-----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, H7dfGRI5mSU3zBjOT71XwZT3ftl+/zG3mOu9wV2vXhPSeLTp4uSgCYeCoEU/441f qe3gtFktMXZKcwCgAMA9eg== 0001040483-99-000004.txt : 19991110 0001040483-99-000004.hdr.sgml : 19991110 ACCESSION NUMBER: 0001040483-99-000004 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 19991031 FILED AS OF DATE: 19991109 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: 4 SEC ACT: SEC FILE NUMBER: 001-09250 FILM NUMBER: 99744306 BUSINESS ADDRESS: STREET 1: 11825 N PENNSYLVANIA ST CITY: CARMEL STATE: IN ZIP: 46032 BUSINESS PHONE: 3178176100 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: DICK ROLLIN M CENTRAL INDEX KEY: 0001040483 STANDARD INDUSTRIAL CLASSIFICATION: [] DIRECTOR FILING VALUES: FORM TYPE: 4 BUSINESS ADDRESS: STREET 1: 11825 N PENNSYLVANIA STREET CITY: CARMEL STATE: IN ZIP: 46032 BUSINESS PHONE: 3178176100 MAIL ADDRESS: STREET 1: 11825 N PENNSYLVANIA STREET CITY: CARMEL STATE: IN ZIP: 46032 4 1 FORM 4 - OCTOBER 31, 1999 UNITED STATES SECURITIES AND EXCHANGE COMMISSION WASHINGTON, D.C. 20549 FORM 4 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP ( ) Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instructions 1(b). 1. Name and Address of Reporting Person Dick, Rollin M. 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 October 31, 1999 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 and Chief Financial Officer 7. Individual or Joint/Group Filing (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 | | | | | Beneficially |(D)or | | | | | | | A/| | Owned at |Indir | | | Date |Code|V| Amount | D | Price | End of Month |ect(I)| | ___________________________________________________________________________________________________________________________________| Common Stock |10/1/9|P | |30,075 |A |$20.00 | |I |By Limited Partnership | |9 | | | | | | | | | - -----------------------------------------------------------------------------------------------------------------------------------| Common Stock |10/4/9|P | |361 |A |$20.88 | |I |By Limited Partnership | |9 | | | | | | | | | - -----------------------------------------------------------------------------------------------------------------------------------| Common Stock |10/5/9|P | |48,120 |A |$20.09 | |I |By Limited Partnership | |9 | | | | | | | | | - -----------------------------------------------------------------------------------------------------------------------------------| Common Stock |10/8/9|P | |7,579 |A |$22.63 | |I |By Limited Partnership | |9 | | | | | | | | | - -----------------------------------------------------------------------------------------------------------------------------------| Common Stock |10/11/|P | |842 |A |$22.50 | |I |By Limited Partnership | |99 | | | | | | | | | - -----------------------------------------------------------------------------------------------------------------------------------| Common Stock |10/13/|P | |66,882 |A |$22.46 | |I |By Limited Partnership | |99 | | | | | | | | | - -----------------------------------------------------------------------------------------------------------------------------------| Common Stock |10/14/|P | |42,653 |A |$21.28 |1,196,512 |I |By Limited Partnership | |99 | | | | | | | | | - -----------------------------------------------------------------------------------------------------------------------------------| Common Stock | | | | | | |530,218 |D | | - -----------------------------------------------------------------------------------------------------------------------------------| Common Stock | | | | | | |774,386(1) |I |By wife | - -----------------------------------------------------------------------------------------------------------------------------------| Common Stock | | | | | | |1,000,000 |I |By Limited Partnership | - -----------------------------------------------------------------------------------------------------------------------------------| Common Stock | | | | | | |177,500 |I |By Trust | - -----------------------------------------------------------------------------------------------------------------------------------| Common Stock | | | | | | |1,534 |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 | | | rities Acqui |Expiration | Securities |vative |tive |ect|Beneficial | |cise | | | red(A) or Dis |Date(Month/| |Secu |Securities |(D)|Ownership | |Price 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 |Date |Code|V| Amount | |ble | | | |Month |(I)| | ___________________________________________________________________________________________________________________________________| | | | | | | | | | | | | | | | ___________________________________________________________________________________________________________________________________|
Explanation of Responses: (1) The reporting person disclaims beneficial ownership of these securities, and this report shall not be deemed an admission that the reporting person is the beneficial owner of such securities for purposes of Section 16 or for any other purpose. SIGNATURE OF REPORTING PERSON /s/Rollin M. Dick by Karl W. Kindig, Attorney-in-Fact DATE November 9, 1999 -----END PRIVACY-ENHANCED MESSAGE-----