0001170961-12-000026.txt : 20120827 0001170961-12-000026.hdr.sgml : 20120827 20120827154558 ACCESSION NUMBER: 0001170961-12-000026 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20120823 FILED AS OF DATE: 20120827 DATE AS OF CHANGE: 20120827 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: 121057096 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 X0306 4 2012-08-23 0 0000814181 PENN TREATY AMERICAN CORP PTYA 0001274426 ROSS PETER M 726 BENT LANE NEWARK DE 19711 1 0 0 0 Common Stock 2012-08-23 4 P 0 2800 0.74 A 10600 I See Ftnote The shares are held in Peter M. Ross' Revocable Trust whereby Peter M. Ross is the Grantor and Trustee to the Revocable Trust Agreement. /s/ Linda G. Carraghan, Esq., as Power of Attorney for Peter M. Ross 2012-08-27