-----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, K7zcSSzlVfbtP7YVf8J/+X5Zq5twfG+3p43H/lTxjADqmURxnwGLZY2iTEwXDrZD Vx08raDg3H+FSkTSifTg3Q== 0001209191-04-026541.txt : 20040519 0001209191-04-026541.hdr.sgml : 20040519 20040519143545 ACCESSION NUMBER: 0001209191-04-026541 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040517 FILED AS OF DATE: 20040519 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: STEPHAN DANIEL J CENTRAL INDEX KEY: 0001183450 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-08738 FILM NUMBER: 04818388 BUSINESS ADDRESS: STREET 1: C/O BANCINSURANCE CORP STREET 2: 250 E BROAD STREET 10TH FL CITY: COLUMBUS STATE: OH ZIP: 43215 BUSINESS PHONE: 6142282800 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: BANCINSURANCE CORP CENTRAL INDEX KEY: 0000276400 STANDARD INDUSTRIAL CLASSIFICATION: FIRE, MARINE & CASUALTY INSURANCE [6331] IRS NUMBER: 310790882 STATE OF INCORPORATION: OH FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 250 EAST BROAD STREET STREET 2: 10TH FLOOR CITY: COLUMBUS STATE: OH ZIP: 43215 BUSINESS PHONE: 6142282800 MAIL ADDRESS: STREET 1: 250 EAST BROAD STREET STREET 2: 10TH FLOOR CITY: COLUMBUS STATE: OH ZIP: 43215 4 1 doc4.xml FORM 4 SUBMISSION X0202 4 2004-05-17 0 0000276400 BANCINSURANCE CORP BCIS 0001183450 STEPHAN DANIEL J 250 E. BROAD ST. 10TH FLOOR COLUMBUS OH 43215 0 1 0 0 SVP Marketing (of Subsidiary) Option to purchase Common Shares 8.0000 2004-05-17 4 A 0 10000.0000 0 A 2005-05-16 2014-05-16 Common Shares 10000.0000 10000.0000 D 20% of the grant becomes exercisable on each of the first five anniversaries of the date of grant. /s/Daniel J. Stephan 2004-05-19 -----END PRIVACY-ENHANCED MESSAGE-----