-----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, IeaSMcyZzrjDZx2dlqyl0drfBurmqcA10PYSfRV8neoXMu9PTvf5IhTC7R5pG/4L 4T9oDikmmShcJMLSPOPFHg== 0000814181-05-000099.txt : 20050913 0000814181-05-000099.hdr.sgml : 20050913 20050913143729 ACCESSION NUMBER: 0000814181-05-000099 CONFORMED SUBMISSION TYPE: 4/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20050908 FILED AS OF DATE: 20050913 DATE AS OF CHANGE: 20050913 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: CLARK ALEXANDER CENTRAL INDEX KEY: 0001252447 STANDARD INDUSTRIAL CLASSIFICATION: ACCIDENT & HEALTH INSURANCE [6321] STATE OF INCORPORATION: PA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4/A SEC ACT: 1934 Act SEC FILE NUMBER: 001-14681 FILM NUMBER: 051081983 BUSINESS ADDRESS: STREET 1: 3440 LEHIGH ST CITY: ALLENTOWN STATE: PA ZIP: 18103 BUSINESS PHONE: 212 484 2900 MAIL ADDRESS: STREET 1: 106 EAST 84TH STREET 8E CITY: NEW YORK STATE: NY ZIP: 10028 4/A 1 form4-a_ac090805ex.xml X0202 4/A 2005-09-08 2005-09-09 0 0000814181 PENN TREATY AMERICAN CORP PTA 0001252447 CLARK ALEXANDER 3440 LEHIGH STREET ALLENTOWN PA 18103 1 0 0 0 Common Stock 2005-09-08 4 P 0 1000 9.22 A 7342 D This amount reflects a 1-for-4 reverse stock split of shares reported by Mr. Clark as of the effective date of the reverse stock split (i.e. July 11, 2005) /s/ Linda G. Carraghan, by power of attorney for Alexander M. Clark 2005-09-13 -----END PRIVACY-ENHANCED MESSAGE-----