0001209191-21-038270.txt : 20210604 0001209191-21-038270.hdr.sgml : 20210604 20210604164141 ACCESSION NUMBER: 0001209191-21-038270 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20210602 FILED AS OF DATE: 20210604 DATE AS OF CHANGE: 20210604 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Gage Errol Dean CENTRAL INDEX KEY: 0001226176 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-16509 FILM NUMBER: 21997042 MAIL ADDRESS: STREET 1: 2900 ESPERANZA CROSSING, 2ND FL CITY: AUSTIN STATE: TX ZIP: 78758 FORMER NAME: FORMER CONFORMED NAME: GAGE ERROL DEAN DATE OF NAME CHANGE: 20030404 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 2021-06-02 0 0000024090 CITIZENS, INC. CIA 0001226176 Gage Errol Dean 11815 ALTERRA PARKWAY, SUITE 1500 AUSTIN TX 78758 1 0 0 0 Citizens, Inc. Class A Common Stock 2021-06-02 4 M 0 1575 A 6370.4395 D Restricted Stock Units 2021-06-02 4 M 0 1575 0.00 D Class A Common Stock 1575 0 D Restricted Stock Units 2021-06-02 4 A 0 2023 0.00 A Class A Common Stock 2023 2023 D Each restricted stock unit represents a contingent right to receive one share of Citizens, Inc. Class A common stock. On June 2, 2020, the reporting person was granted 1,575 restricted stock units, vesting on June 2, 2021. The restricted stock units vest 100% on the first anniversary of the date of the grant (June 2, 2022), subject to the director's continued service on the Board of Directors through such date. Exhibit List Exhibit 24 - Power of Attorney /s/ Sheryl Kinlaw, Attorney-in-Fact 2021-06-04 EX-24.4_990626 2 poa.txt POA DOCUMENT POWER OF ATTORNEY Know all by these presents, that the undersigned hereby constitutes and appoints each of Sheryl Kinlaw and Jeffery P. Conklin, or either of them signing singly, and with full power of substitution, the undersigned's true and lawful attorney-in-fact to: (1) prepare, execute in the undersigned's name and on the undersigned's behalf, and submit to the U.S. Securities and Exchange Commission (the "SEC") a Form ID, including amendments thereto, and any other documents necessary or appropriate to obtain codes and passwords enabling the undersigned to make electronic filings with the SEC of reports required by Section 16(a) of the Securities Exchange Act of 1934 or any rule or regulation of the SEC; (2) execute for and on behalf of the undersigned, in the undersigned's capacity as an officer and/or director of Citizens, Inc. (the "Company"), Forms 3, 4, and 5 in accordance with Section 16(a) of the Securities Exchange Act of 1934 and the rules thereunder; (3) do and perform any and all acts for and on behalf of the undersigned which may be necessary or desirable to complete and execute any such Form 3, 4, or 5, complete and execute any amendment or amendments thereto, and timely file such form with the SEC and any stock exchange or similar authority; and (4) take any other action of any type whatsoever in connection with the foregoing which, in the opinion of such attorney-in-fact, may be of benefit to, in the best interest of, or legally required by, the undersigned, it being understood that the documents executed by such attorney-in-fact on behalf of the undersigned pursuant to this Power of Attorney shall be in such form and shall contain such terms and conditions as such attorney-in-fact may approve in such attorney-in-fact's discretion. The undersigned hereby grants to each such attorney-in-fact full power and authority to do and perform any and every act and thing whatsoever requisite, necessary, or proper to be done in the exercise of any of the rights and powers herein granted, as fully to all intents and purposes as the undersigned might or could do if personally present, with full power of substitution or revocation, hereby ratifying and confirming all that such attorney-in-fact, or such attorney-in-fact's substitute or substitutes, shall lawfully do or cause to be done by virtue of this power of attorney and the rights and powers herein granted. The undersigned acknowledges that the foregoing attorneys in fact, in serving in such capacity at the request of the undersigned, are not assuming, nor is the Company assuming, any of the undersigned's responsibilities to comply with Section 16 of the Securities Exchange Act of 1934. This Power of Attorney shall remain in full force and effect until the undersigned is no longer required to file Forms 3, 4, and 5 with respect to the undersigned's holdings of and transactions in securities issued by the Company, unless earlier revoked by the undersigned in a signed writing delivered to the foregoing attorneys in fact. IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be executed as of this 1st day of June, 2021. /s/ Errol Dean Gage Signature Errol Dean Gage Print Name