0001209191-21-031585.txt : 20210511 0001209191-21-031585.hdr.sgml : 20210511 20210511153853 ACCESSION NUMBER: 0001209191-21-031585 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210507 FILED AS OF DATE: 20210511 DATE AS OF CHANGE: 20210511 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Eliasberg James A. CENTRAL INDEX KEY: 0001497157 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-16509 FILM NUMBER: 21911074 MAIL ADDRESS: STREET 1: 2900 ESPERANZA CROSSING, 2ND FLOOR CITY: AUSTIN STATE: TX ZIP: 78758 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: CITIZENS, INC. CENTRAL INDEX KEY: 0000024090 STANDARD INDUSTRIAL CLASSIFICATION: LIFE INSURANCE [6311] IRS NUMBER: 840755371 STATE OF INCORPORATION: TX FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 11815 ALTERRA PKWY STREET 2: SUITE 1500 CITY: AUSTIN STATE: TX ZIP: 78758 BUSINESS PHONE: 5128377100 MAIL ADDRESS: STREET 1: P O BOX 149151 CITY: AUSTIN STATE: TX ZIP: 78714 FORMER COMPANY: FORMER CONFORMED NAME: CITIZENS INC DATE OF NAME CHANGE: 19920703 FORMER COMPANY: FORMER CONFORMED NAME: CONTINENTAL INVESTORS LIFE INC DATE OF NAME CHANGE: 19881222 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2021-05-07 0 0000024090 CITIZENS, INC. CIA 0001497157 Eliasberg James A. C/O CITIZENS, INC. 11815 ALTERRA PARKWAY, SUITE 1500 AUSTIN TX 78758 0 1 0 0 Former VP, Chief Legal Officer Citizens, Inc. Class A Common Stock 2021-05-07 4 M 0 7883 A 40929 D Citizens, Inc. Class A Common Stock 2021-05-07 4 F 0 1920 5.70 D 39009 D Citizens, Inc. Class A Common Stock 2021-05-07 4 M 0 10486 A 49495 D Citizens, Inc. Class A Common Stock 2021-05-07 4 F 0 2556 5.70 D 46939 D Restricted Stock Units 2021-05-07 4 M 0 10486 0.00 D Class A Common Stock 10486 0 D Restricted Stock Units 2021-05-07 4 M 0 7883 0.00 D Class A Common Stock 7883 0 D Represents shares of Citizens, Inc. Class A Common Stock issued upon accelerated vesting of Restricted Stock Units (RSUs) pursuant to the terms of the Separation and Release Agreement by and between the Reporting Person and Citizens, Inc. dated April 29, 2021 (the "Separation Agreement"). Each restricted stock unit represents a contingent right to receive one share of Citizens, Inc. Class A common stock. The RSUs were granted on January 29, 2021. The RSUs were scheduled to vest annually at a rate of 1/3 on each anniversary of the grant date. All of the unvested RSUs were accelerated on the Transaction Date pursuant to the terms of the Separation Agreement. The RSUs were granted on April 15, 2020. 1/2 of the RSUs previously vested on April 15, 2021 and the remaining 1/2 were scheduled to vest on April 15, 2022. All of the unvested RSUs were accelerated on the Transaction Date pursuant to the terms of the Separation Agreement. The Reporting Person resigned from Citizens Inc. effective April 30, 2021. As a result, the Reporting Person is no longer subject to Section 16 in connection with his transactions in the equity securities of Citizens, Inc. and, therefore, will no longer report any such transactions on Form 4 or Form 5. /s/ Jeffery P. Conklin, Attorney-in-Fact 2021-05-11