-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, QbUcY+yVokAhXK408siq3kBFZLsQ7znY7xHVDV7Pq6qjlqGTrD7pRA8OriCJlZLz iFlr9mTFV5LSTS7ECHK4eQ== 0001013698-00-000023.txt : 20001211 0001013698-00-000023.hdr.sgml : 20001211 ACCESSION NUMBER: 0001013698-00-000023 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20001130 FILED AS OF DATE: 20001208 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: SYMONS INTERNATIONAL GROUP INC CENTRAL INDEX KEY: 0001013698 STANDARD INDUSTRIAL CLASSIFICATION: FIRE, MARINE & CASUALTY INSURANCE [6331] IRS NUMBER: 351707115 STATE OF INCORPORATION: IN FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: SEC FILE NUMBER: 000-29042 FILM NUMBER: 785363 BUSINESS ADDRESS: STREET 1: 4720 KINGSWAY DRIVE CITY: INDIANAPOLIS STATE: IN ZIP: 46205 BUSINESS PHONE: 3172596400 MAIL ADDRESS: STREET 1: 4720 KINGSWAY DRIVE CITY: INDIANAPOLIS STATE: IN ZIP: 46205 COMPANY DATA: COMPANY CONFORMED NAME: GORAN CAPITAL INC CENTRAL INDEX KEY: 0000925600 STANDARD INDUSTRIAL CLASSIFICATION: FIRE, MARINE & CASUALTY INSURANCE [6331] OWNER IRS NUMBER: 000000000 FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 BUSINESS ADDRESS: STREET 1: 2 EVA ROAD SUITE 200 CITY: TORONTO ONTARIO CANA STATE: A6 BUSINESS PHONE: 3172596400 MAIL ADDRESS: STREET 1: 2 EVA ROAD SUITE 200 CITY: TORONTO ONTARIO CANA STATE: A6 4 1 0001.txt STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 FORM 4 SYMONS INTERNATIONAL GROUP, INC. STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP: ( ) Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instructions 1 (b). 1. Name and Address of Reporting Person Goran Capital Inc. 2 Eva Road, Suite 201 Etobicoke, Ontario Canada M9C 2A8 Canada 2. Issuer Name and Ticker or Trading Symbol Symons International Group, Inc. SIGC 3. IRS or Social Security Number of Reporting Person (Voluntary) 4. Statement for Month/Year 11/00 5. If Amendment, Date of Original (Month/Year) 6. Relationship of Reporting Person (s) to Issuer (Check all applicable) ( ) Director (X) 10% Owner () Officer (give title below) ( ) Other (Specify Below) 7. Individual or Joint/Group Filing (Check Applicable Line) (X) Form filed by One Reporting Person ( ) Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned 1.Title of 2. 4. Securities acquired (A) or 5. Amount of Securities 6. Direct 7. Nature of Security 3. Disposed of (D) Benefically Owned at (D) or Indirect Benefical Transactions End of Month Indirect Ownership (I) Date Code V Amount A/D Price Common 11/14/00 P 15,000 A .500 11/15/00 P 110,000 A .500 11/16/00 P 60,000 A .500 11/17/00 P 15,000 A .500 11/20/00 P 11,100 A .500 11/30/00 P 50,000 A .310 7,532,300 D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned 1. Title of Derivative 2. Conversion of Exercise 3. 5. Number of 6. Date Exercisable Security Price of Derivative Security 4. Derivative and Expiration Date Transaction Securities (Month/Day/Year) Acquired (A) or Disposed (D) Date Code V Amount A/D Date Expiration Exercisable Date 7. Title and Amount 8. Price of Derivative Security 9. Number of Derivative Securities of Underlying Securities Beneficially Owned at End of Month Title and Number of Shares
___________________ Douglas H. symons Executive Vice President Goran Capital Inc. -----END PRIVACY-ENHANCED MESSAGE-----