-----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, WGJzeZ7ShNm22KMQM+Y9T83itr3M0HxKN4QpN/TgryrLIyirHliU/Wj6x/z/hp43 yzIJlqHsx/XDWmxrHIS1IQ== 0000814181-04-000058.txt : 20040604 0000814181-04-000058.hdr.sgml : 20040604 20040604143300 ACCESSION NUMBER: 0000814181-04-000058 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040423 FILED AS OF DATE: 20040604 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: PENN TREATY AMERICAN CORP CENTRAL INDEX KEY: 0000814181 STANDARD INDUSTRIAL CLASSIFICATION: ACCIDENT & HEALTH INSURANCE [6321] IRS NUMBER: 231664166 STATE OF INCORPORATION: PA FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 3440 LEHIGH ST CITY: ALLENTOWN STATE: PA ZIP: 18103 BUSINESS PHONE: 6109652222 MAIL ADDRESS: STREET 1: 3440 LEHIGH ST CITY: ALLENTOWN STATE: PA ZIP: 18103 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: GRILL MICHAEL F CENTRAL INDEX KEY: 0001252450 STANDARD INDUSTRIAL CLASSIFICATION: ACCIDENT & HEALTH INSURANCE [6321] STATE OF INCORPORATION: PA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-14681 FILM NUMBER: 04849547 BUSINESS ADDRESS: STREET 1: 3440 LEHIGH ST CITY: ALLENTOWN STATE: PA ZIP: 18103 BUSINESS PHONE: 610 948 0855 MAIL ADDRESS: STREET 1: 40 IROQUOIS DRIVE CITY: ROYERSFORD STATE: PA ZIP: 19468 4 1 form4_mg0604ex.xml X0202 4 2004-04-23 1 0000814181 PENN TREATY AMERICAN CORP PTA 0001252450 GRILL MICHAEL F 3440 LEHIGH ST ALLENTOWN PA 18103 0 1 0 0 Former VP & Treasurer Common Stock 2004-04-23 4 I 0 848 2.23 D 0 I 401(K) Plan Based on information provided by Plan Administrator on 6/4/04. /s/Linda G. Carraghan, by Power of Attorney for Michael F. Grill 2004-06-04 -----END PRIVACY-ENHANCED MESSAGE-----