0001170961-11-000002.txt : 20111017
0001170961-11-000002.hdr.sgml : 20111017
20111017145852
ACCESSION NUMBER: 0001170961-11-000002
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20111013
FILED AS OF DATE: 20111017
DATE AS OF CHANGE: 20111017
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: ROSS PETER M
CENTRAL INDEX KEY: 0001274426
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-14681
FILM NUMBER: 111143669
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: 2500 LEGACY DRIVE
STREET 2: SUITE 130
CITY: FRISCO
STATE: TX
ZIP: 75034
BUSINESS PHONE: 4693621214
MAIL ADDRESS:
STREET 1: 2500 LEGACY DRIVE
STREET 2: SUITE 130
CITY: FRISCO
STATE: TX
ZIP: 75034
4
1
primary_doc.xml
PRIMARY DOCUMENT
X0304
4
2011-10-13
0
0000814181
PENN TREATY AMERICAN CORP
PTA
0001274426
ROSS PETER M
726 BENT LANE
NEWARK
DE
19711
1
0
0
0
Common Stock
2011-10-13
4
P
0
2500
0.2
A
7800
I
See Ftn.
The shares are held in Peter M. Ross's Revocable Trust whereby Peter M. Ross is the Grantor and Trustee pursuant to the Revocable Trust Agreement.
/s/ Linda G. Carraghan, Esq., as Power of Attorney for Peter M. Ross
2011-10-17