-----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, S2UX+OvSltAqtlyp8yeuf+wS+LYCAeVmYE+Mrm4Jv97Ul6mbkPpeu5SbDBzyQlA5 xwgjGRqp/dmZxNDAP4XQYA== 0001209191-04-009977.txt : 20040213 0001209191-04-009977.hdr.sgml : 20040213 20040213182849 ACCESSION NUMBER: 0001209191-04-009977 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20031231 FILED AS OF DATE: 20040213 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: CITIZENS INC CENTRAL INDEX KEY: 0000024090 STANDARD INDUSTRIAL CLASSIFICATION: LIFE INSURANCE [6311] IRS NUMBER: 840755371 STATE OF INCORPORATION: CO FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 400 EAST ANDERSON LANE CITY: AUSTIN STATE: TX ZIP: 78752 BUSINESS PHONE: 5128377100 MAIL ADDRESS: STREET 1: 400 EAST ANDERSON LANE CITY: AUSTIN STATE: TX ZIP: 78752 FORMER COMPANY: FORMER CONFORMED NAME: CONTINENTAL INVESTORS LIFE INC DATE OF NAME CHANGE: 19881222 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: RILEY RAY A CENTRAL INDEX KEY: 0001227896 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 000-16509 FILM NUMBER: 04601435 BUSINESS ADDRESS: STREET 1: P O BOX 149151 CITY: AUSTIN STATE: TX ZIP: 78714 BUSINESS PHONE: 5128377100 5 1 bdn12705_bdn1rar5.xml MAIN DOCUMENT DESCRIPTION X0201 5 2003-12-31 0 0 0 0000024090 CITIZENS INC CIA 0001227896 RILEY RAY A 400 E. ANDERSON LANE AUSTIN TX 78752 0 1 0 0 VP, Chief Operations Officer Class A Common Stock 2003-04-01 5 G 0 19528.0000 0 A 236098.0000 D Class A Common Stock 2003-12-31 5 J 0 16482.0000 0 A 252580.0000 D Class A Common Stock 2003-12-31 5 J 0 709.0000 0 A 253289.0000 D Class A Common Stock 2003-12-31 5 J 0 91.0000 0 A 253380.0000 D Class A Common Stock 2003-04-01 5 G 0 3780.0000 0 A 19104.0000 I Joint Tenant with Spouse Class A Common Stock 2003-12-31 5 J 0 1701.0000 0 A 20805.0000 I Joint Tenant with Spouse Class A Common Stock 2003-02-25 5 G 0 3380.0000 0 A 126022.0000 I Custodian Account for Children Class A Common Stock 2003-04-01 5 G 0 7560.0000 0 A 133582.0000 I Custodian Account for Children Class A Common Stock 2003-12-31 5 J 0 9354.0000 0 A 142936.0000 I Custodian Account for Children These shares were received through a stock dividend on December 31, 2003. These shares were purchased through a Stock Investment Plan These shares were received through a stock dividend on December 31, 2003 on Ray Riley's Stock Investment Account. These shares were received through a stock dividend on December 31, 2003. /s/ Ray A. Riley 2004-02-13 -----END PRIVACY-ENHANCED MESSAGE-----