shares), of ICC Holdings, Inc. (the Issuer). The address and principal executive office of the Issuer is 225 20th Street, Rock Island, Illinois 61201.
Item 2. Identity and Background
(a) - (b) This Schedule 13D is being filed by (i) Mutual Capital Group, Inc., a Pennsylvania corporation (MCG), (ii) Mutual
Capital Holdings, Inc., a Pennsylvania corporation (MCH) and direct wholly-owned subsidiary of MCG, and (iii) Tuscarora Wayne Insurance Company, a Pennsylvania corporation and direct wholly-owned subsidiary of MCG
(Tuscarora, and together with MCG and MCH, the Reporting Persons). The address of the principal place of business and principal office of the Reporting Persons is 41908 Route 6, PO Box 7, Wyalusing, Pennsylvania 18853.
(c) MCG is a mutual insurance holding company, and MCH is its wholly-owned subsidiary and intermediate holding company, which owns various
insurance company subsidiaries, including Tuscarora, that engage in property and casualty insurance business and related services.
(d)
During the last five years, neither the Reporting Persons nor, to the best knowledge of the Reporting Persons, the other persons named on Schedule I have been convicted in a criminal proceeding (excluding traffic violations or similar
misdemeanors).
(e) During the last five years, neither the Reporting Persons nor, to the best knowledge of the Reporting Persons, the
other persons named on Schedule I are or have been a party to a civil proceeding of a judicial or administrative body of competent jurisdiction and as a result of such proceeding were or are subject to a judgment, decree or final order
enjoining future violations of, or prohibiting or mandating activities subject to, federal or state securities laws or finding any violation with respect to such laws.
Attached as Schedule I, and incorporated herein by reference, is a chart setting forth, with respect to each executive officer,
director and controlling person of the Reporting Persons, his or her name, residence or business address and present principal occupation or employment (along with the name, principal business and address of any corporation or other organization in
which such employment is conducted), in each case as of the date hereof.
To the best of the knowledge of the Reporting Persons, the
persons named on Schedule I are citizens of the United States.
Any disclosures herein with respect to persons other than the
Reporting Persons are made on information and belief after making inquiry to the appropriate party.
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