-----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, J8Ee9fOdF92Syccz3UIBCwQ4FR8kmV/LaSfNjstjqS5Nld29c+299K9CpR+Fg8zb XiPRIRqMR/UOoFi+PXrG4g== 0000814181-07-000014.txt : 20070123 0000814181-07-000014.hdr.sgml : 20070123 20070123102307 ACCESSION NUMBER: 0000814181-07-000014 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20061222 FILED AS OF DATE: 20070123 DATE AS OF CHANGE: 20070123 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: 07544897 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_mc012307ex.xml X0202 4 2006-12-22 0 0000814181 PENN TREATY AMERICAN CORP PTA 0001252448 CLOUTIER MARK D 3440 LEHIGH STREET ALLENTOWN PA 18103 0 1 0 0 Senior VP, CFO & Treasurer Incentive stock option (right to buy) 6.67 2006-12-22 4 A 0 4223 A 2007-12-22 2016-12-22 Common Stock 4223 15973 D Grant of incentive stock options as officer. Reflects effect of the 1-for-4 reverse stock split on stock options reported by Mr. Cloutier as of the effective date of the reverse stock split (ie.July 11, 2005) /s/ Linda G. Carraghan, by power of attorney for Mark Cloutier 2007-01-23 -----END PRIVACY-ENHANCED MESSAGE-----