-----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, KBZTBLiIIraETtbtd7rfSp6dWmAU3X6kEZc6HTrD2qIyskcO0Sw/BYG3Mpco+FNB azfOQ+xy2D8veP/ndpMXZA== 0001181431-04-025359.txt : 20040511 0001181431-04-025359.hdr.sgml : 20040511 20040511162058 ACCESSION NUMBER: 0001181431-04-025359 CONFORMED SUBMISSION TYPE: 4/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040430 FILED AS OF DATE: 20040511 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: ROSE EDWARD R III CENTRAL INDEX KEY: 0001059270 FILING VALUES: FORM TYPE: 4/A SEC ACT: 1934 Act SEC FILE NUMBER: 001-12117 FILM NUMBER: 04796655 BUSINESS ADDRESS: STREET 1: 500 CRESCENT COURT SUITE 250 CITY: DALLAS STATE: TX ZIP: 75201 MAIL ADDRESS: STREET 1: 500 CRESCENT COURT STREET 2: SUITE 250 CITY: DALLAS STATE: TX ZIP: 75201 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: FIRST ACCEPTANCE CORP /DE/ CENTRAL INDEX KEY: 0001017907 STANDARD INDUSTRIAL CLASSIFICATION: FIRE, MARINE & CASUALTY INSURANCE [6331] IRS NUMBER: 751328153 STATE OF INCORPORATION: DE FISCAL YEAR END: 0630 BUSINESS ADDRESS: STREET 1: 3813 GREEN HILLS VILLAGE DRIVE CITY: NASHVILLE STATE: TN ZIP: 37215 BUSINESS PHONE: 615-844-2800 MAIL ADDRESS: STREET 1: 3813 GREEN HILLS VILLAGE DRIVE CITY: NASHVILLE STATE: TN ZIP: 37215 FORMER COMPANY: FORMER CONFORMED NAME: LIBERTE INVESTORS INC DATE OF NAME CHANGE: 19960701 4/A 1 rrd42254.xml FORM 4-A/ 5-11-2004 X0202 4/A 2004-04-30 2004-05-04 0 0001017907 FIRST ACCEPTANCE CORP /DE/ FAC 0001059270 ROSE EDWARD R III 500 CRESCENT COURT, SUITE 250 DALLAS TX 75201 1 0 0 0 Common Stock 2004-04-30 4 P 0 290379 4.00 A 766411 I By Willowwood Partners, L.P. The reporting person is the sole shareholder of Cardinal Investment Company, Inc. (f k a Cardinal Holding Corporation), the general partner of Willowwood Partners, L.P., a Texas limited partnership (the Partnership). The Partnership was issued the shares of Common Stock following the exercise of its rights to acquire such shares of Common Stock in a rights offering consummated by First Acceptance Corporation on April 30, 2004. The reported securities are owned directly by the Partnership and indirectly by Cardinal Investment Company, Inc., as general partner of the Partnership, and the reporting person, as the sole shareholder of Cardinal Investment Company, Inc. The reporting person disclaims beneficial ownership of the securities reported in Table I, Column 5, except to the extent of his pecuniary interest therein, and this report shall not be deemed an admission that the reporting person is the beneficial owner of the disclaimed securities for purposes of Section 16 or for any other purpose. The reporting person is the sole shareholder of the general partner of the Partnership. The reporting person disclaims beneficial ownership of the securities reported in Table I,Column 5, except to the extent of his pecuniary interest therein, and this report shall not be deemed an admission that the reporting person is the beneficial owner of the disclaimed securities for purposes of Section 16 or for any other purpose. /s/ Edward W. Rose III 2004-05-11 -----END PRIVACY-ENHANCED MESSAGE-----