-----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, I1Um1YNLsflM7vdv67Stqb2GjpBFOzNGMvVpaAwX7C6eJl5jL7YoYnKLnivsNuik yNSMLaY3TNSSnfFvT/P5Gw== 0000814181-04-000087.txt : 20040824 0000814181-04-000087.hdr.sgml : 20040824 20040824101237 ACCESSION NUMBER: 0000814181-04-000087 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040823 FILED AS OF DATE: 20040824 DATE AS OF CHANGE: 20040824 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: CLOUTIER MARK D CENTRAL INDEX KEY: 0001252448 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: 04993194 BUSINESS ADDRESS: STREET 1: 3440 LEHIGH ST CITY: ALLENTOWN STATE: PA ZIP: 18103 BUSINESS PHONE: 215 219 5128 MAIL ADDRESS: STREET 1: 7150 LAWNDALE STREET CITY: PHILADELPHIA STATE: PA ZIP: 19111 4 1 form4_mcex.xml X0202 4 2004-08-23 0 0000814181 PENN TREATY AMERICAN CORP PTA 0001252448 CLOUTIER MARK D 3440 LEHIGH ST ALLENTOWN PA 18103 0 1 0 0 Senior VP, CFO & Treasurer Common Stock 2004-08-23 4 P 0 1000 1.59 A 1000 D /s/Linda G. Carraghan, by Power of Attorney for Mark D. Cloutier 2004-08-24 -----END PRIVACY-ENHANCED MESSAGE-----