0001209191-11-056913.txt : 20111117 0001209191-11-056913.hdr.sgml : 20111117 20111117184703 ACCESSION NUMBER: 0001209191-11-056913 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20111115 FILED AS OF DATE: 20111117 DATE AS OF CHANGE: 20111117 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: NICHOLS TOM C CENTRAL INDEX KEY: 0001339915 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-12117 FILM NUMBER: 111214410 MAIL ADDRESS: STREET 1: 4500 MERCANTILE PLAZA DRIVE, SUITE 300 CITY: FORT WORTH STATE: TX ZIP: 76137 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: 3322 WEST END AVENUE STREET 2: SUITE 1000 CITY: NASHVILLE STATE: TN ZIP: 37203 BUSINESS PHONE: 615-844-2800 MAIL ADDRESS: STREET 1: 3322 WEST END AVENUE STREET 2: SUITE 1000 CITY: NASHVILLE STATE: TN ZIP: 37203 FORMER COMPANY: FORMER CONFORMED NAME: LIBERTE INVESTORS INC DATE OF NAME CHANGE: 19960701 4 1 c24965_4x0.xml MAIN DOCUMENT DESCRIPTION X0304 4 2011-11-15 0001017907 FIRST ACCEPTANCE CORP /DE/ FAC 0001339915 NICHOLS TOM C 4500 MERCANTILE PLAZA DRIVE SUITE 300 FORT WORTH TX 76137 1 0 0 0 Common Stock 2011-11-15 4 A 0 1000 A 52500 D Awarded pursuant to the Amended and Restated 2002 Long Term Incentive Plan for service as a director for fiscal 2012. These shares are subject to forfeiture if the director ceases to serve as a director for six months from the date of the award. /s/ TOM C. NICHOLS 2011-11-17