-----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, T3Hwubgsw7jHYOs9Zg2B3D1tUsy/l84janB+6HCVZl4qHXKj+4/ZTjKimtppJE+z 438dI/HuvU5vkQbdBAhmdQ== 0001209191-09-008942.txt : 20090213 0001209191-09-008942.hdr.sgml : 20090213 20090213145848 ACCESSION NUMBER: 0001209191-09-008942 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20081017 FILED AS OF DATE: 20090213 DATE AS OF CHANGE: 20090213 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: 09602256 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 X0303 4 2008-10-17 0 0000276400 BANCINSURANCE CORP BCIS 0000949067 SOKOL JOHN S 250 E. BROAD ST. 10TH FLOOR COLUMBUS OH 43215 1 1 1 0 Chairman, CEO and President Common Shares 2008-10-17 5 G 0 E 594563.67 0.00 A 1750000 I By Limited Partnership Common Shares 2009-01-16 5 G 0 E 8550 0.00 A 53197 I Custodian for minor children The reported securities are owned by Falcon Equity Partners, L.P. ("Falcon"), an Ohio limited partnership whose partners are members of the Si Sokol family, including the reporting person, and trusts for the benefit of members of the Si Sokol family. Following the transaction reported herein, the reporting person holds, directly and indirectly as trustee of trusts for the benefit of members of the Si Sokol family, a 44.4% interest in Falcon. On October 17, 2008, (a) the reporting person received a gift of a 0.3% interest in Falcon in his individual capacity and (b) three trusts, of which the reporting person is the sole trustee and members of the Si Sokol family are the beneficiaries, received in the aggregate gifts of a 33.7% interest in Falcon. The reporting person disclaims beneficial ownership of the BCIS common shares held by Falcon, except to the extent of his pecuniary interest therein. These 53,197 BCIS common shares are beneficially owned by the reporting person, as custodian for his minor children. The reporting person also directly beneficially owns 246,694 BCIS common shares. The reporting person's wife, Elizabeth M. Sokol, also owns 2,100 BCIS common shares. The reporting person disclaims beneficial ownership of such BCIS common shares, and the filing of this report is not an admission that the reporting person is the beneficial owner of such BCIS common shares for the purpose of Section 16 or any other purpose. /s/ John S. Sokol 2009-02-13 -----END PRIVACY-ENHANCED MESSAGE-----