-----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, WWUG6l7wYFBatV/yB/o5q5jCZOSRu32qE0lxkOAZXhXfqBGKopwWjH2rP1Aqm3xf 5xDr2T8eSrhbb5mnfHa1+Q== 0001040490-97-000006.txt : 19971110 0001040490-97-000006.hdr.sgml : 19971110 ACCESSION NUMBER: 0001040490-97-000006 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 19971031 FILED AS OF DATE: 19971107 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: 4 SEC ACT: SEC FILE NUMBER: 001-09250 FILM NUMBER: 97710201 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: ADAMAS JAMES S CENTRAL INDEX KEY: 0001040490 STANDARD INDUSTRIAL CLASSIFICATION: [] OFFICER 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, 1997 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 Adams, James S. 11825 N. Pennsylvania Street Carmel, IN 46032 U.S.A. 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, 1997 5. If Amendment, Date of Original (Month/Year) 6. Relationship of Reporting Person(s) to Issuer (Check all applicable) ( ) Director ( ) 10% Owner (X) Officer (give title below) ( ) Other (specify below) Senior Vice President, Chief Accounting Officer and Treasurer 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 | |4,288 |A |$48.73 | | | | |7 | | | | | | | | | - -----------------------------------------------------------------------------------------------------------------------------------| Common Stock |10/2/9|P | |713 |A |$48.93 | | | | |7 | | | | | | | | | - -----------------------------------------------------------------------------------------------------------------------------------| Common Stock |10/3/9|P | |7,500 |A |$48.95 | | | | |7 | | | | | | | | | - -----------------------------------------------------------------------------------------------------------------------------------| Common Stock |10/6/9|P | |5,000 |A |$48.94 | | | | |7 | | | | | | | | | - -----------------------------------------------------------------------------------------------------------------------------------| Common Stock |10/9/9|P | |364 |A |$47.65 |209,788 |D | | |7 | | | | | | | | | - -----------------------------------------------------------------------------------------------------------------------------------| Preferred Redeemable Increa| | | | | | | | | | sed Dividend Equity Securit| | | | | | | | | | ies, 7% PRIDES, | | | | | | | | | | - -----------------------------------------------------------------------------------------------------------------------------------| Convertible Preferred Sto| | | | | | |1,000 |I |By Estate | ck | | | | | | | | | | - -----------------------------------------------------------------------------------------------------------------------------------| ___________________________________________________________________________________________________________________________________| ___________________________________________________________________________________________________________________________________ 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: SIGNATURE OF REPORTING PERSON /s/ James S. Adams by Karl W. Kindig, Attorney-in-Fact DATE November 6, 1997 -----END PRIVACY-ENHANCED MESSAGE-----