-----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, Mk/TGHj9EMDw0rZG7meD0TSvPi0UVR0snnkdWLvTT2RCiU1Mw73YsFGuUNPJPnaC zayHapSDWtSUIe8eqNvdQg== 0001209191-05-004518.txt : 20050124 0001209191-05-004518.hdr.sgml : 20050124 20050124210008 ACCESSION NUMBER: 0001209191-05-004518 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20050120 FILED AS OF DATE: 20050124 DATE AS OF CHANGE: 20050124 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: FORD GERALD J CENTRAL INDEX KEY: 0001021572 STATE OF INCORPORATION: DE FISCAL YEAR END: 0630 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-12117 FILM NUMBER: 05545741 BUSINESS ADDRESS: BUSINESS PHONE: 2132104931 MAIL ADDRESS: STREET 1: 350 S GRAND AVENUE STREET 2: 52ND FLOOR CITY: LOS ANGELES STATE: CA ZIP: 90071 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 1 bod21937_bod1gjf.xml MAIN DOCUMENT DESCRIPTION X0202 4 2005-01-20 0001017907 FIRST ACCEPTANCE CORP /DE/ FAC 0001021572 FORD GERALD J 200 CRESCENT COURT SUITE 1350 DALLAS TX 75201 1 1 1 0 Chairman Common Stock 2005-01-20 4 J 0 1000000 D 13712854 I See footnote. On January 20, 2005, Hunter's Glen/Ford, Ltd., a Texas limited partnership "HG/F", made a distribution to its limited partner of 1,000,000 shares of common stock of First Acceptance Corporation (the "Common Stock"), which made a distribution of 1,000,000 shares of Common Stock to Jeremy B. Ford on such date. Not applicable. Includes (i) 563,728 shares of Common Stock held by Mr. Ford, (ii) 11,919,408 shares of Common Stock held by HG/F and (iii) 1,229,718 shares of Common Stock held by Turtle Creek Revocable Trust "TCRT". Mr. Ford is a general partner of HG/F. Mr. Ford is also the settlor of TCRT. Mr. Ford expressly disclaims beneficial ownership of the securities reported herein, except to the extent of his pecuniary interest therein. /s/ Gerald J. Ford 2005-01-24 -----END PRIVACY-ENHANCED MESSAGE-----