-----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, Q19V/dujZV+ZWFk6sHPZIX3iaQFlzwVnXwFBWo9bGoCCNSuXT8qIA+4D/NHIAnGe Ole0mD8qw3k90hPVgkPByQ== 0001024245-98-000001.txt : 19980217 0001024245-98-000001.hdr.sgml : 19980217 ACCESSION NUMBER: 0001024245-98-000001 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 19971231 FILED AS OF DATE: 19980212 SROS: NYSE SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: CONSECO INC CENTRAL INDEX KEY: 0000719241 STANDARD INDUSTRIAL CLASSIFICATION: ACCIDENT & HEALTH INSURANCE [6321] IRS NUMBER: 351468632 STATE OF INCORPORATION: IN FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 5 SEC ACT: SEC FILE NUMBER: 001-09250 FILM NUMBER: 98533729 BUSINESS ADDRESS: STREET 1: 11825 N PENNSYLVANIA ST CITY: CARMEL STATE: IN ZIP: 46032 BUSINESS PHONE: 3175736100 MAIL ADDRESS: STREET 1: 11825 N PENNSYLVANIA ST CITY: CARMEL STATE: IN ZIP: 46032 FORMER COMPANY: FORMER CONFORMED NAME: SECURITY NATIONAL OF INDIANA CORP DATE OF NAME CHANGE: 19840207 COMPANY DATA: COMPANY CONFORMED NAME: CUNEO NGAIRE E CENTRAL INDEX KEY: 0001024245 STANDARD INDUSTRIAL CLASSIFICATION: [] DIRECTOR FILING VALUES: FORM TYPE: 5 BUSINESS ADDRESS: STREET 1: DUKE REALTY INVESTMENTS INC STREET 2: 8888 KEYSTONE CROSSING STE 1200 CITY: INDIANAPOLIS STATE: IN ZIP: 46240 BUSINESS PHONE: 3175758888 MAIL ADDRESS: STREET 1: C/O DUKE REALTY INESTMENTS INC STREET 2: 8888 KEYSTONE CROSSING STE 1200 CITY: INDIANAPOLIS STATE: IN ZIP: 46240 5 1 FORM 5 - DECEMBER 31, 1997 UNITED STATES SECURITIES AND EXCHANGE COMMISSION WASHINGTON, D.C. 20549 FORM 5 ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP ( ) Check box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instructions 1(b). ( ) Form 3 Holdings Reported ( ) Form 4 Transactions Reported 1. Name and Address of Reporting Person Cuneo, Ngaire E. 11825 N. Pennsylvania Street Carmel, IN 46032 USA 2. Issuer Name and Ticker or Trading Symbol Conseco, Inc. CNC 3. IRS or Social Security Number of Reporting Person (Voluntary) 4. Statement for Month/Year December 31, 1997 5. If Amendment, Date of Original (Month/Year) 6. Relationship of Reporting Person(s) to Issuer (Check all applicable) (X) Director ( ) 10% Owner (X) Officer (give title below) ( ) Other (specify below) Executive Vice President, Corporate Development 7. Individual or Joint/Group Reporting (Check Applicable Line) (X) Form filed by One Reporting Person ( ) Form filed by More than One Reporting Person
___________________________________________________________________________________________________________________________________ Table I -- Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | ___________________________________________________________________________________________________________________________________| 1. Title of Security |2. |3. |4.Securities Acquired (A) |5.Amount of |6.Dir |7.Nature of Indirect | |Transaction| or Disposed of (D) | Securities |ect | Beneficial Ownership | |Date |Code| | Beneficially |(D)or | | | | | | A/| | Owned at |Indir | | | | | Amount | D | Price | End of Year |ect(I)| | ___________________________________________________________________________________________________________________________________| Common Stock | | | | | |914,729 |D | | - -----------------------------------------------------------------------------------------------------------------------------------| Common Stock | | | | | |34,000 |I |By Trust | - -----------------------------------------------------------------------------------------------------------------------------------| Common Stock | | | | | |33,000 |I |By Trust | - -----------------------------------------------------------------------------------------------------------------------------------| Common Stock | | | | | |33,000 |I |By Trust | - -----------------------------------------------------------------------------------------------------------------------------------| Common Stock | | | | | |290 |I |By 401(k) Plan | - -----------------------------------------------------------------------------------------------------------------------------------| ___________________________________________________________________________________________________________________________________| ___________________________________________________________________________________________________________________________________ Table II -- Derivative Securitites Acquired, Disposed of, or Beneficially Owned | ___________________________________________________________________________________________________________________________________| 1.Title of Derivative |2.Con |3. |4. |5.Number of De |6.Date Exer|7.Title and Amount |8.Price|9.Number |10.|11.Nature of| Security |version |Transaction rivative Secu |cisable and| of Underlying |of Deri|of Deriva |Dir|Indirect | |or Exer |Date |Code| rities Acqui |Expiration | Securities |vative |tive |ect|Beneficial | |cise Pr | | | red(A) or Dis |Date(Month/| |Secu |Securities |(D)|Ownership | |ice of | | | posed of(D) |Day/Year) | |rity |Benefi |or | | |Deriva | | | |Date |Expir| | |ficially |Ind| | |tive | | | | A/|Exer-|ation| Title and Number | |Owned at |ire| | |Secu | | | | D |cisa-|Date | of Shares | |End of |ct | | |rity | | | Amount | |ble | | | |Year |(I)| | ___________________________________________________________________________________________________________________________________| Stock Units (1) |-0- |3/31/|A |23,638.3 |A |(1) |(1) |Common Stock|23,638.| | |D | | | |97 | | | | | | |3 | | | | | - -----------------------------------------------------------------------------------------------------------------------------------| Stock Units (1) |-0- |4/1/9|A |79.7 |A |(1) |(1) |Common Stock|79.7 | | |D | | | |7 | | | | | | | | | | | | - -----------------------------------------------------------------------------------------------------------------------------------| Stock Units (1) |-0- |7/1/9|A |81.1 |A |(1) |(1) |Common Stock|81.1 | | |D | | | |7 | | | | | | | | | | | | - -----------------------------------------------------------------------------------------------------------------------------------| Stock Units (1) |-0- |10/1/|A |240.2 |A |(1) |(1) |Common Stock|240.2 | | |D | | | |97 | | | | | | | | | | | | - -----------------------------------------------------------------------------------------------------------------------------------| Stock Units (1) |-0- |1/2/9|A |259.6 |A |(1) |(1) |Common Stock|259.6 | |94,224.5 |D | | | |8 | | | | | | | | | | | | - -----------------------------------------------------------------------------------------------------------------------------------| Common Stock Warrants | | | | | | | | | | |10,000 |D | | - -----------------------------------------------------------------------------------------------------------------------------------| Options to Purchase (2) | | | | | | | | | | |1,221,607 |D | | - -----------------------------------------------------------------------------------------------------------------------------------| Stock Units (3) | | | | | | | | | | |72,980.4 |D | | - -----------------------------------------------------------------------------------------------------------------------------------| ___________________________________________________________________________________________________________________________________|
Explanation of Responses: (1) Granted under the Conseco, Inc. 1994 Stock and Incentive Plan. (2) Represents stock options held by the Reporting Person as previously reported. (3) Represents common stock units conditionally awarded under the Issuer's Executive Deferred Compensation Program as previously reported. SIGNATURE OF REPORTING PERSON /s/Ngaire E. Cuneo by Karl W. Kindig, Attorney-in-Fact DATE February 12, 1998 -----END PRIVACY-ENHANCED MESSAGE-----