-----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, Dpq79eSR7ys4RywnjMpoUhBBuM1yzo8R0TG7GULgtBeFxmjvttDAxM2ZM9LMXRfr yUCd/gJZHMenMJ6jtn+BYg== 0001040486-98-000001.txt : 19980211 0001040486-98-000001.hdr.sgml : 19980211 ACCESSION NUMBER: 0001040486-98-000001 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 19971231 FILED AS OF DATE: 19980210 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: 98527927 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: MASSEY JAMES D CENTRAL INDEX KEY: 0001040486 STANDARD INDUSTRIAL CLASSIFICATION: [] DIRECTOR FILING VALUES: FORM TYPE: 5 BUSINESS ADDRESS: STREET 1: 11825 N PENNSYLVANIA STREET CITY: CARMEL STATE: IN ZIP: 46032 BUSINESS PHONE: 3178176100 MAIL ADDRESS: STREET 1: 11825 N PENNSYLVANIA ST CITY: CARMEL STATE: IN ZIP: 46032 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 Massey, James D. 10494 Hyde Park 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 ( ) Officer (give title below) ( ) Other (specify below) 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 | | | | | |204,000 |D | | - -----------------------------------------------------------------------------------------------------------------------------------| ___________________________________________________________________________________________________________________________________| ___________________________________________________________________________________________________________________________________ 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)| | ___________________________________________________________________________________________________________________________________| Options to Purchase (1) |$40.44 |5/13/|A |5,000 |A |(1) |5/12/|Common Stock|5,000 | |5,000 |D | | | |97 | | | | |07 | | | | | | | - -----------------------------------------------------------------------------------------------------------------------------------| Options to Purchase (2) | | | | | | | | | | |50,000 |D | | - -----------------------------------------------------------------------------------------------------------------------------------| Stock Units (3) |-0- |3/31/|A |714.3 |A |(3) |(3) |Common Stock|714.3 | | |D | | | |97 | | | | | | | | | | | | - -----------------------------------------------------------------------------------------------------------------------------------| Stock Units (3) |-0- |4/1/9|A |3.8 |A |(3) |(3) |Common Stock|3.8 | | |D | | | |7 | | | | | | | | | | | | - -----------------------------------------------------------------------------------------------------------------------------------| Stock Units (3) |-0- |7/1/9|A |3.9 |A |(3) |(3) |Common Stock|3.9 | | |D | | | |7 | | | | | | | | | | | | - -----------------------------------------------------------------------------------------------------------------------------------| Stock Units (3) |-0- |10/1/|A |11.5 |A |(3) |(3) |Common Stock|11.5 | | |D | | | |97 | | | | | | | | | | | | - -----------------------------------------------------------------------------------------------------------------------------------| Stock Units (3) |-0- |1/2/9|A |12.4 |A |(3) |(3) |Common Stock|12.4 | |4,498.3 |D | | | |8 | | | | | | | | | | | | - -----------------------------------------------------------------------------------------------------------------------------------| ___________________________________________________________________________________________________________________________________|
Explanation of Responses: (1) Granted under the Conseco, Inc. 1994 Stock and Incentive Plan. The options become exercisable in five equal annual installments beginning May 13, 1998. (2) Represents stock options held by the Reporting Person as previously reported. (3) Granted under the Conseco, Inc. 1994 Stock and Incentive Plan. SIGNATURE OF REPORTING PERSON /s/James D. Massey by Karl W. Kindig, Attorney-in-Fact -----END PRIVACY-ENHANCED MESSAGE-----