5 1 rbk50202.txt FORM 5 FOR 2001 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. [ ] Form 3 Holdings Reported [ ] Form 4 Transactions Reported 1. Name and Address of Reporting Person(s) KELLY, RICHARD B 2865 NO. BEND ROAD CINCINNATI, OH 45239 2. Issuer Name and Ticker or Trading Symbol Ohio Casualty Corporation (OCAS) 3. I.R.S. Identification Number of Reporting Person, if an entity (Voluntary) 4. Statement for Month/Year 12/01 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 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)Trans- 3.Trans- 4.Securities Acquired(A) 5)Amount of 6) 7)Nature of action action or Disposed of (D) Securities Indirect Date Code A Beneficially D Beneficial (Month/ or Owned at or Ownership Day/Year) Code Amount D Price End of Year I ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 241 I Supplemental ESP Common Stock 3,660 I Employee Savings Pln Table II (PART 1) Derivative Securitites Acquired, Disposed of, or Beneficially Owned (Columns 1 through 6) ------------------------------------------------------------------------------------------------------------------------------------ 1)Title of Derivative 2)Conversion 3)Trans- 4)Trans- 5)Number of Derivative 6)Date Exercisable and Security or Exercise action action Securities Acquired (A) Expiration Date Price of Date Code or Disposed of (D) Derivative Security Code A D Exercisable Expiration ------------------------------------------------------------------------------------------------------------------------------------ Incentive Stock Option (right $8.9900 06/01/01 A 15,264 06/01/11 to buy) Incentive Stock Option (right $20.3438 02/18/00 02/18/09 to buy) Non-Qualified Stock Option $8.9900 06/01/01 A 15,736 06/01/11 (right to buy) Non-Qualified Stock Option $12.3750 02/28/01 02/28/10 (right to buy) Table II (PART 2) Derivative Securitites Acquired, Disposed of, or Beneficially Owned (Columns 1,3 and 7 through 11) ------------------------------------------------------------------------------------------------------------------------------------ 1)Title of Derivative 3)Trans- 7)Title and Amount 8)Price 9)Number of 10) 11)Nature of Security action of Underlying of Deri- Derivative Indirect Date Securities vative Securities D Beneficial Amount or Security Beneficially or Ownership Number of Owned at I - Title Shares End of Year ------------------------------------------------------------------------------------------------------------------------------------ Incentive Stock Option (right 06/01/01 Common Stock 15,264 15,264 D Direct to buy) Incentive Stock Option (right Common Stock 8,000 8,000 D Direct to buy) Non-Qualified Stock Option 06/01/01 Common Stock 15,736 15,736 D Direct (right to buy) Non-Qualified Stock Option Common Stock 15,000 15,000 D Direct (right to buy) Explanation of Responses:
SIGNATURE OF REPORTING PERSON /S/ KELLY, RICHARD B DATE 01/24/02