0001335237-21-000002.txt : 20211213 0001335237-21-000002.hdr.sgml : 20211213 20211213144404 ACCESSION NUMBER: 0001335237-21-000002 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211209 FILED AS OF DATE: 20211213 DATE AS OF CHANGE: 20211213 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Boone David S CENTRAL INDEX KEY: 0001335237 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-55522 FILM NUMBER: 211487799 MAIL ADDRESS: STREET 1: AMERICAN CARESOURCE HOLDINGS, INC. STREET 2: 5429 LYNDON B. JOHNSON FREEWAY, #100 CITY: DALLAS STATE: TX ZIP: 75240 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: National Western Life Group, Inc. CENTRAL INDEX KEY: 0001635984 STANDARD INDUSTRIAL CLASSIFICATION: LIFE INSURANCE [6311] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: C/O NATIONAL WESTERN LIFE INSURANCE CO. STREET 2: PO BOX 209080 CITY: AUSTIN STATE: TX ZIP: 78720-9080 BUSINESS PHONE: (512) 719-0143 MAIL ADDRESS: STREET 1: C/O NATIONAL WESTERN LIFE INSURANCE CO. STREET 2: PO BOX 209080 CITY: AUSTIN STATE: TX ZIP: 78720-9080 4 1 wf-form4_163942462991438.xml FORM 4 X0306 4 2021-12-09 0 0001635984 National Western Life Group, Inc. NWLI 0001335237 Boone David S 10801 N. MOPAC EXPY BLDG 3 AUSTIN TX 78759 1 0 0 0 Class A Common Stock 2021-12-09 4 M 0 340 0 A 340 D Class A Common Stock 2021-12-09 4 M 0 340 221.13 D 0 D Restricted Stock Units 2021-12-09 4 M 0 340 0 A 2021-12-09 2021-12-09 Class A Common Stock 340.0 0 D Each restricted stock unit represents a contingent right to receive the cash value of one share of NWLIC Class A common stock based on the 20 day average of the Class A common stock leading up to and including the date exercisable. Each restricted stock unit represents a contingent right to receive, with no additional consideration payable, the cash value of one share of NWLI Class A common stock on the Date Exercisable. David S. Boone 2021-12-13