-----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, TwKEOhfai9dr304VVa9x6/19BCW6Pi1LtgqaNAGEDpelMlxPnAzdfUJTVKfgNzO6 Lr6ld1WWo2jygBKf9PyRUg== 0001209191-04-059247.txt : 20041223 0001209191-04-059247.hdr.sgml : 20041223 20041223103150 ACCESSION NUMBER: 0001209191-04-059247 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20041221 FILED AS OF DATE: 20041223 DATE AS OF CHANGE: 20041223 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 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SOKOL JOHN S CENTRAL INDEX KEY: 0000949067 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-08738 FILM NUMBER: 041222635 BUSINESS ADDRESS: STREET 1: 20 EAST STREET 2: 20 EAST BROAD STREET 4TH FLOOR CITY: COLUMBUS STATE: OH ZIP: 43215 BUSINESS PHONE: 6142282800 MAIL ADDRESS: STREET 1: 20 EAST BROAD STREET 4TH FLOOR CITY: COLUMBUS STATE: OH ZIP: 43215 4 1 doc4.xml FORM 4 SUBMISSION X0202 4 2004-12-21 0 0000276400 BANCINSURANCE CORP BCIS 0000949067 SOKOL JOHN S 250 E. BROAD ST. 10TH FLOOR COLUMBUS OH 43215 1 1 0 0 President Option to Purchase Common Shares 7.04 2004-12-21 4 A 0 100000 0.00 A 2004-12-21 2014-12-20 Common Shares 100000 100000 D 20% of the grant becomes exercisable on each of the first five anniversaries of the date of grant. /s/John S. Sokol 2004-12-23 -----END PRIVACY-ENHANCED MESSAGE-----